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Fear of pain and movement is an important factor in the development of hypervigilance and avoidance behaviours. We examined the effectiveness of exercise training on improving fear-avoidance beliefs. A systematic review (data sources MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL) and metaanalysis of randomised controlled/clinical trials of exercise training in adults versus relevant nonexercise comparators that quantified fear-avoidance was conducted. After screening 4603 identified records, 17 (2014 participants) and 13 (1152 participa