scholarly journals Effectiveness of exercise on work disability in patients with non-acute non-specific low back pain: Systematic review and meta-analysis of randomised controlled trials

2010 ◽  
Vol 42 (3) ◽  
pp. 193-205 ◽  
Author(s):  
P Oesch ◽  
J Kool ◽  
KB Hagen ◽  
S Bachmann
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.


2010 ◽  
Vol 92 (7) ◽  
pp. 595-598 ◽  
Author(s):  
Dionysios Trigkilidas

INTRODUCTION Chronic low back pain is a common condition affecting a significant proportion of the population and has large economic implications on the society. Acupuncture has grown in popularity as an alternative therapy for chronic low back pain. Recent National Institute for Health and Clinical Excellence (NICE) guidelines on low back pain offer a course of acupuncture as a baseline treatment option according to patient preference. The aim of this systematic review was to evaluate if this treatment option is justified in view of recent evidence available on the efficacy of acupuncture. MATERIALS AND METHODS Studies included were identified by a PubMed search for relevant, randomised, controlled trials on the 23 July 2009. A systematic review was performed. RESULTS Fifteen randomised controlled trials were identified. Of these, four met the eligibility criteria and were critically appraised. These trials suggest acupuncture can be superior to usual care in treating chronic low back pain, especially, when patients have positive expectations about acupuncture. CONCLUSIONS NICE guidelines of a course of acupuncture, offered according to patient preference as a treatment option for chronic low back pain, are justified.


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