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    The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews

    199461_199461.pdf (872.2Kb)
    Access Status
    Open access
    Authors
    Hidalgo, B.
    Detrembleur, C.
    Hall, Toby
    Mahaudens, P.
    Nielens, H.
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Hidalgo, B. and Detrembleur, C. and Hall, T. and Mahaudens, P. and Nielens, H. 2014. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews. Journal of Manual and Manipulative Therapy. 22 (2): pp. 59-74.
    Source Title
    Journal of Manual and Manipulative Therapy
    DOI
    10.1179/2042618613Y.0000000041
    ISSN
    1066-9817
    Remarks

    http://www.maneypublishing.com/

    URI
    http://hdl.handle.net/20.500.11937/41312
    Collection
    • Curtin Research Publications
    Abstract

    Objective: to review and update the evidence for different forms of manual therapy (MT) for patients with different stages of non-specific low back pain (LBP).Data sources: MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EMBASE. Method: A systematic review of MT with a literature search covering the period of January 2000 to April 2013 was conducted by two independent reviewers according to Cochrane and PRISMA guidelines. A total of 360 studies were evaluated using qualitative criteria. Two stages of LBP were categorized; combined acute–subacute and chronic. Further sub-classification was made according to MT intervention: MT1 (manipulation); MT2 (mobilization and soft-tissue-techniques); and MT3 (MT1 combined with MT2). In each sub-category, MT could be combined or not with exercise or usual medical care (UMC). Consequently, quantitative evaluation criteria were applied to 56 eligible randomized controlled trials (RCTs), and hence 23 low-risk of bias RCTs were identified for review. Only studies providing new updated information (11/23 RCTs) are presented here.Results: Acute–subacute LBP: STRONG-evidence in favour of MT1 when compared to sham for pain, function and health improvements in the short-term (1–3 months). MODERATE-evidence to support MT1 and MT3 combined with UMC in comparison to UMC alone for pain, function and health improvements in the short-term. Chronic LBP: MODERATE to STRONG-evidence in favour of MT1 in comparison to sham for pain, function and overall-health in the short-term. MODERATE-evidence in favour of MT3 combined with exercise or UMC in comparison to exercise and back-school was established for pain, function and quality-of-life in the short and long-term. LIMITED-evidence in favour of MT2 combined with exercise and UMC in comparison to UMC alone for pain and function from short to long-term. LIMITED-evidence of no effect for MT1 with extension-exercise compared to extension-exercise alone for pain in the short to long-term. Conclusion: This systematic review updates the evidence for MT with exercise or UMC for different stages of LBP and provides recommendations for future studies.

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