A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain

Objective: Our aim was to systematically review and meta-analyze the effectiveness of graded activity (GA) or graded exposure (GEXP) for chronic nonspecific low back pain (CNSLBP). Methods: A literature search of multiple databases (MEDLINE, EMBASE, PEDro, CINAHL, and PsychINFO) was conducted to ide...

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Authors: López De Uralde Villanueva, Ibai Julio, Muñoz García, Daniel, Gil Martínez, Alfonso, Pardo Montero, Joaquín, Muñoz Plata, Rosa, Angulo Díaz-Parreño, Santiago, Gómez Martínez, Miguel, La Touche, Roy
Format: article
Publication Date:2016
Country:España
Institution:Universidad Complutense de Madrid (UCM)
Repository:Docta Complutense
Language:English
OAI Identifier:oai:docta.ucm.es:20.500.14352/92694
Online Access:https://hdl.handle.net/20.500.14352/92694
Access Level:Open access
Keyword:615.8
Recurrent Low Back Pain
Pain Catastrophizing
Cognitive Behavior Therapy
Behavioural Graded Activity
Physiotherapy
Fisioterapia (Enfermería, Fisioterapia y Podología)
Fisioterapia (Medicina)
Medicina Física y Rehabilitación
3213.11 Fisioterapia
3204.04 Rehabilitación (Médica)
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network_acronym_str ES
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repository_id_str
spelling A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back PainLópez De Uralde Villanueva, Ibai JulioMuñoz García, DanielGil Martínez, AlfonsoPardo Montero, JoaquínMuñoz Plata, RosaAngulo Díaz-Parreño, SantiagoGómez Martínez, MiguelLa Touche, Roy615.8Recurrent Low Back PainPain CatastrophizingCognitive Behavior TherapyBehavioural Graded ActivityPhysiotherapyFisioterapia (Enfermería, Fisioterapia y Podología)Fisioterapia (Medicina)Medicina Física y Rehabilitación3213.11 Fisioterapia3204.04 Rehabilitación (Médica)Objective: Our aim was to systematically review and meta-analyze the effectiveness of graded activity (GA) or graded exposure (GEXP) for chronic nonspecific low back pain (CNSLBP). Methods: A literature search of multiple databases (MEDLINE, EMBASE, PEDro, CINAHL, and PsychINFO) was conducted to identify randomized control trials (RCTs). Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for relevant outcome measures (pain intensity, disability, quality of life, and catastrophizing). Results: Thirteen RCTs met the inclusion criteria. Only nine studies were included in the meta-analysis. GA was significantly more effective than the control group (CG) for improvements in disability in the short term (three studies: n = 254, SMD = -0.3, 95% CI -0.55 to -0.05, P = 0.02) and long term (two studies: n = 238, SMD = -0.53, 95% CI -0.79 to -0.27, P < 0.0001). GA was significantly less effective than GEXP for the improvement of disability in the short term (two studies: n = 105, SMD = 0.39, 95% CI 0.003-0.78, P = 0.048). GA was also significantly less effective than GEXP at improving catastrophizing in the short term (two studies: n = 105, SMD = 0.48, 95% CI 0.09-0.87, P = 0.02). Conclusion: Limited evidence has been found to show that GA significantly reduces disability in the short and long term when compared with the CG in CNSLBP. There is moderate evidence that GEXP more effectively decreases catastrophizing than GA in the short term. No difference was found between GA and other exercise for any variable.Oxford University PressUniversidad Complutense de Madrid20162016-01-0120162016-01-01journal articlehttp://purl.org/coar/resource_type/c_6501CVoRhttp://purl.org/coar/version/c_e19f295774971610info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/92694reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/926942026-06-02T12:44:21Z
dc.title.none.fl_str_mv A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
title A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
spellingShingle A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
López De Uralde Villanueva, Ibai Julio
615.8
Recurrent Low Back Pain
Pain Catastrophizing
Cognitive Behavior Therapy
Behavioural Graded Activity
Physiotherapy
Fisioterapia (Enfermería, Fisioterapia y Podología)
Fisioterapia (Medicina)
Medicina Física y Rehabilitación
3213.11 Fisioterapia
3204.04 Rehabilitación (Médica)
title_short A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
title_full A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
title_fullStr A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
title_full_unstemmed A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
title_sort A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
dc.creator.none.fl_str_mv López De Uralde Villanueva, Ibai Julio
Muñoz García, Daniel
Gil Martínez, Alfonso
Pardo Montero, Joaquín
Muñoz Plata, Rosa
Angulo Díaz-Parreño, Santiago
Gómez Martínez, Miguel
La Touche, Roy
author López De Uralde Villanueva, Ibai Julio
author_facet López De Uralde Villanueva, Ibai Julio
Muñoz García, Daniel
Gil Martínez, Alfonso
Pardo Montero, Joaquín
Muñoz Plata, Rosa
Angulo Díaz-Parreño, Santiago
Gómez Martínez, Miguel
La Touche, Roy
author_role author
author2 Muñoz García, Daniel
Gil Martínez, Alfonso
Pardo Montero, Joaquín
Muñoz Plata, Rosa
Angulo Díaz-Parreño, Santiago
Gómez Martínez, Miguel
La Touche, Roy
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 615.8
Recurrent Low Back Pain
Pain Catastrophizing
Cognitive Behavior Therapy
Behavioural Graded Activity
Physiotherapy
Fisioterapia (Enfermería, Fisioterapia y Podología)
Fisioterapia (Medicina)
Medicina Física y Rehabilitación
3213.11 Fisioterapia
3204.04 Rehabilitación (Médica)
topic 615.8
Recurrent Low Back Pain
Pain Catastrophizing
Cognitive Behavior Therapy
Behavioural Graded Activity
Physiotherapy
Fisioterapia (Enfermería, Fisioterapia y Podología)
Fisioterapia (Medicina)
Medicina Física y Rehabilitación
3213.11 Fisioterapia
3204.04 Rehabilitación (Médica)
description Objective: Our aim was to systematically review and meta-analyze the effectiveness of graded activity (GA) or graded exposure (GEXP) for chronic nonspecific low back pain (CNSLBP). Methods: A literature search of multiple databases (MEDLINE, EMBASE, PEDro, CINAHL, and PsychINFO) was conducted to identify randomized control trials (RCTs). Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for relevant outcome measures (pain intensity, disability, quality of life, and catastrophizing). Results: Thirteen RCTs met the inclusion criteria. Only nine studies were included in the meta-analysis. GA was significantly more effective than the control group (CG) for improvements in disability in the short term (three studies: n = 254, SMD = -0.3, 95% CI -0.55 to -0.05, P = 0.02) and long term (two studies: n = 238, SMD = -0.53, 95% CI -0.79 to -0.27, P < 0.0001). GA was significantly less effective than GEXP for the improvement of disability in the short term (two studies: n = 105, SMD = 0.39, 95% CI 0.003-0.78, P = 0.048). GA was also significantly less effective than GEXP at improving catastrophizing in the short term (two studies: n = 105, SMD = 0.48, 95% CI 0.09-0.87, P = 0.02). Conclusion: Limited evidence has been found to show that GA significantly reduces disability in the short and long term when compared with the CG in CNSLBP. There is moderate evidence that GEXP more effectively decreases catastrophizing than GA in the short term. No difference was found between GA and other exercise for any variable.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016-01-01
2016
2016-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
CVoR
http://purl.org/coar/version/c_e19f295774971610
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/92694
url https://hdl.handle.net/20.500.14352/92694
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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