Author:
Yu Hainan,Wang Dan,Verville Leslie,Southerst Danielle,Bussières André,Gross Douglas P.,Pereira Paulo,Mior Silvano,Tricco Andrea C.,Cedraschi Christine,Brunton Ginny,Nordin Margareta,Shearer Heather M.,Wong Jessica J.,Connell Gaelan,Myrtos Danny,da Silva-Oolup Sophia,Young James J.,Funabashi Martha,Romanelli Andrew,Lee Joyce G. B.,Stuber Kent,Guist Brett,Muñoz Laguna Javier,Hofstetter Léonie,Murnaghan Kent,Hincapié Cesar A.,Cancelliere Carol
Abstract
Abstract
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.
Funder
World Health Organization
University of Zurich
Publisher
Springer Science and Business Media LLC
Subject
Occupational Therapy,Rehabilitation
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献