Manual Therapy Effect in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis.

Autor:	Molina-Álvarez M; Escuela Internacional de Doctorado, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain.; Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain., Arribas-Romano A; Escuela Internacional de Doctorado, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain.; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcón, Spain., Rodríguez-Rivera C; Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain.; High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain., García MM; Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain.; High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain.; Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain., Fernández-Carnero J; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcón, Spain.; Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain.; La Paz Hospital Institute for Health Research, IdiPAZ, 28029 Madrid, Spain., Armijo-Olivo S; Faculty of Business and Social Sciences, University of Applied Sciences, 30A, 49076 Osnabruck, Germany.; Faculties of Rehabilitation Medicine and Medicine and Dentistry, 3-48 Corbett Hall, Edmonton, AB T6G 2G4, Canada., Goicoechea Garcia C; Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain.; High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain.; Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain.
Jazyk:	angličtina
Zdroj:	International journal of environmental research and public health [Int J Environ Res Public Health] 2022 Oct 28; Vol. 19 (21). Date of Electronic Publication: 2022 Oct 28.
DOI:	10.3390/ijerph192114021
Abstrakt:	Purpose: Background: Evaluate whether the design of placebo control groups could produce different interpretations of the efficacy of manual therapy techniques. Methods: Nine databases were searched (EMBASE, CINAHL, PsycINFO, MEDLINE, PubMed, SCOPUS, WEB of SCIENCE, COCHRANE, and PEDro). Randomized placebo-controlled clinical trials that used manual therapy as a sham treatment on subjects suffering from pain were included. Data were summarized qualitatively, and meta-analyses were conducted with R. Results: 53 articles were included in the qualitative analysis and 48 were included in the quantitative analyses. Manipulation techniques did not show higher effectiveness when compared with all types of sham groups that were analyzed (SMD 0.28; 95%CI [-0.24; 0.80]) (SMD 0.28; 95%CI [-0.08; 0.64]) (SMD 0.42; 95%CI [0.16; 0.67]) (SMD 0.82; 95%CI [-0.57; 2.21]), raising doubts on their therapeutic effect. Factors such as expectations of treatment were not consistently evaluated, and analysis could help clarify the effect of different sham groups. As for soft tissue techniques, the results are stronger in favor of these techniques when compared to sham control groups (SMD 0.40; 95%CI [0.19, 0.61]). Regarding mobilization techniques and neural gliding techniques, not enough studies were found for conclusions to be made. Conclusions: The literature presents a lack of a unified placebo control group design for each technique and an absence of assessment of expectations. These two issues might account for the unclear results obtained in the analysis.
Databáze:	MEDLINE
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