Article type
Year
Abstract
Introduction: In recent years, a number of meta-analyses of therapeutic modalities available for the treatment of low back pain (LBP) have been published by our research group and others. We systematically review the scientific literature to analyse the effectiveness of the various treatment options for LBP. As the randomised clinical trial (RCT) is generally accepted as the paradigm of intervention research, we will assess the methodological quality and the outcomes of RCTs on the efficacy of therapeutic interventions for LBP.
Objective: The objective of this study is to assess the efficacy of conservative treatment modalities for non-specific LBP.
Methods: Update of the existing meta-analyses on manipulation and mobilisation, exercise therapy, back schools, bedrest and orthoses, traction, epidural steroid injections, and NSAIDs. Using the same literature (Medline) search as the original meta-analyses, we intend to trace all newly published RCTs until 1 June 1995. Additionally, the following interventions will be included: antidepressants, analgesics, muscle relaxants, TENS, EMG-biofeedback and behavioral therapy. A literature (Medline) search will be carried out for the period from 1966 to June 1995. Subsequently, the references given in relevant publications will be further examined. The methodological quality of the RCTs will be assessed by two reviewers independently, using generally accepted criteria. The criteria refer to topics of study population, description of interventions, outcome measurements, and data presentation and analysis. Disagreements between the two reviewers will be resolved by consensus or by consultation of a third referee. The criteria will be summated into an overall score reflecting the methodological quality of each study. Overall, about 220 RCTs will be reviewed.
Results/Discussion: LBP will be categorised as radicular or non-radicular and as acute/subacute or chronic. For each subcategory of LBP, the efficacy of the interventions will be analysed by evaluating ('best-evidence synthesis') the outcomes of the methodologically best studies per intervention group. The efficacy of these interventions will be assessed by the difference in success rate between the intervention and reference groups.
Objective: The objective of this study is to assess the efficacy of conservative treatment modalities for non-specific LBP.
Methods: Update of the existing meta-analyses on manipulation and mobilisation, exercise therapy, back schools, bedrest and orthoses, traction, epidural steroid injections, and NSAIDs. Using the same literature (Medline) search as the original meta-analyses, we intend to trace all newly published RCTs until 1 June 1995. Additionally, the following interventions will be included: antidepressants, analgesics, muscle relaxants, TENS, EMG-biofeedback and behavioral therapy. A literature (Medline) search will be carried out for the period from 1966 to June 1995. Subsequently, the references given in relevant publications will be further examined. The methodological quality of the RCTs will be assessed by two reviewers independently, using generally accepted criteria. The criteria refer to topics of study population, description of interventions, outcome measurements, and data presentation and analysis. Disagreements between the two reviewers will be resolved by consensus or by consultation of a third referee. The criteria will be summated into an overall score reflecting the methodological quality of each study. Overall, about 220 RCTs will be reviewed.
Results/Discussion: LBP will be categorised as radicular or non-radicular and as acute/subacute or chronic. For each subcategory of LBP, the efficacy of the interventions will be analysed by evaluating ('best-evidence synthesis') the outcomes of the methodologically best studies per intervention group. The efficacy of these interventions will be assessed by the difference in success rate between the intervention and reference groups.