Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Needling Therapies for Chronic Primary Low Back Pain in Adults.

Autor: Yu H; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada., Wang D; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada., Verville L; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada., Southerst D; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada., Bussières A; Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.; School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada., Gross DP; Department of Physical Therapy, University of Alberta, Edmonton, Canada., Pereira P; Department of Neurosurgery, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal., Mior S; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.; Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada., Tricco AC; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.; Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada., Cedraschi C; Division of General Medical Rehabilitation, Geneva University and University Hospitals, Geneva, Switzerland.; Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland., Brunton G; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.; EPPI-Centre, UCL Institute of Education, University College London, London, England, UK.; Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada., Nordin M; Departments of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, New York University, New York, USA., Shearer HM; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.; Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada.; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada., Wong JJ; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada., Connell G; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada., Myrtos D; Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada., da Silva-Oolup S; Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Canada.; Department of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada., Young JJ; Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada.; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada.; Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark., Funabashi M; Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.; Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada., Romanelli A; Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada., Lee JGB; Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada., Stuber K; Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada.; Parker University Research Center, Dallas, USA., Guist B; Department of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada., Muñoz Laguna J; EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland.; Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.; University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland., Hofstetter L; EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland.; Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.; University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland., Murnaghan K; Library and Information Services, Canadian Memorial Chiropractic College, Toronto, Canada., Hincapié CA; EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland. cesar.hincapie@uzh.ch.; Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland. cesar.hincapie@uzh.ch.; University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland. cesar.hincapie@uzh.ch., Cancelliere C; Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada. carolina.cancelliere@ontariotechu.ca.
Jazyk: angličtina
Zdroj: Journal of occupational rehabilitation [J Occup Rehabil] 2023 Dec; Vol. 33 (4), pp. 661-672. Date of Electronic Publication: 2023 Nov 22.
DOI: 10.1007/s10926-023-10125-3
Abstrakt: Purpose: Evaluate benefits and harms of needling therapies (NT) 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 NT compared with placebo/sham, usual care, or no intervention (comparing interventions where the attributable effect could be isolated). We conducted meta-analyses where indicated and graded the certainty of evidence.
Results: We screened 1831 citations and 109 full text RCTs, yeilding 37 RCTs. The certainty of evidence was low or very low across all included outcomes. There was little or no difference between NT and comparisons across most outcomes; there may be some benefits for certain outcomes. Compared with sham, NT improved health-related quality of life (HRQoL) (physical) (2 RCTs; SMD = 0.20, 95%CI 0.07; 0.32) at 6 months. Compared with no intervention, NT reduced pain at 2 weeks (21 RCTs; MD = - 1.21, 95%CI - 1.50; - 0.92) and 3 months (9 RCTs; MD = - 1.56, 95%CI - 2.80; - 0.95); and reduced functional limitations at 2 weeks (19 RCTs; SMD = - 1.39, 95%CI - 2.00; - 0.77) and 3 months (8 RCTs; SMD = - 0.57, 95%CI - 0.92; - 0.22). In older adults, NT reduced functional limitations at 2 weeks (SMD = - 1.10, 95%CI - 1.71; - 0.48) and 3 months (SMD = - 1.04, 95%CI - 1.66; - 0.43). Compared with usual care, NT reduced pain (MD = - 1.35, 95%CI - 1.86; - 0.84) and functional limitations (MD = - 2.55, 95%CI - 3.70; - 1.40) at 3 months.
Conclusion: Based on low to very low certainty evidence, adults with CPLBP experienced some benefits in pain, functioning, or HRQoL with NT; however, evidence showed little to no differences for other outcomes.
(© 2023. The Author(s).)
Databáze: MEDLINE
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