Efficacy of conservative therapy in older people with nonspecific low back pain: A systematic review with meta-analysis and GRADE recommendations
| Autor: | Mariana G.M. Campos, Alessandra de Carvalho Bastone, Leani Souza Máximo Pereira, Lorena K.B. Amaral, Vinícius Cunha Oliveira, Rodrigo de Oliveira Mascarenhas, Mateus B. Souza, Vanessa Mendonça |
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| Rok vydání: | 2020 |
| Předmět: |
Aging
medicine.medical_specialty Coping (psychology) Health (social science) MEDLINE Conservative Treatment Placebo 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Exercise Aged Aged 80 and over 030214 geriatrics business.industry Low back pain Confidence interval Exercise Therapy Sample size determination Meta-analysis Quality of Life Physical therapy Geriatrics and Gerontology medicine.symptom business Low Back Pain Gerontology Body mass index |
| Zdroj: | Archives of Gerontology and Geriatrics. 90:104177 |
| ISSN: | 0167-4943 |
| Popis: | Purpose This systematic review aimed to investigate the effectiveness of conservative therapy in older people with nonspecific low back pain. Materials and methods Searches were conducted on Medline, Amed, Embase, Cochrane, Psycinfo and Pedro databases up to 2020. Risk of bias were assessed using the 0−10 PEDro scale. Weighted mean differences (WMDs) or mean differences (MDs) with 95 % confidence intervals (CIs) were reported for each conservative therapy, and strength of the current evidence was assessed using the GRADE approach. Results Eleven original trials were included investigating effects on disability, pain, coping, quality of life, strength, balance, depression, falls, sleep quality, mobility, body mass index, percentage body fat, trunk muscle mass and waist-to-hip ratio. Moderate quality evidence showed short-term effects of trigger point acupuncture on disability (WMD = 5.0 points [95 % CI 3.5–6.4] on a 25-point scale) and pain (WMD = 35.9 points [95 % CI 22.2–49.7] on a 101-point scale), and of exercise on disability (WMD = 1.7 points [95 % CI 0.3–3.0]) when compared with control (placebo, sham, waiting list or no intervention). Moderate quality evidence showed no short-term effect of exercise on coping (95 % CI −5.0 to 14.6). Moreover, evidence for other important outcomes in older people is scarce and we did not find any trial investigating pharmacological therapies. Conclusion Findings support partially exercise and trigger point acupuncture to improve disability and/or pain. Future trials with appropriate sample sizes are likely to impact on the estimates and need to clarify medium- and long-term effects. |
| Databáze: | OpenAIRE |
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