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Latest & greatest articles for low back pain
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on low back pain or other clinical topics then use Trip today.
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Is there an association between hip range of motion and nonspecific lowbackpain? A systematic review. To systematically review whether there is an association between hip range of motion (ROM) and nonspecific lowbackpain (NSLBP).MEDLINE, EMBASE, Cochrane library, PsychINFO, CINAHL and AMED databases were searched from year of inception until October 31st, 2018, using a combination of LBP and hip joint search terms. Commonly cited journals were also hand searched within the previous two (...) reduced in NSLBP subjects compared to healthy individuals. Overall the quality of evidence was very low. Common sources of study bias included lack of sample size justification, blinding of outcome assessors, adjusting for key confounders, and poor reporting.There is very low-quality evidence to support an association between limited hip ROM and NSLBP. Limited hip IR ROM was the only movement impairment found to be significantly associated with NSLBP, however this should be viewed with caution due
Diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in lowback-related leg pain: protocol for a systematic review. Neuropathic lowback-related leg pain (LBLP) can be a challenge to healthcare providers to diagnose and treat. Accurate diagnosis of neuropathic pain is fundamental to ensure appropriate intervention is given. However, to date there is no gold standard to diagnose neuropathic LBLP. Patient examination guidelines (...) and screening tools have been developed and validated for the purpose of diagnosing neuropathic pain in LBLP; however, there has been no systematic review conducted to compare the diagnostic validity of these methods. Therefore, this systematic review will investigate the diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in LBLP.This protocol is informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta
Acupoint injection for nonspecific chronic lowbackpain: A protocol of systematic review: Erratum. 31702688 2020 01 08 1536-5964 98 45 2019 11 Medicine Medicine (Baltimore) Acupoint injection for nonspecific chronic lowbackpain: A protocol of systematic review: Erratum. e18084 10.1097/MD.0000000000018084 eng Journal Article Published Erratum United States Medicine (Baltimore) 2985248R 0025-7974 AIM IM Medicine (Baltimore). 2019 Jul;98(29):e16478 31335709 2019 11 9 6 0 2019 11 9 6 0 2019 11 9
The McKenzie Method and its association with psychosocial outcomes in lowbackpain: a systematic review. Study Design: Systematic Literature Review.Background: The McKenzie Method (MDT) is a comprehensive conservative approach commonly used for the management of lowbackpain (LBP); however, its association with psychosocial outcomes in this population is less clear.Objectives: Evaluate whether MDT has an association with psychosocial outcomes for individuals with LBP.Methods: The following (...) the GRACE scale.Results: The initial search resulted in 181 articles to review. After screening abstracts, then full articles, a total of 16 studies were included, 5 of which were RCTs rated 5-8/10 on the PEDro scale. A qualitative review was performed and the studies' results were synthesized into five main findings: fear-avoidance beliefs, depression symptoms, pain self-efficacy, psychological distress, and return to work (RTW).Conclusions: There is evidence that MDT has an association with improving
Conditioned Pain Modulation in Chronic LowBackPain: A Systematic Review of Literature. The objective of the review is to determine whether conditioned pain modulation (CPM) is impaired in adults with chronic lowbackpain (CLBP) when compared with pain-free individuals.A a systematic search of the literature was undertaken using the databases: MEDLINE, Scopus, CINAHL and Web of Science. The citations of included studies were reviewed for additional studies. Observational, cross-sectional (...) , case-control studies published in English between January 1990 and August 2019 were considered. Studies that investigated the efficiency of standardized CPM regimens among defined cases of CLBP and in comparison, with pain-free controls were included. After initial title and abstract screening, 2 authors reviewed the full texts of the eligible articles independently. Risk of bias was carried out using assessment of 4 categories: blinding of the outcome assessors, representativeness of cases
Changes in the macroscopic morphology of hip muscles in lowbackpain. Lowbackpain is a major health issue affecting the lumbopelvic muscles. Morphological changes in hip muscles, such as alterations in the muscle cross-sectional area and muscle volume, may occur in patients with lowbackpain. This systematic review was conducted to investigate whether patients with lowbackpain have macroscopic changes in their hip muscle morphology compared with asymptomatic, healthy individuals, based (...) on current evidence. The electronic databases of PubMed/Medline, Ovid, Scopus, Embase® , and Google Scholar were searched from the inception to August 31, 2018. We only included full texts of original studies regarding macroscopic morphological alterations, including atrophy and fat infiltration, in hip muscles of patients with lowbackpain compared with asymptomatic controls. The quality of the included studies was determined using an assessment tool based on the Newcastle-Ottawa Scale. The scale
The Effectiveness of Group-Based Physiotherapy-Led Behavioral Psychological Interventions on Adults With Chronic LowBackPain: A Systematic Review and Meta-Analysis. Group-based physiotherapy-led behavioral psychological interventions (GPBPIs) are an emerging treatment for chronic lowbackpain, but the efficacy of these interventions is uncertain. A review of relevant randomized controlled trials and a meta-analysis was conducted to evaluate the effectiveness of GPBPIs on pain relief (...) in adults with chronic lowbackpain. Literature databases, Google Scholar, bibliographies, and other relevant sources were searched. Thirteen intervention studies (13) published from 1998 to 2013 were included. The meta-analysis was conducted using RevMan software in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. In reviewing the short- (<6 mos), intermediate- (≥6 and <12 mos), and longer-term (≥12 mos) effects of GPBPIs, long-term follow-up evaluations showed large
The effectiveness of incidental physical activity interventions compared to other interventions in the management of people with lowbackpain: A systematic review and meta-analysis of randomised controlled trials. To investigate the effectiveness of incidental (non-structured) physical activity interventions for the management of people with lowbackpain (LBP).Systematic review and meta-analyses of randomised controlled trials.Eligible published trials from the earliest date available (...) to November 2017.People with non-specific LBP aged 18 years or over.Pain, disability and physical activity-related outcomes.Three trials were included (including a total of 422 participants). The quality of trials, assessed by PEDro scale, was high (7 out of 10). For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective
Exercise treatment effect modifiers in persistent lowbackpain: an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials. Lowbackpain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific lowbackpain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise.In parallel (...) (mean effect/100 (95% CI) -10.2 (-13.2 to -7.3)) at short-term follow-up. Not having heavy physical demands at work and medication use for lowbackpain were potential treatment effect modifiers-these were associated with superior exercise outcomes relative to non-exercise comparisons. Lower body mass index was also associated with better outcomes in exercise compared with no treatment/usual care. This study was limited by inconsistent availability and measurement of participant characteristics.This
WITHDRAWN: Response to letter to editor concerning: Effectiveness of movement control exercise on patients with non-specific lowbackpain and movement control impairment: A systematic review and metaanalyse. 30612979 2019 11 20 2468-7812 2018 Dec 31 Musculoskeletal science & practice Musculoskelet Sci Pract WITHDRAWN: Response to letter to editor concerning: Effectiveness of movement control exercise on patients with non-specific lowbackpain and movement control impairment: A systematic
Minimal physical therapy utilization compared with higher physical therapy utilization for patients with lowbackpain: a systematic review. Currently there is a large and perhaps unwarranted variation regarding physical therapy utilization for individuals with lowbackpain (LBP). The purpose of this systematic review was to compare the effects of minimal physical therapy utilization/education (two visits or less) versus typical physical therapy utilization (three visits or more) on patient (...) using Hedge's g and were adjusted for baseline values at each time period.When compared with minimal utilization, higher utilization demonstrated no significant differences on pain, disability, or quality of life at the 1-year follow-up. However, two of the three studies that analyzed cost-effectiveness found higher utilization to be more cost-effective at 1-year follow-up. Moreover, there was insufficient evidence available to investigate patient subgroups (acuity, risk for chronicity), multiple
Is spinal mobilization effective for lowbackpain?: A systematic review. 30712746 2019 11 20 1873-6947 34 2019 02 Complementary therapies in clinical practice Complement Ther Clin Pract Is spinal mobilization effective for lowbackpain?: A systematic review. 51-63 S1744-3881(18)30420-1 10.1016/j.ctcp.2018.11.003 Aoyagi Kosaku K Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd/ MS 2002, Kansas City, KS, 66160, USA. Heller David
The impact of pragmatic vs. prescriptive study designs on the outcomes of lowback and neck pain when using mobilization or manipulation techniques: a systematic review and meta-analysis. The purpose of this systematic review and meta-analysis was to examine the impact of pragmatic versus prescriptive study designs on the outcomes of lowback and neck pain when using mobilization or manipulation techniques.This study design was a systematic review and meta-analysis, which was performed (...) according to the PRISMA guidelines. A search of MEDLINE and CINAHL complete databases was performed. Article titles and abstracts were reviewed to identify studies comparing mobilization and manipulation in lowback or neck pain that met eligibility criteria. Validity of studies was examined using the Cochrane Risk of Bias tool. Data analysis was performed using RevMan 5.3. Forest plots were constructed after data were analyzed to determine effect sizes.Thirteen studies with a total of 1313 participants
Effectiveness of interventions for non-specific lowbackpain in older adults. A systematic review and meta-analysis. Systematically review the literature about all available interventions to manage non-specific lowbackpain (NSLBP) in older adults (≥60 years).We searched the Medline, EMBASE, CINAHL, LILACS, PEDro, and Cochrane CENTRAL databases reference lists for randomized controlled trials (RCTs) testing interventions for NSLBP. Two independent reviewers extracted data, assessed the risk (...) of bias and completeness of the description of interventions.Eighteen (RCTs) fulfilled the eligibility criteria. Evidence about interventions to manage NSLBP in older adults is weak. Very low to moderate quality evidence showed that complementary health approach (i.e., manual therapy, acupuncture, mindfulness, yoga), percutaneous electrical nerve stimulation (PENS), education, exercise or pharmacological agents were not effective to produce a clinically significant reduction in pain and disability
Alterations in pro-nociceptive and anti-nociceptive mechanisms in patients with lowbackpain: a systematic review with meta-analysis. Altered pro-nociceptive and anti-nociceptive mechanisms are often implicated in painful conditions and have been increasingly studied over the past decade. For some painful conditions alterations are well-established, but in lowbackpain (LBP) populations there remains considerable debate whether these mechanisms are altered. The present systematic review aimed (...) to address this issue by identifying studies assessing Conditioned Pain Modulation (CPM) and/or Temporal Summation of Pain (TSP) in LBP patients, comparing to either a healthy control group or using a method with reference data available. Qualitative synthesis and quantitative meta-analysis of group differences were performed. For CPM and TSP, 20 and 29 original articles were eligible, with data for meta-analysis obtainable from 18 (1500 patients, 505 controls) and 27 (1507 patients, 1127 controls
LowBackPain in the Emergency Department: Prevalence of Serious Spinal Pathologies and Diagnostic Accuracy of Red Flags - A Systematic Review Very little evidence is available on the prevalence of serious spinal pathologies and the diagnostic accuracy of red flags in patients presenting to the emergency department (ED). This systematic review aims to investigate the prevalence of serious spinal pathologies and the diagnostic accuracy of red flags in patients presenting with lowbackpain
Exercise alone and exercise combined with education both prevent episodes of lowbackpain and related absenteeism: systematic review and network meta-analysis of randomised controlled trials (RCTs) aimed at preventing backpain. We aimed to investigate which prevention strategies for lowbackpain (LBP) are most effective.We completed a Bayesian network meta-analysis to summarise the comparative effectiveness of LBP prevention strategies. The primary outcomes were an episode of LBP and LBP
Which specific modes of exercise training are most effective for treating lowbackpain? Network meta-analysis. Examine the effectiveness of specific modes of exercise training in non-specific chronic lowbackpain (NSCLBP).Network meta-analysis (NMA).MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL.Exercise training randomised controlled/clinical trials in adults with NSCLBP.Among 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function (...) ), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): -1.86 (-2.54 to -1.19)), resistance (SUCRA=80%; -1.14 (-1.71 to -0.56)) and stabilisation/motor control (SUCRA=80%; -1.13 (-1.53 to -0.74)) for physical function
Efficacy of antibiotic treatment in patients with chronic lowbackpain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial. To assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic lowbackpain, previous disc herniation, and vertebral endplate changes (Modic changes).Double blind, parallel group, placebo controlled, multicentre trial.Hospital outpatient clinics at six hospitals in Norway.180 (...) patients with chronic lowbackpain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017.Patients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription.The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention
No difference in pressure pain threshold and temporal summation after lumbar spinal manipulation compared to sham: A randomised controlled trial in adults with lowbackpain. Changes in quantitative sensory tests have been observed after spinal manipulative therapy (SMT), particularly in pressure pain thresholds (PPT) and temporal summation (TS). However, a recent systematic review comparing SMT to sham found no significant difference in PPT in patients with musculoskeletal pain. The sham (...) -controlled studies were generally low quality, and conclusions about other quantitative sensory tests could not be made.We aimed to perform a sham-controlled study with the specific objective of investigating changes in PPT and TS short-term after lumbar SMT compared to sham manipulation in people with lowback pain.This was a double-blind randomised controlled trial comparing high-velocity low-amplitude lumbar SMT against sham manipulation in participants with lowbackpain. Primary outcome measures