IS ONE-MONTH RECOVERY TOO SOON TO EXPECT FROM PATIENTS WITH ACUTE LOW BACK PAIN? A SYSTEMATIC REVIEW

Background: The purpose of this systematic review was to: (I) determine the quality of evidence from studies assessing trunk isokinetic strength in subjects with acute low back pain (ALBP) compared to healthy subjects and (II) establish reference values of isokinetic trunk strength in subjects with ALBP. Methodology: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with trunk, strength and low back pain. Four databases were used: PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: A total of 1604 articles were retrieved, four included in this review. All were evaluated as high risk of bias (Rob). Due to the high Rob and the diversity of protocols, instruments and variables used, it was not possible to determine reference values for subjects with ALBP, we can only establish a range of flexion peak torque (PT) between 175.1 and 89.7 Nm at 60°/s and between 185 and 81.5 Nm at 120°/s, and for extension PT between 240.0 and 91.5 Nm at 60°/s and between 217.5 and 69.2 Nm at 120°/s in subjects with ALBP. Conclusions: Due to the low quality of the evidence and the diversity of protocols used when measuring trunk isokinetic strength, it is necessary to carry out new high-quality research to establish reference values of trunk strength in subjects with ALBP.

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Summarizing the Effects of Different Exercise Types in Chronic Low Back Pain – A Systematic Review of Systematic Reviews

10.21203/rs.3.rs-349097/v1 ◽

2021 ◽

Author(s):

Wilhelmus JA Grooten ◽

Carina Boström ◽

Åsa Stephansson Dedering ◽

Marie Halvorsen ◽

Roman P Kuster ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Resistance Training ◽

Exercise Therapy ◽

Systematic Reviews ◽

Low Back ◽

Moderate Evidence ◽

Acute Low Back Pain ◽

Review Of Reviews

Abstract Background Recently, a review of reviews concluded that exercise therapy of any type makes no difference to the effect on pain or disability in adult patients with acute low back pain (LBP). Whether this is also the case for exercise therapy in chronic LBP is still unknown. Objectives To summarize and synthesize systematic reviews (SR) and meta-analyses (MA) investigating the effects on pain and disability of common exercise types used in chronic LBP. Methods We included systematic reviews from several databases in which ≥ 75% of the studies were RCTs on adults between 18 and 70 years of age suffering from chronic or recurrent LBP for a period of at least 12 weeks. These were grouped into nine exercise types: Aerobic training, Aquatic exercises, Motor control exercises (MCE), Resistance training, Pilates, Sling exercises, Traditional Chinese Exercises (TCE), Walking, and Yoga. The study quality was assessed with AMSTAR-2. For each type of exercise, a narrative analysis was performed, and the levels of evidence for the effects of exercise were assessed through GRADE. Results The wide search resulted in 2,345 studies, and out of the 246 full texts that were screened, 41 SR/MA were included. Of these, 10 SR/MA were of high quality, 15 of moderate, 14 of low, and two of critically low quality. We found low to moderate evidence of mainly short-term and small beneficial effects on pain and disability for MCE, Resistance training, Pilates, TCE, and Yoga compared to no intervention. Few reviews were found for Aerobic, Aquatic, Sling, and Walking exercises, but with promising results. Aquatic exercises seem to be more beneficial compared to land exercises (low level of evidence). Conclusions In line with previous studies but in a broader perspective, this systematic review of reviews showed that there is low to moderate evidence that exercises are effective for reducing pain and disability compared to no or minimal interventions, but that no exercise type is more effective than other conservative interventions (very low to moderate evidence). Systematic review registration number PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=190409

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Transcutaneous electric nerve stimulation (TENS) for acute low back pain: systematic review

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0124 ◽

2019 ◽

Vol 19 (2) ◽

pp. 225-233 ◽

Cited By ~ 5

Author(s):

Justine Binny ◽

Ngar Lok Joshua Wong ◽

Shirali Garga ◽

Chung-Wei Christine Lin ◽

Chris G. Maher ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Pain Relief ◽

Nerve Stimulation ◽

Low Back ◽

Transcutaneous Electric Nerve Stimulation ◽

Acute Low Back Pain ◽

Electric Nerve Stimulation ◽

Quality Evidence

Abstract Background and aims There has been no comprehensive evaluation of the efficacy of transcutaneous electric nerve stimulation (TENS) for acute low back pain (LBP). The aim of this systematic review was to investigate the efficacy and safety of TENS for acute LBP. Methods We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL and PsycINFO (inception to May 2018) for randomised placebo controlled trials. The primary outcome measure was pain relief in the immediate term (within 2-weeks of administration) assessed using the 100 mm visual analogue scale. A mean difference of at least 10 points on the 100-point pain scale was considered clinically significant. Methodological quality of the eligible studies was assessed using the PEDro scale and overall quality assessment rating was assessed using GRADE. Results Three placebo controlled studies (n = 192) were included. One low quality trial (n = 63) provides low quality evidence that ~30 min treatment with TENS in an emergency-care setting provides clinically worthwhile pain relief for moderate to severe acute LBP in the immediate term compared with sham TENS [Mean Difference (MD) – 28.0 (95% CI – 32.7, −23.3)]. Two other studies which administered a course of TENS over 4–5 weeks, in more usual settings provide inconclusive evidence; MD −2.75 (95% CI −11.63, 6.13). There was limited data on adverse events or long term follow-up. Conclusions The current evidence is insufficient to support or dismiss the use of TENS for acute LBP. Implications There is insufficient evidence to guide the use of TENS for acute LBP. There is low quality evidence of moderate improvements in pain with a short course of TENS (~30 min) during emergency transport of patients to the hospital. Future research should evaluate whether TENS has an opioid sparing role in the management of acute LBP.

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Faculty Opinions recommendation of Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727496313.793536551 ◽

2017 ◽

Author(s):

César Fernández de las Peñas

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Clinical Benefit ◽

Meta Analysis ◽

Spinal Manipulative Therapy ◽

Low Back ◽

Manipulative Therapy ◽

Acute Low Back Pain

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Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: an update of a systematic review of the literature

Occupational and Environmental Medicine ◽

10.1136/oemed-2011-100382.242 ◽

2011 ◽

Vol 68 (Suppl_1) ◽

pp. A74-A75 ◽

Cited By ~ 2

Author(s):

I. Steenstra ◽

L. de Bruin ◽

Q. Mahood ◽

E. Irvin ◽

S. Hogg-Johnson ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Prognostic Factors ◽

Back Pain ◽

Sick Leave ◽

Low Back ◽

Review Of The Literature ◽

Acute Low Back Pain

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Acute low back pain: systematic review of its prognosis

BMJ ◽

10.1136/bmj.327.7410.323 ◽

2003 ◽

Vol 327 (7410) ◽

pp. 323-0 ◽

Cited By ~ 530

Author(s):

L. H M Pengel

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Acute Low Back Pain

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The Effect of Timing of Physical Therapy for Acute Low Back Pain on Health Services Utilization: A Systematic Review

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2018.11.025 ◽

2019 ◽

Vol 100 (7) ◽

pp. 1324-1338 ◽

Cited By ~ 14

Author(s):

Elizabeth Arnold ◽

Janna La Barrie ◽

Lisley DaSilva ◽

Meagan Patti ◽

Adam Goode ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Health Services ◽

Health Services Utilization ◽

Low Back ◽

Services Utilization ◽

Acute Low Back Pain

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Effects of exercise therapy in patients with acute low back pain: a systematic review of systematic reviews

Systematic Reviews ◽

10.1186/s13643-020-01412-8 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Marc Karlsson ◽

Anna Bergenheim ◽

Maria E. H. Larsson ◽

Lena Nordeman ◽

Maurits van Tulder ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Exercise Therapy ◽

Systematic Reviews ◽

Low Back ◽

Stabilization Exercise ◽

Acute Low Back Pain ◽

Randomized Controlled ◽

Pain Disability

Abstract Background Acute low back pain is associated with pain and disability, but symptoms are often self-healing. The effectiveness of exercise therapy for acute low back pain remains uncertain with conflicting evidence from systematic reviews. The aim of this systematic review of systematic reviews was to assess the overall certainty of evidence for the effects of exercise therapy, compared with other interventions, on pain, disability, recurrence, and adverse effects in adult patients with acute low back pain. Methods PubMed, the Cochrane library, CINAHL, PEDro, Open Grey, Web of Science, and PROSPERO were searched for systematic reviews of randomized controlled trials. Methodological quality was assessed independently by two authors using AMSTAR. Meta-analyses were performed if possible, using data from the original studies. Data for pain, disability, recurrence, and adverse effects were analyzed. Certainty of evidence was assessed using GRADE. Results The searches retrieved 2602 records, of which 134 publications were selected for full-text screening. Twenty-four reviews were included, in which 21 randomized controlled trials (n = 2685) presented data for an acute population, related to 69 comparisons. Overlap was high, 76%, with a corrected covered area of 0.14. Methodological quality varied from low to high. Exercise therapy was categorized into general exercise therapy, stabilization exercise, and McKenzie therapy. No important difference in pain or disability was evident when exercise therapy was compared with sham ultrasound, nor for the comparators usual care, spinal manipulative therapy, advice to stay active, and educational booklet. Neither McKenzie therapy nor stabilization exercise yielded any important difference in effects compared with other types of exercise therapy. Certainty of evidence varied from very low to moderate. Conclusions The findings suggest very low to moderate certainty of evidence that exercise therapy may result in little or no important difference in pain or disability, compared with other interventions, in adult patients with acute low back pain. A limitation of this systematic review is that some included reviews were of low quality. When implementing findings of this systematic review in clinical practice, patients’ preferences and the clinician’s expertise also should be considered, to determine if and when exercise therapy should be the intervention of choice. Systematic review registration PROSPERO: CRD46146, available at: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=46146.

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