We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured and Standardized Education or Advice for Chronic Primary low back pain in Adults.
- Authors
Southerst, Danielle; Hincapié, Cesar A.; Yu, Hainan; Verville, Leslie; Bussières, André; Gross, Douglas P.; Pereira, Paulo; Mior, Silvano; Tricco, Andrea C.; Cedraschi, Christine; Brunton, Ginny; Nordin, Margareta; Wong, Jessica J.; Connell, Gaelan; Shearer, Heather M.; DeSouza, Astrid; Muñoz Laguna, Javier; Lee, Joyce G. B.; To, Daphne; Lalji, Rahim
- Abstract
Purpose: Evaluate benefits and harms of education/advice for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods: Electronic databases were searched for randomized controlled trials (RCTs) assessing education/advice compared with placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of education/advice could be isolated). We conducted meta-analyses and graded the certainty of evidence. Results: We screened 2514 citations and 86 full text RCTs and included 15 RCTs. Most outcomes were assessed 3 to 6 months post-intervention. Compared with no intervention, education/advice improved pain (10 RCTs, MD = -1.1, 95% CI -1.63 to -0.56), function (10 RCTs, SMD = -0.51, 95% CI -0.89 to -0.12), physical health-related quality of life (HRQoL) (2 RCTs, MD = 24.27, 95% CI 12.93 to 35.61), fear avoidance (5 RCTs, SMD = -1.4, 95% CI -2.51 to -0.29), depression (1 RCT; MD = 2.10, 95% CI 1.05 to 3.15), and self-efficacy (1 RCT; MD = 4.4, 95% CI 2.77 to 6.03). Education/advice conferred less benefit than sham Kinesio taping for improving fear avoidance regarding physical activity (1 RCT, MD = 5.41, 95% CI 0.28 to 10.54). Compared with usual care, education/advice improved pain (1 RCT, MD = -2.10, 95% CI -3.13 to -1.07) and function (1 RCT, MD = -7.80, 95% CI -14.28 to -1.32). There was little or no difference between education/advice and comparisons for other outcomes. For all outcomes, the certainty of evidence was very low. Conclusion: Education/advice in adults with CPLBP was associated with improvements in pain, function, HRQoL, and psychological outcomes, but with very low certainty.
- Subjects
WORLD Health Organization; LUMBAR pain; CHRONIC pain; MEDICAL databases; CINAHL database; CONFIDENCE intervals; META-analysis; MEDICAL information storage &; retrieval systems; SYSTEMATIC reviews; PHYSICAL therapy; MEDICAL protocols; DESCRIPTIVE statistics; RESEARCH funding; PATIENT education; MEDLINE; PAIN management; EDUCATIONAL outcomes
- Publication
Journal of Occupational Rehabilitation, 2023, Vol 33, Issue 4, p625
- ISSN
1053-0487
- Publication type
Article
- DOI
10.1007/s10926-023-10120-8