Preventive physiotherapy interventions for back care in children and adolescents: a meta-analysis

BMC Musculoskeletal Disorders

Julio Sánchez-Meca¹  Antonia Gómez-Conesa²  Inmaculada Calvo-Muñoz² 

[1] Dept. of Basic Psychology and Methodology, University of Murcia, 30100, Murcia, Spain;Dept. of Physiotherapy, University of Murcia, Murcia, Spain

关键词: Back care;    Meta-analysis;    Adolescents;    Children;    Efficacy;    Prevention;    Physiotherapy;   

Others  :  1145927
DOI  :  10.1186/1471-2474-13-152

 received in 2012-03-02, accepted in 2012-08-16,  发布年份 2012

【 摘 要 】

Background

Preventive interventions improve healthy behaviours and they also increase knowledge regarding back care in children and adolescents, but studies exhibit great variability in their contents, duration and number of sessions, and in the assessment methods. The purpose of this study was to review the empirical evidence regarding preventive physiotherapy interventions for back care in children and adolescents, and to ascertain the most efficacious treatments, in what way and under which circumstances.

Methods

Studies were located from computerized databases (Cochrane Library, Medline, PEDro, Web of Science and IME) and other sources. The search period extended to May 2012. To be included in the meta-analysis, studies had to use physical therapy methodologies of preventive treatment on children and adolescents, and to compare a treatment and a control group. Treatment, participant, methodological, and extrinsic characteristics of the studies were coded. Two researchers independently coded all of the studies. As effect size indices, standardized mean differences were calculated for measures of behaviours and knowledge, both in the posttest and in the follow-up. The random and mixed-effects models were used for the statistical analyses and sensitivity analyses were carried out in order to check the robustness of the meta-analytic results.

Results

A total of 19 papers fulfilled the selection criteria, producing 23 independent studies. On average, the treatments reached a statistically significant effectiveness in the behaviours acquired, both in the posttest and in the follow-up (d₊ = 1.33 and d₊ = 1.80, respectively), as well as in measures of knowledge (posttest; d₊ = 1.29; follow-up: d₊ = 0.76). Depending on the outcome measure, the effect sizes were affected by different moderator variables, such as the type of treatment, the type of postural hygiene, the teaching method, or the use of paraprofessionals as cotherapists.

Conclusions

The interventions were successful in significantly increasing the behaviours and knowledge acquired both in the posttest and in the follow-up. The combined treatment of postural hygiene with physiotherapy exercise exhibited the best results. The small number of studies limits the generalizability of the results.

【 授权许可】

   
2012 Calvo-Muñoz et al.; licensee BioMed Central Ltd.

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