Objective To systematically review the effect of the abdominal drawing-in maneuver (ADIM) on chronic nonspecific low back pain (CNLBP).

Methods PubMed, Web of Science, Embase, The Cochrane Library, CNKI, VIP, WanFang Data and SinoMed databases were electronically searched to collect randomized controlled trials (RCTs) on the treatment of CNLBP with ADIM from inception to January 31, 2026. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.4 software.

Results A total of 13 RCTs involving 402 patients were included. The results of Meta-analysis showed that the ADIM group was superior to the control group (blank control or conventional treatment) in alleviating pain in patients with CNLBP [MD=-2.08, 95%CI (-2.60, -1.56), P < 0.001]; in terms of improving functional disability, the ADIM group showed significantly better outcomes than the control group in both the Oswestry Disability Index score [MD=-1.21, 95%CI (-2.05, -0.37),P = 0.005] and Roland Morris Disability Questionnaire score [MD =-3.12, 95%CI (-4.66, -1.58),P < 0.001], with statistically significant differences. The subgroup analysis results showed that ADIM protocols with ≥ 8 weeks of intervention, > 3 weekly sessions, and ≤ 30 minutes per session may best improve CNLBP.

Conclusion Current evidence shows that ADIM can reduce pain and improve functional disability in CNLBP patient.

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