ABSTRACT
A holistic understanding of human behaviour is considered key for a successful fight against climate change and environmental degradation. In the pursuit of a holistic understanding, empirical research frequently applies the concept of "lifestyle". The concept, which plays a significant role in segmenting customers in the field of marketing, is increasingly used in the cross-domain analysis of behaviour in the field of sustainability. This increase is tied to the challenge that the meaning and operationalisation of the lifestyle concept are still highly fragmented after decades of empirical studies. While this methodological heterogeneity and pluralism of research traditions bring creativity and dynamic to the field, it makes the orientation and a comparison of studies challenging. Previous attempts to streamline lifestyle oriented research have often aimed for a single mode of operationalisation, but this does not meet the diversity of possible applications of the concept. Therefore, a better understanding of the field seems necessary. To fill this gap, we review the understanding and use of the "lifestyle" concept in 53 empirical studies in the field of sustainability and identify 12 variants of lifestyle related research, differing along three dimensions. According to our results, (I) lifestyle can either be used as a cause or as a consequence, (II) the analytical scope can be on a micro-, meso- or macro level, and (III) the behavioural scope can be either limited to a single behavioural domain or cover multiple domains. The three dimensions allow a mapping of existing and future empirical research using the "lifestyle" concept, improve the orientation in the field, facilitate the identification of relevant studies, and avoid imprecise comparisons due to methodological differences.
ABSTRACT
Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = -0.15, -0.15, -0.19), pain intensity (SMD = -0.19, -0.26, -0.26) and disability (SMD = -0.15, -0.27, -0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention.
