Hainan Yu, Danielle Southerst, Jessica J Wong, Leslie Verville, Gaelan Connell, Lauren Ead, Silvano Mior, Lise Hestbaek, Michael Swain, Ginny Brunton, Heather M Shearer, Efrosini Papaconstantinou, Daphne To, Darrin Germann, Katie Pohlman, Christine Cedraschi, Carol Cancelliere
{"title":"儿童背痛康复：混合研究系统综述。","authors":"Hainan Yu, Danielle Southerst, Jessica J Wong, Leslie Verville, Gaelan Connell, Lauren Ead, Silvano Mior, Lise Hestbaek, Michael Swain, Ginny Brunton, Heather M Shearer, Efrosini Papaconstantinou, Daphne To, Darrin Germann, Katie Pohlman, Christine Cedraschi, Carol Cancelliere","doi":"10.1186/s12998-024-00538-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking.</p><p><strong>Objectives: </strong>To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population.</p><p><strong>Methods: </strong>Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach.</p><p><strong>Results: </strong>We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1-2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified.</p><p><strong>Conclusions: </strong>Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed.</p><p><strong>Trial registration: </strong>CRD42019135009 (PROSPERO).</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080233/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rehabilitation of back pain in the pediatric population: a mixed studies systematic review.\",\"authors\":\"Hainan Yu, Danielle Southerst, Jessica J Wong, Leslie Verville, Gaelan Connell, Lauren Ead, Silvano Mior, Lise Hestbaek, Michael Swain, Ginny Brunton, Heather M Shearer, Efrosini Papaconstantinou, Daphne To, Darrin Germann, Katie Pohlman, Christine Cedraschi, Carol Cancelliere\",\"doi\":\"10.1186/s12998-024-00538-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking.</p><p><strong>Objectives: </strong>To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population.</p><p><strong>Methods: </strong>Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach.</p><p><strong>Results: </strong>We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1-2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified.</p><p><strong>Conclusions: </strong>Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed.</p><p><strong>Trial registration: </strong>CRD42019135009 (PROSPERO).</p>\",\"PeriodicalId\":48572,\"journal\":{\"name\":\"Chiropractic & Manual Therapies\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080233/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chiropractic & Manual Therapies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12998-024-00538-z\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chiropractic & Manual Therapies","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12998-024-00538-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
Rehabilitation of back pain in the pediatric population: a mixed studies systematic review.
Background: A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking.
Objectives: To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population.
Methods: Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach.
Results: We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1-2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified.
Conclusions: Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed.
期刊介绍：
Chiropractic & Manual Therapies publishes manuscripts on all aspects of evidence-based information that is clinically relevant to chiropractors, manual therapists and related health care professionals.
Chiropractic & Manual Therapies is an open access journal that aims to provide chiropractors, manual therapists and related health professionals with clinically relevant, evidence-based information. Chiropractic and other manual therapies share a relatively broad diagnostic practice and treatment scope, emphasizing the structure and function of the body''s musculoskeletal framework (especially the spine). The practices of chiropractic and manual therapies are closely associated with treatments including manipulation, which is a key intervention. The range of services provided can also include massage, mobilisation, physical therapies, dry needling, lifestyle and dietary counselling, plus a variety of other associated therapeutic and rehabilitation approaches.
Chiropractic & Manual Therapies continues to serve as a critical resource in this field, and as an open access publication, is more readily available to practitioners, researchers and clinicians worldwide.
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