scholarly journals Extracorporeal Shockwave Therapy for Treating Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Lei Yue ◽  
Ming-shuai Sun ◽  
Hao Chen ◽  
Guan-zhang Mu ◽  
Hao-lin Sun
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Low Back ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Randomized Controlled

Objective. To assess the effectiveness and safety of extracorporeal shockwave therapy (ESWT) for the treatment of chronic low back pain (CLBP). Methods. This was a systematic review and meta-analysis of randomized controlled trials (RCTs) designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement standard. We identified relevant studies by searching multiple electronic databases, trial registries, and websites up to April 30, 2021, and examining reference lists. We selected RCTs that compared ESWT, in unimodal or multimodal therapeutic approaches, with sham ESWT or other active therapies. Two investigators independently extracted data and assessed the risk of bias and quality of the evidence. The main outcomes were pain intensity and disability status, examined as standardized mean differences (SMD) with 95% confidence intervals (CI). The risk of bias was assessed by using Cochrane Back and Neck (CBN) Group risk of bias tool and Jadad score, and GRADE was applied to determine the confidence in effect estimates. Heterogeneity was explored using sensitivity analysis and meta-regression. Results. Ten RCTs, including a total of 455 young to middle-aged individuals (29.2–55.8 years), were identified. Compared with control, the ESWT group showed lower pain intensity at month 1 ( SMD = − 0.81 , 95% CI −1.21 to −0.42), as well as lower disability score at month 1 ( SMD = − 1.45 , 95% CI −2.68 to −0.22) and at month 3 ( SMD = − 0.69 , 95% CI −1.08 to −0.31). No serious shockwave-related adverse events were reported. Conclusion. The use of ESWT in CLBP patients results in significant and quantifiable reductions in pain and disability in the short term. However, further well-conducted RCTs are necessary for building high-quality evidence and promoting the application of ESWT in clinical practice.

scholarly journals Psychological interventions for chronic non-specific low back pain: protocol of a systematic review with network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034996
Author(s):  
Emma Ho ◽  
Manuela Ferreira ◽  
Lingxiao Chen ◽  
Milena Simic ◽  
Claire Ashton-James ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Psychological Interventions ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Low Back ◽  
Fear Avoidance

IntroductionPsychological factors such as fear avoidance beliefs, depression, anxiety, catastrophic thinking and familial and social stress, have been associated with high disability levels in people with chronic low back pain (LBP). Guidelines endorse the integration of psychological interventions in the management of chronic LBP. However, uncertainty surrounds the comparative effectiveness of different psychological approaches. Network meta-analysis (NMA) allows comparison and ranking of numerous competing interventions for a given outcome of interest. Therefore, we will perform a systematic review with a NMA to determine which type of psychological intervention is most effective for adults with chronic non-specific LBP.Methods and analysisWe will search electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS and CINAHL) from inception until 22 August 2019 for randomised controlled trials comparing psychological interventions to any comparison interventions in adults with chronic non-specific LBP. There will be no restriction on language. The primary outcomes will include physical function and pain intensity, and secondary outcomes will include health-related quality of life, fear avoidance, intervention compliance and safety. Risk of bias will be assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2) tool and confidence in the evidence will be assessed using the Confidence in NMA (CINeMA) framework. We will conduct a random-effects NMA using a frequentist approach to estimate relative effects for all comparisons between treatments and rank treatments according to the mean rank and surface under the cumulative ranking curve values. All analyses will be performed in Stata.Ethics and disseminationNo ethical approval is required. The research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019138074.

scholarly journals Efficacy of Auricular Acupressure for Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Li-Hua Yang ◽  
Pei-Bei Duan ◽  
Qing-Mei Hou ◽  
Shi-Zheng Du ◽  
Jin-Fang Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Acupressure

Objectives. To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review.Methods. A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.Results. A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = −1.13, 95% CI (-1.70,-0.56),P<0.001). But, for the disability level, the therapeutic effect was not significant (mean difference = −1.99, 95% CI (-4.93, 0.95),P=0.18). No serious adverse effects were recorded.Conclusions. The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.

Sign in / Sign up

Export Citation Format

Share Document