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

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 compare...

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Detalles Bibliográficos
Autores principales: 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, Stuber, Kent, Funabashi, Martha, Hofstetter, Léonie, Myrtos, Danny, Romanelli, Andrew, Guist, Brett, Young, James J., da Silva-Oolup, Sophia, Stupar, Maja, Wang, Dan, Murnaghan, Kent, Cancelliere, Carol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684630/
https://www.ncbi.nlm.nih.gov/pubmed/37991651
http://dx.doi.org/10.1007/s10926-023-10120-8
Descripción
Sumario: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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10926-023-10120-8.

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