The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews
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 cove...
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| Format: | Journal Article |
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Maney Publishing
2014
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| Online Access: | http://hdl.handle.net/20.500.11937/41312 |
| _version_ | 1848756109930659840 |
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| author | Hidalgo, B. Detrembleur, C. Hall, Toby Mahaudens, P. Nielens, H. |
| author_facet | Hidalgo, B. Detrembleur, C. Hall, Toby Mahaudens, P. Nielens, H. |
| author_sort | Hidalgo, B. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T09:06:59Z |
| format | Journal Article |
| id | curtin-20.500.11937-41312 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:06:59Z |
| publishDate | 2014 |
| publisher | Maney Publishing |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-413122017-09-13T14:13:45Z The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews Hidalgo, B. Detrembleur, C. Hall, Toby Mahaudens, P. Nielens, H. randomized controlled trails manual therapy spinal manipulation efficacy Non-specific low back pain 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. 2014 Journal Article http://hdl.handle.net/20.500.11937/41312 10.1179/2042618613Y.0000000041 Maney Publishing fulltext |
| spellingShingle | randomized controlled trails manual therapy spinal manipulation efficacy Non-specific low back pain Hidalgo, B. Detrembleur, C. Hall, Toby Mahaudens, P. Nielens, H. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| title | The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| title_full | The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| title_fullStr | The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| title_full_unstemmed | The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| title_short | The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| title_sort | efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews |
| topic | randomized controlled trails manual therapy spinal manipulation efficacy Non-specific low back pain |
| url | http://hdl.handle.net/20.500.11937/41312 |