scholarly journals Evidence of efficacy of acupuncture in the management of low back pain: a systematic review and meta-analysis of randomised placebo- or sham-controlled trials

2019 ◽  
Vol 38 (1) ◽  
pp. 15-24
Author(s):  
Yan Xiang ◽  
Jin-yuan He ◽  
Huan-huan Tian ◽  
Bing-yan Cao ◽  
Rui Li
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Pain Reduction ◽  
Mean Difference ◽  
Controlled Trials ◽  
Low Back ◽  
Randomised Controlled

Objectives: To assess the evidence for the efficacy of acupuncture for non-specific low back pain (NSLBP), compared with sham or placebo therapies. Methods: We searched Cochrane CENTRAL to December 2016, and conducted searches from 1980 to December 2016 in PubMed, MEDLINE and Embase. There were no regional restrictions applied. We included only randomised controlled trials of adults with NSLBP. Placebo/sham procedures were required of the control interventions. The trials were combined using meta-analysis when the data reported allowed for statistical pooling. Results: 14 trials (2110 participants) were included in the review, and 9 were included in the meta-analysis. Immediately after the acupuncture treatment we found statistically significant differences in pain reduction between acupuncture and sham or placebo therapy (standardised mean difference (SMD) −0.40, 95% CI −0.54 to −0.25; I2 7%; 753 participants; 9 studies), but there were no differences in function (weighted mean difference (WMD) −1.05, 95% CI −3.61 to 1.52; I2 79%; 462 participants; 4 studies). At follow-up, there were significant differences in pain reduction (SMD −0.46, 95% CI −0.82 to −0.09; I2 67%), but not in function (WMD −0.98, 95%CI −3.36 to 1.40; I2 87%). We conducted subgroup analyses both immediately after treatment and at follow-up. Conclusion: There is moderate evidence of efficacy for acupuncture in terms of pain reduction immediately after treatment for NSLBP ((sub)acute and chronic) when compared to sham or placebo acupuncture. Registration: PROSPERO registration no. CRD42017059438.

scholarly journals Efficacy of Auricular Acupressure for Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Li-Hua Yang ◽  
Pei-Bei Duan ◽  
Qing-Mei Hou ◽  
Shi-Zheng Du ◽  
Jin-Fang Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Acupressure

Objectives. To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review.Methods. A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.Results. A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = −1.13, 95% CI (-1.70,-0.56),P<0.001). But, for the disability level, the therapeutic effect was not significant (mean difference = −1.99, 95% CI (-4.93, 0.95),P=0.18). No serious adverse effects were recorded.Conclusions. The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.

scholarly journals Gabapentinoids for chronic low back pain: a protocol for systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e013200 ◽  
Author(s):  
Harsha Shanthanna ◽  
Ian Gilron ◽  
Lehana Thabane ◽  
Philip J Devereaux ◽  
Mohit Bhandari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Randomised Controlled

scholarly journals Identification of subgroup effect with an individual participant data meta-analysis of randomised controlled trials of three different types of therapist-delivered care in low back pain

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Siew Wan Hee ◽  
◽  
Dipesh Mistry ◽  
Tim Friede ◽  
Sarah E. Lamb ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Individual Participant Data ◽  
Low Back ◽  
Individual Participant ◽  
Randomised Controlled

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.

Short-Term Effect of Kinesiotaping on Chronic Nonspecific Low Back Pain and Disability: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 100 (2) ◽  
pp. 238-254
Author(s):  
Shanshan Lin ◽  
Bo Zhu ◽  
Guozhi Huang ◽  
Chuhuai Wang ◽  
Qing Zeng ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Data Extraction ◽  
Meta Analysis ◽  
Pain Reduction ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled

Abstract Background Low back pain (LBP) is a very common and disabling disorder in modern society. The intervention strategies for LBP include drug therapy, surgery, and physical interventions. Recently, kinesiotaping, as a simple and noninvasive treatment, has been used to treat chronic nonspecific LBP, but its effectiveness and true merit remains unclear. Purpose The purpose of this study was to summarize the results of randomized controlled trials (RCTs) on the effectiveness of kinesiotaping (KT) for chronic nonspecific low back pain (CNLBP) and disability. Data Sources Medline, Cochrane Library, Google Scholar, Web of Science, and EmBase were searched from inception to September 1, 2018. Study Selection Studies were included in the review if they met the following criteria: RCTs published in English; patients (&gt;18 years old) diagnosed with CNLBP (pain duration of &gt; 12 weeks), with or without leg pain; KT as a single treatment or as a part of other forms of physical therapy; outcomes measured included pain intensity and disability. Data Extraction Three independent investigators completed data extraction. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were applied to assess the confidence of the effect estimates. Data Synthesis Eleven RCT studies involving 785 patients were retained for the meta-analysis. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. Compared with the control group， the pooled SMD of pain intensity was significantly reduced (SMD = −0.73; 95% CI = −1.12 to −0.35; GRADE: low) and disability was improved (SMD = −0.51; 95% CI = −0.85 to −0.17; GRADE: low) in the KT group. Subgroup analyses showed that, compared with the control, the I strip of KT significantly reduced pain (SMD = −0.48; GRADE: low) but not disability (SMD = −0.26; GRADE: low). Compared with sham/placebo tape, KT provided significant pain reduction (SMD = −0.84; GRADE: low) and disability improvement (SMD = −0.56; GRADE: low). Moreover, compared with the no-tape group, the KT group also showed pain reduction (SMD = −0.74; GRADE: low) and disability improvement (SMD = −0.65; GRADE: low). Limitations Limitations of the review included a lack of homogeneity, different methodologies and treatment duration of KT application, and relatively small sample sizes. Conclusions There is low-quality evidence that KT has a beneficial role in pain reduction and disability improvement for patients with CNLBP. More high-quality studies are required to confirm the effects of KT on CNLBP.

Manipulation erzeugt bei chronischem LBP ähnliche Verbesserungen wie andere empfohlene Therapien

2020 ◽  
Vol 24 (03) ◽  
pp. 106-106
Author(s):  
Arne Vielitz
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Spinal Manipulative Therapy ◽  
Controlled Trials ◽  
Low Back ◽  
Manipulative Therapy ◽  
Randomised Controlled

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

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