The effectiveness of incidental physical activity interventions compared to other interventions in the management of people with low back pain: A systematic review and meta-analysis of randomised controlled trials

2019 ◽  
Vol 36 ◽  
pp. 34-42 ◽  
Author(s):  
Hosam Alzahrani ◽  
Martin Mackey ◽  
Emmanuel Stamatakis ◽  
Marina B. Pinheiro ◽  
Manuela Wicks ◽  
...  
BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e013200 ◽  
Author(s):  
Harsha Shanthanna ◽  
Ian Gilron ◽  
Lehana Thabane ◽  
Philip J Devereaux ◽  
Mohit Bhandari ◽  
...  

2020 ◽  
Vol 24 (03) ◽  
pp. 106-106
Author(s):  
Arne Vielitz

Rubinstein SM, de Zoete A, van Middelkoop M et al. Benefits and Harms of Spinal Manipulative Therapy for the Treatment of Chronic Low Back Pain: Systematic Review and Meta-analysis of Randomised Controlled Trials. BMJ 2019; 364: l689. doi: 10.1136/bmj.l689


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Siew Wan Hee ◽  
◽  
Dipesh Mistry ◽  
Tim Friede ◽  
Sarah E. Lamb ◽  
...  

Abstract Background Proven treatments for low back pain, at best, only provide modest overall benefits. Matching people to treatments that are likely to be most effective for them may improve clinical outcomes and makes better use of health care resources. Methods We conducted an individual participant data meta-analysis of randomised controlled trials of three types of therapist delivered interventions for low back pain (active physical, passive physical and psychological treatments). We applied two statistical methods (recursive partitioning and adaptive risk group refinement) to identify potential subgroups who might gain greater benefits from different treatments from our individual participant data meta-analysis. Results We pooled data from 19 randomised controlled trials, totalling 9328 participants. There were 5349 (57%) females with similar ratios of females in control and intervention arms. The average age was 49 years (standard deviation, SD, 14). Participants with greater psychological distress and physical disability gained most benefit in improving on the mental component scale (MCS) of SF-12/36 from passive physical treatment than non-active usual care (treatment effects, 4.3; 95% confidence interval, CI, 3.39 to 5.15). Recursive partitioning method found that participants with worse disability at baseline gained most benefit in improving the disability (Roland Morris Disability Questionnaire) outcome from psychological treatment than non-active usual care (treatment effects, 1.7; 95% CI, 1.1 to 2.31). Adaptive risk group refinement did not find any subgroup that would gain much treatment effect between psychological and non-active usual care. Neither statistical method identified any subgroups who would gain an additional benefit from active physical treatment compared to non-active usual care. Conclusions Our methodological approaches worked well and may have applicability in other clinical areas. Passive physical treatments were most likely to help people who were younger with higher levels of disability and low levels of psychological distress. Psychological treatments were more likely to help those with severe disability. Despite this, the clinical importance of identifying these subgroups is limited. The sizes of sub-groups more likely to benefit and the additional effect sizes observed are small. Our analyses provide no evidence to support the use of sub-grouping for people with low back pain.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034036
Author(s):  
Joanna Sweeting ◽  
Dafna Merom ◽  
Putu Ayu Swandewi Astuti ◽  
Michael Antoun ◽  
Kate Edwards ◽  
...  

ObjectivesCompared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness.DesignA systematic review of articles reporting physical activity interventions in visually impaired individuals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure.SettingMost interventions were conducted in a group setting, with some including an at-home, self-directed component.ParticipantsFollowing identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment.Primary and secondary outcome measuresOutcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait.ResultsEighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and diverse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale.ConclusionsPhysical activity interventions in individuals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger sample sizes, stronger designs and longer follow-up periods are needed.PROSPERO registration numberCRD42018103638.


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