Osteopathic intervention in chronic non-specific low back pain: a systematic review

BMC Musculoskeletal Disorders

Stephen P Myers¹  Paul J Orrock² 

[1] NatMed Research, Southern Cross University, PO Box 157, Lismore, NSW 2481, Australia;School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2481, Australia

关键词: Clinical trial methodology;    Manual therapy;    Non-specific low back pain;    Chronic low back pain;    Low back pain;    Osteopathic manipulative treatment;    Osteopathy;    Systematic review;   

Others  :  1132793
DOI  :  10.1186/1471-2474-14-129

 received in 2012-09-13, accepted in 2013-03-25,  发布年份 2013

【 摘 要 】

Background

Chronic Non Specific Low Back Pain (CNSLBP) is a common, complex and disabling condition that has been present for longer than three months and is not caused by a serious pathology. Osteopaths are health practitioners who commonly diagnose and treat CNSLBP patients using a complex set of interventions that includes manual therapy. The study aimed to complete a Systematic Review of clinical research into osteopathic intervention in CNSLBP using a rigorous assessment of study quality.

Methods

The literature was searched to August 2011 using the following databases: AMED, CINAHL Plus, Cochrane Central Register of Clinical Trials, MEDLINE Plus, EMBASE, MANTIS, OSTMED, PEDro, ScienceDirect. Multiple search terms were used in various combinations: osteopathy/osteopathic, osteopathic manipulative technique, OMT, Spinal Manipulative Therapy, SMT, clinical trial, back pain, chronic back pain. The inclusion criteria were papers that: reported clinical trials; had adult participants; tested the effectiveness and/or efficacy of osteopathic manual therapy intervention applied by osteopaths, and had a study condition of CNSLBP. The quality of the papers was assessed using the Cochrane Back Review Risk of Bias criteria. A meta-analysis would proceed if the studies had adequate clinical and methodological homogeneity.

Results

Initial searches revealed 809 papers, 772 of which were excluded on the basis of abstract alone. The remaining 37 trial papers were subjected to a more detailed analysis of the full text, which resulted in 35 being excluded. The two remaining trials had a lack of methodological and clinical homogeneity, precluding a meta-analysis. The trials used different comparators with regards to the primary outcomes, the number of treatments, the duration of treatment and the duration of follow-up.

Conclusion

There are only two studies assessing the effect of the manual therapy intervention applied by osteopathic clinicians in adults with CNSLBP. One trial concluded that the osteopathic intervention was similar in effect to a sham intervention, and the other suggests similarity of effect between osteopathic intervention, exercise and physiotherapy. Further clinical trials into this subject are required that have consistent and rigorous methods. These trials need to include an appropriate control and utilise an intervention that reflects actual practice.

【 授权许可】

   
2013 Orrock and Myers; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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