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@physicaltherapyresearch
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400 Likes20 Comments

📚🔬
Best Treatments for Chronic Low Back Pain
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INTRO:
Low back pain is the leading cause of disability
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While Chronic Low Back Pain (CLBP) makes up approximately 20% of all low back pain cases, it generates approximately 80% of the direct costs.
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Owen et al. (2019), evaluated the efficacy of interventions best capable of treating nonspecific CLBP.
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METHODS:
A Systematic Review and Meta-Analysis was performed, including effects on:
Pain
Physical function
Mental health
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Interventions Investigated:
Exercise training
Manual Therapy
Hands-Off (Education, and general practitioner management).
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RESULTS:
9543 records we found.
89 studies, including 5578 patients were eligible for qualitative synthesis.
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Studies included for Network Meta-analyis:
70 (pain)
63 (physical function)
16 (mental health)
4 (trunk muscle strength)
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Most Beneficial Exercise Training Modalities:
Pilates for pain.
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Resistance and stabilization/motor control for physical function.
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Resistance and Aerobic for mental health. .
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Least Beneficial Modalities in Order:
True control was most likely to be the worst treatment for all outcomes.
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Hands-off treatments for pain and physical function.
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Manual Therapy for mental health.
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Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function. .
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CONCLUSIONS:
Low quality evidence Suggests:
Pilates, Stabilization/motor control, Resistance training and Aerobic exercise training are the most effective treatments, for adults with Non-specific CLBP. .
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Exercise training may also be more effective than therapist hands-on treatment. .
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LIMITATIONS:
Low Quality Evidence according to Grading of Recommendations Assessment, Development and Evaluation criteria. .
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Thoughts? Questions? Comments?
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Write them below. .
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SOURCE:
Owen PJ, Miller CT, Mundell NL, et al. Br J Sports Med. doi:10.1136/ bjsports-2019-100886

05 Nov 2019

Comments
  • @danielcavallin

    @luke__boykett another spicy one

    05 Nov 2019

  • @mr.kinesiology

    I’m working on strengthening my research skills! how much should the low quality evidence affect how much I trust the research? Should I delve into the studies used in the systematic review to see methods?

    05 Nov 2019

  • @lujhayes

    @g.moginie

    05 Nov 2019

  • @reubencrhodes

    @lujhayes thought this might interest you people!

    05 Nov 2019

  • @liam.mckenny

    @jboxer8

    05 Nov 2019

  • @grizzledoldphysio

    So all those years in PT school and I could have just been a Pilates instructor over the weekend with a nicer studio? Just kidding. My biggest issue with these studies are the over generalization of treatment methods. Just what pilates movements are we talking about and what qualifies as one? Which manual therapy treatments were implemented? The study essentially leaves us with more questions for "best treatment", which isn't actually a bad thing.

    05 Nov 2019

  • @hamishcstuart

    @thomas_raphael_

    05 Nov 2019

  • @luccas_giorgio

    @wueylanicoly

    05 Nov 2019

  • @robhwagner

    Sounds like it reinforces current beliefs. I think these reviews don't represent practice. The question that always comes out of these is e.g. "does adding MT to an exercise program enhance outcomes?" Because these things are not usually done in isolation. Another issue is it is much easier to control MT studies than exercise interventions so it makes outcomes slightly easier to elucidate.

    05 Nov 2019

  • @physicaltherapyresearch

    #rehab #pain #painscience #physiology #physicaltherapy #physiotherapy #massage #orthopedic #chiropractic #medicine #sportsmedicine #science #research #health #wellness #nervoussystem #neuroscience #brain #physicaltherapyresearch #dpt #dptstudent #exercise #fitness #workout #lowbackpain #lowbackpainrelief

    05 Nov 2019