scholarly journals The Effect of Cognitive Functional Therapy for Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Takahiro Miki ◽  
Yu Kondo ◽  
Hiroshi Kurakata ◽  
Eva Buzasi ◽  
Tsuneo Takebayashi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Meta Analysis ◽  
Tertiary Care ◽  
Low Back ◽  
Functional Therapy

Abstract Background: To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP). Objectives: To compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors.Design: Systematic review and meta-analysis. Method: Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment.Results: Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95% CIs] was -2.78 [-2.78−0.02] and -1.01 [-1.92−-0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95% CIs] was -0.76 [-1.46−-0.07]　at the intermediate for three studies and MD [95% CIs] was -0.84 [-11.47−-5.49] at long term for two studies. About fear of physical activity, MD [95% CIs] was -3.01 [-5.14−-0.88] and -3.56 [-6.43−-0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low. Conclusions: Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future.PROSPERO registration number CRD42020158182

scholarly journals The Effect of Cognitive Functional Therapy for Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Takahiro Miki ◽  
Yu Kondo ◽  
Hiroshi kurakata ◽  
Eva Buzasi ◽  
Tsuneo Takebayashi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Meta Analysis ◽  
Tertiary Care ◽  
Low Back ◽  
Functional Therapy

Abstract BackgroundTo apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP). ObjectivesTo compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors. DesignSystematic review and meta-analysis. MethodLiterature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment. ResultsThree studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95% CIs] was -2.78 [-2.78−0.02] and -1.01 [-1.92−-0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95% CIs] was -0.76 [-1.46−-0.07]　at the intermediate for three studies and MD [95% CIs] was -0.84 [-11.47−-5.49] at long term for two studies. About fear of physical activity, MD [95% CIs] was -3.01 [-5.14−-0.88] and -3.56 [-6.43−-0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low. ConclusionsThree studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future.PROSPERO registration number CRD42020158182

scholarly journals The Effect of Cognitive Functional Therapy for Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Takahiro Miki ◽  
Yu Kondo ◽  
Hiroshi kurakata ◽  
Eva Buzasi ◽  
Tsuneo Takebayashi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Meta Analysis ◽  
Tertiary Care ◽  
Low Back ◽  
Functional Therapy

Abstract Background: To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP). Objectives: To compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors.Design: Systematic review and meta-analysis. Method: Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment.Results: Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95% CIs] was -2.78 [-2.78−0.02] and -1.01 [-1.92−-0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95% CIs] was -0.76 [-1.46−-0.07]　at the intermediate for three studies and MD [95% CIs] was -0.84 [-11.47−-5.49] at long term for two studies. About fear of physical activity, MD [95% CIs] was -3.01 [-5.14−-0.88] and -3.56 [-6.43−-0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low.Conclusions: Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future.PROSPERO registration number CRD42020158182

scholarly journals Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Activity Limitations ◽  
Low Back ◽  
Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

scholarly journals Tuina-Focused Integrative Chinese Medical Therapies for Inpatients with Low Back Pain: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Ling Jun Kong ◽  
Min Fang ◽  
Hong Sheng Zhan ◽  
Wei An Yuan ◽  
Jiang Hui Pu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Low Back ◽  
Medical Therapies ◽  
Meta Analyses

Objective. To evaluate the effectiveness of Tuina-focused integrative Chinese medical therapies (TICMT) on inpatients with low back pain (LBP).Methods. 6 English and Chinese databases were searched for randomized controlled trials (RCTs) of TICMT for in-patients with LBP. The methodological quality of the included RCTs was assessed based on PEDro scale. And the meta-analyses of TICMT for LBP on pain and functional status were conducted.Results. 20 RCTs were included. The methodological quality of the included RCTs was poor. The meta-analyses' results showed that TICMT had statistically significant effects on pain and functional status, especially Tuina plus Chinese herbal medicine (standardised mean difference, SMD: 1.17; 95% CI 0.75 to 1.60 on pain; SMD: 1.31; 95% CI 0.49 to 2.14 on functional status) and Tuina plus acupuncture (SMD: 0.94; 95% CI 0.38 to 1.50 on pain; SMD: 0.53; 95% CI 0.21 to 0.85 on functional status). But Tuina plus moxibustion or hot pack did not show significant improvements on pain. And the long-term evidence of TICMT was far from sufficient.Conclusions. The preliminary evidence from current studies suggests that TICMT might be effective complementary and alternative treatments for in-patients with LBP. However, the poor methodological quality of the included RCTs means that high-quality RCTs with long follow-up are warranted.

scholarly journals Psychological Interventions in Chronic Low Back Pain: A Systematic Review

2021 ◽  
Vol 7 (2) ◽  
pp. 67-74
Author(s):  
Sajjad Saadat ◽  
◽  
Mozaffar Hosseininezhad ◽  
Seyed Sepehr Khatami ◽  
Reza Ghasemi Jobaneh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Psychological Interventions ◽  
Low Back

Background and Aim: Chronic low Back Pain (CLBP) is one of the most common musculoskeletal disorders with possible psychological consequences for the patients. This study aimed to review all evidence on the effectiveness of psychological interventions in improving the mental status of people with CLBP and providing recommendations for future therapeutic interventions. Methods and Materials/Patients: This systematic review was conducted on the articles published from January 2010 to December 2020. The keywords included “psychology”, “intervention”, “low back pain”, “chronic disease”, “quality of life”, “empowerment”, “psychotherapy”, “psychological interventions”, “clinical trials”, and “randomized clinical trials” in the indexing databases of Magiran, PubMed, Scopus, and Google Scholar. Of the total 1740 articles found, 14 articles were selected for review. Results: The results showed that Cognitive-Behavioral Therapy (CBT) and its combination therapies with mindfulness techniques played an influential role in improving psychological status and quality of life, and reducing pain perception in CLBP patients. The lack of RCT (randomized controlled trial) research and follow-up to assess long-term outcomes are the main limitations of the studies conducted in Iran. Conclusion: It is recommended that psychological interventions be considered alongside medical therapies to improve CLBP patients’ adjustment to chronic condition and their quality of life. Researchers and therapists should consider treatment programs based on RCT plans and long-term follow-up.

scholarly journals Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 121-145 ◽  
Author(s):  
Joshua Robert Zadro
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Low Back ◽  
Pharmacological Interventions ◽  
Meta Analyses

Background: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Current intervention strategies are failing to reduce the enormous global burden of LBP and are prompting researchers to investigate alternative management strategies, such as vitamin D supplementation. Vitamin D supplementation appears to down regulate pro-inflammatory cytokines which lead to pain and up regulate anti-inflammatory cytokines that reduce inflammation. These mechanisms might explain the increasing interest in the use of vitamin D supplementation for LBP. Objectives: To determine whether vitamin D supplementation improves pain more than a control intervention for individuals with LBP. Study Design: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Methods: We performed searches in numerous electronic databases combining key words relating to “vitamin D” and “LBP” until March 2017. Studies were included if they investigated vitamin D supplementation in participants with LBP, provided there was a comparison intervention. There was no restriction on the type of LBP, the intervention parameters investigated, or the type of clinical trial (e.g., randomized, non-randomized). Two reviewers independently performed the selection of studies, extracted data, rated the methodological quality of the included studies, and evaluated the overall quality of the evidence using the Grading of Recommendations Assessment, Delevopment, and Evaulation (GRADE) approach. Results: After screening 3,534 articles, 8 clinical trials were included in this systematic review. There is very low quality evidence (based on the GRADE approach) that vitamin D supplementation is not more effective than any intervention (including placebo, no intervention, and other conservative/ pharmacological interventions) (continuous pain measures [0–100]: mean difference [MD] = -2.65, 95% confidence interval [CI]: -10.42 to 5.12, P = 0.504, n = 5; self-reported reduction in pain: pooled odds ratio [OR] = 1.07, 95% CI: 0.35 to 3.26, P = 0.906, n = 5) or placebo/no intervention for individuals with LBP (continuous pain measures: MD = 1.29, 95% CI: -3.81 to 6.39, P = 0.620, n = 4; self-reported reduction in pain: pooled OR = 1.53, 95% CI: 0.38 to 6.20, P = 0.550, n = 4), where ‘n’ is the number of studies included in the meta-analysis. These results did not change when we stratified the meta-analyses by the type of vitamin supplementation (vitamin D3 vs. alfacalcidol) or the type of LBP (non-specific vs. LBP resulting from osteoporosis or vertebral fractures). Limitations: The overall quality of evidence was “very low” due to the poor methodological quality and small sample sizes of the included studies. Conclusions: Vitamin D supplementation is not more effective than placebo, no intervention, or other conservative/pharmacological interventions for LBP (based on very low quality evidence). These results are consistent, regardless of the type of LBP or vitamin D supplementation. Until well-designed and adequately powered clinical trials suggest otherwise, the prescription of vitamin D for LBP cannot be recommended. PROSPERO Registration No: CRD42016046874. www.crd.york.ac.uk/PROSPERO/display_record. asp?ID = CRD42016046874 Key words: Vitamin D, low back pain, chronic low back pain, alfacalcidol, osteoporosis, vertebral fractures, serum 25-hydroxyvitamin D, systematic review

scholarly journals Ozone Therapy as a Treatment for Low Back Pain Secondary to Herniated Disc: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2012 ◽  
Vol 2;15 (2;3) ◽  
pp. E115-E129
Author(s):  
Erich T. Fonoff
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Ozone Therapy ◽  
Randomized Controlled

Background: Low back pain (LBP) is one of the most common and important health problems affecting the population worldwide and remains mostly unsolved. Ozone therapy has emerged as an additional treatment method. Questions persist concerning its clinical efficacy. Objective: The purpose of our study was to evaluate the therapeutic results of percutaneous injection of ozone for low back pain secondary to disc herniation. Study Design: A systematic review and meta-analysis of randomized controlled trials. Methods: A comprehensive literature search was conducted using all electronic databases from 1966 through September 2011. The quality of individual articles was assessed based on the modified Cochrane review criteria for randomized trials and criteria from the Agency for Healthcare Research and Quality. Outcome Parameters: The outcome measure was short-term pain relief of at least 6 months or long-term pain relief of more than 6 months. Results: Eight observational studies were included in the systematic review and 4 randomized trials in the meta-analysis. The indicated level of evidence for long-term pain relief was II-3 for ozone therapy applied intradiscally and II-1 for ozone therapy applied paravertebrally. The grading of recommendation was 1C for intradiscal ozone therapy and 1B for paravertebral ozone therapy. Limitations: The main limitations of this review are the lack of precise diagnosis and the frequent use of mixed therapeutic agents. The meta-analysis included mainly active-control trials. No placebo-controlled trial was found. Conclusions: Ozone therapy appears to yield positive results and low morbidity rates when applied percutaneously for the treatment of chronic low back pain. Key words: Low back pain, oxygen-ozone, ozone therapy, chronic pain, failed back surgery syndrome.

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