Dataset Information

Effectiveness of extrinsic feedback for management of non-specific low back pain: a systematic review protocol.

ABSTRACT:

Introduction

Low back pain is the greatest cause of years lived with disability worldwide and is linked with high societal and economic burden. Neuromuscular control impairments are a common clinical presentation in patients with non-specific low back pain. Musculoskeletal physiotherapists commonly use feedback as a part of the management of low back disorders. This systematic review will aim to assess the effectiveness of extrinsic biofeedback for reducing pain, disability and recurrence of pain in patients with non-specific low back pain.

Methods and analysis

Systematic searches will be performed in CINAHL, Embase, Medline, PsycInfo, Scopus and Web of Science. We will include randomised controlled trial studies, if the study recruited patients with non-specific low back pain; compared extrinsic feedback versus either placebo or control; another intervention; or in addition to an intervention versus that intervention alone; and have used pain, disability scores or low back pain recurrence as outcome measures. We will exclude studies with designs other than randomised controlled trials. We will assess the risk of bias within included studies using the PEDro scale, and the strength of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach.

Ethics and dissemination

Ethical approval and patient consent are not required since this is a systematic review based on published studies. The results of this study will be published in an international peer-reviewed journal.

Prospero registration number

CRD42017077888.

SUBMITTER: Ribeiro DC

PROVIDER: S-EPMC5942401 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effectiveness of extrinsic feedback for management of non-specific low back pain: a systematic review protocol.

Ribeiro Daniel Cury DC Mącznik Aleksandra Katarzyna AK Milosavljevic Stephan S Abbott J Haxby JH

BMJ open 20180505 5

<h4>Introduction</h4>Low back pain is the greatest cause of years lived with disability worldwide and is linked with high societal and economic burden. Neuromuscular control impairments are a common clinical presentation in patients with non-specific low back pain. Musculoskeletal physiotherapists commonly use feedback as a part of the management of low back disorders. This systematic review will aim to assess the effectiveness of extrinsic biofeedback for reducing pain, disability and recurrenc ...[more]

PMID: 29730631

Similar Datasets

Project description:BackgroundAntidepressants are commonly used in the management of low-back pain. However, their use is controversial.ObjectivesThe aim of this review was to determine whether antidepressants are more effective than placebo for the treatment of non-specific low-back pain.Search strategyRandomised controlled trials were identified from MEDLINE and EMBASE (to September 2007), PsycINFO to June 2006, the Cochrane Central Register of Controlled Trials 2006, issue 2, and previous systematic reviews.Selection criteriaWe included randomised controlled trials that compared antidepressant medication and placebo for patients with non-specific low-back pain, and used at least one clinically relevant outcome measure.Data collection and analysisTwo blinded review authors independently extracted data and assessed the methodological quality of the trials. Meta-analyses were used to examine the effect of antidepressants on pain, depression and function, and the effect of antidepressant type on pain. To account for studies that could not be pooled, additional qualitative analyses were performed using the levels of evidence recommended by the Cochrane Back Review Group.Main resultsTen trials that compared antidepressants with placebo were included in this review. The pooled analyses showed no difference in pain relief (six trials; standardized mean difference (SMD) -0.06 (95% confidence interval (CI) -0.28 to 0.16)) or depression (two trials; SMD 0.06 (95% CI -0.29 to 0.40)) between antidepressant and placebo treatments. The qualitative analyses found conflicting evidence on the effect of antidepressants on pain intensity in chronic low-back pain, and no clear evidence that antidepressants reduce depression in chronic low-back pain patients. Two pooled analyses showed no difference in pain relief between different types of antidepressants and placebo. Our findings were not altered by the sensitivity analyses which varied the level of methodological quality required for inclusion in the meta-analyses to allow data from additional trials to be examined. Two additional trials were identified in September 2007 and await assessment.Authors' conclusionsThere is no clear evidence that antidepressants are more effective than placebo in the management of patients with chronic low-back pain. These findings do not imply that severely depressed patients with back pain should not be treated with antidepressants; furthermore, there is evidence for their use in other forms of chronic pain.

Project description:BackgroundPatient education, advice on returning to normal activities and (home-based) exercise therapy are established treatment options for patients with non-specific low back pain (LBP). However, the effectiveness of physiotherapy interventions on physical functioning and prevention of recurrent events largely depends on patient self-management, adherence to prescribed (home-based) exercises and recommended physical activity behaviour. Therefore we have developed e-Exercise LBP, a blended intervention in which a smartphone application is integrated within face-to-face care. E-Exercise LBP aims to improve patient self-management skills and adherence to exercise and physical activity recommendations and consequently improve the effectiveness of physiotherapy on patients' physical functioning. The aim of this study is to investigate the short- (3 months) and long-term (12 and 24 months) effectiveness on physical functioning and cost-effectiveness of e-Exercise LBP in comparison to usual primary care physiotherapy in patients with LBP.MethodsThis paper presents the protocol of a prospective, multicentre cluster randomized controlled trial. In total 208 patients with LBP pain were treated with either e-Exercise LBP or usual care physiotherapy. E-Exercise LBP is stratified based on the risk for developing persistent LBP. Physiotherapists are able to monitor and evaluate treatment progress between face-to-face sessions using patient input from the smartphone application in order to optimize physiotherapy care. The smartphone application contains video-supported self-management information, video-supported exercises and a goal-oriented physical activity module. The primary outcome is physical functioning at 12-months follow-up. Secondary outcomes include pain intensity, physical activity, adherence to prescribed (home-based) exercises and recommended physical activity behaviour, self-efficacy, patient activation and health-related quality of life. All measurements will be performed at baseline, 3, 12 and 24 months after inclusion. An economic evaluation will be performed from the societal and the healthcare perspective and will assess cost-effectiveness of e-Exercise LBP compared to usual physiotherapy at 12 and 24 months.DiscussionA multi-phase development and implementation process using the Center for eHealth Research Roadmap for the participatory development of eHealth was used for development and evaluation. The findings will provide evidence on the effectiveness of blended care for patients with LBP and help to enhance future implementation of blended physiotherapy.Trial registrationISRCTN, ISRCTN94074203. Registered 20 July 2018 - Retrospectively registered.

Project description:BackgroundImaging is overused in the management of low back pain, resulting in overdiagnosis, increased healthcare utilisation, and increased costs. Few effective interventions to decrease inappropriate use have been developed and have typically not been developed using behaviour change theory. An intervention to reduce non-indicated imaging for low back pain was developed using behavioural change theory, incorporating a novel low back pain management booklet to facilitate patient education and reassurance. The aim of this study was to assess the adoption and feasibility of use of the developed intervention within clinical practice and to determine appropriate implementation strategies to address identified barriers to use.MethodsFourteen general medical practitioners were recruited and trained to use the booklet with low back pain patients over a minimum 5-month period. Quantitative data on use of the booklet were collected and analysed descriptively. Qualitative data on use of the booklet and training session were collected in general medical practitioner interviews and thematically analysed. Barriers to use were identified and mapped to suitable implementation strategies using the Behaviour Change Wheel.ResultsPractitioners used the booklet with 73 patients. The booklet was used with 63% of patients presenting with low back pain. Facilitators for using the booklet included patient's requesting imaging and lower practitioner confidence in managing low back pain. Barriers included accessible storage and remembering to use the booklet. Implementation strategies were identified to increase adoption and feasibility of use, including development of a digital version of the booklet.ConclusionsGeneral medical practitioners reported that the low back pain management booklet and training were useful for clinical practice, particularly with patients requesting imaging. Barriers to use were identified and implementation strategies to address these barriers will be incorporated into future effectiveness studies. This study forms one of a series of studies to thoroughly develop and test an intervention to reduce non-indicated imaging for low back pain; a successful intervention would decrease healthcare costs and improve patient management.

Project description:IntroductionMany patients experience acute lower back pain that becomes chronic pain. The proportion of patients using complementary and alternative medicine to treat lower back is increasing. Even though several moxibustion clinical trials for lower back pain have been conducted, the effectiveness and safety of moxibustion intervention is controversial. The purpose of this study protocol for a systematic review is to evaluate the effectiveness and safety of moxibustion treatment for non-specific lower back pain patients.Methods and analysisWe will conduct an electronic search of several databases from their inception to May 2017, including Embase, PubMed, Cochrane Central Register of Controlled Trial, Allied and Complementary Medicine Database, Wanfang Database, Chongqing VIP Chinese Science and Technology Periodical Database, China National Knowledge Infrastructure Database, Korean Medical Database, Korean Studies Information Service System, National Discovery for Science Leaders, Oriental Medicine Advanced Searching Integrated System, the Korea Institute of Science and Technology, and KoreaMed. Randomised controlled trials investigating any type of moxibustion treatment will be included. The primary outcome will be pain intensity and functional status/disability due to lower back pain. The secondary outcome will be a global measurement of recovery or improvement, work-related outcomes, radiographic improvement of structure, quality of life, and adverse events (presence or absence). Risk ratio or mean differences with a 95% confidence interval will be used to show the effect of moxibustion therapy when it is possible to conduct a meta-analysis.Ethics and disseminationThis review will be published in a peer-reviewed journal and will be presented at an international academic conference for dissemination. Our results will provide current evidence of the effectiveness and safety of moxibustion treatment in non-specific lower back pain patients, and thus will be beneficial to patients, practitioners, and policymakers.Trial registration numberCRD42016047468 in PROSPERO 2016.

Dataset Information

Effectiveness of extrinsic feedback for management of non-specific low back pain: a systematic review protocol.

Introduction

Methods and analysis

Ethics and dissemination

Prospero registration number

Publications

Effectiveness of extrinsic feedback for management of non-specific low back pain: a systematic review protocol.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets