Leonardo Piano, Paolo Audasso, Lorenzo Benzi, Adele Occhionero, Marco Trucco, Tiziano Innocenti, Raymond Ostelo, Alessandro Chiarotto
{"title":"慢性腰痛患者的个体教育:与非教育干预相比,可能对长期残疾有临床相关影响。荟萃分析的系统评价。","authors":"Leonardo Piano, Paolo Audasso, Lorenzo Benzi, Adele Occhionero, Marco Trucco, Tiziano Innocenti, Raymond Ostelo, Alessandro Chiarotto","doi":"10.2519/jospt.2025.12794","DOIUrl":null,"url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To assess the effectiveness of individual education for patients with chronic low back pain (CLBP), compared to no intervention, placebo, noneducational interventions, or other type of education. <b>DESIGN:</b> Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). <b>LITERATURE SEARCH:</b> PubMed, CINAHL, PEDro, Embase, and Scopus (up to January 14, 2024); citation tracking in Web of Science, grey literature and reference lists of previous systematic reviews. <b>STUDY SELECTION CRITERIA:</b> We included RCTs that evaluated individual patient education interventions for adults with CLBP. <b>DATA SYNTHESIS:</b> Random-effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of Bias 2.0, and applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the certainty of evidence. <b>RESULTS:</b> We included 17 RCTs (n = 1893). There was moderate-certainty evidence that individual patient education had a clinically relevant effect compared to noneducational interventions on long-term disability (standardized mean difference, -0.23; 95% confidence interval [CI]: -1.13, 0.66). There was moderate-certainty evidence that individual patient education had no effect on short-term health-related quality of life compared to no intervention (mean difference, -0.003; 95% CI: -0.04, 0.04), and no effect on medium-term disability (SMD, 0.10; 95% CI: -0.37, 0.57) and long-term pain intensity (mean difference, -2.20; 95% CI: -14.43, 10.03) compared to noneducational interventions. <b>CONCLUSION:</b> Individual patient education provided a clinically relevant effect on long-term disability when compared to noneducational interventions. There were no other clinically relevant effects of individual patient education for CLBP. <i>J Orthop Sports Phys Ther 2025;55(5):1-13. Epub 20 March 2025. doi:10.2519/jospt.2025.12794</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 5","pages":"331-343"},"PeriodicalIF":6.0000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Individual Education for Patients With Chronic Low Back Pain: Likely a Clinically Relevant Effect for Long-term Disability Compared to Noneducational Interventions. A Systematic Review With Meta-Analysis.\",\"authors\":\"Leonardo Piano, Paolo Audasso, Lorenzo Benzi, Adele Occhionero, Marco Trucco, Tiziano Innocenti, Raymond Ostelo, Alessandro Chiarotto\",\"doi\":\"10.2519/jospt.2025.12794\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>OBJECTIVE:</b> To assess the effectiveness of individual education for patients with chronic low back pain (CLBP), compared to no intervention, placebo, noneducational interventions, or other type of education. <b>DESIGN:</b> Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). <b>LITERATURE SEARCH:</b> PubMed, CINAHL, PEDro, Embase, and Scopus (up to January 14, 2024); citation tracking in Web of Science, grey literature and reference lists of previous systematic reviews. <b>STUDY SELECTION CRITERIA:</b> We included RCTs that evaluated individual patient education interventions for adults with CLBP. <b>DATA SYNTHESIS:</b> Random-effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of Bias 2.0, and applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the certainty of evidence. <b>RESULTS:</b> We included 17 RCTs (n = 1893). There was moderate-certainty evidence that individual patient education had a clinically relevant effect compared to noneducational interventions on long-term disability (standardized mean difference, -0.23; 95% confidence interval [CI]: -1.13, 0.66). There was moderate-certainty evidence that individual patient education had no effect on short-term health-related quality of life compared to no intervention (mean difference, -0.003; 95% CI: -0.04, 0.04), and no effect on medium-term disability (SMD, 0.10; 95% CI: -0.37, 0.57) and long-term pain intensity (mean difference, -2.20; 95% CI: -14.43, 10.03) compared to noneducational interventions. <b>CONCLUSION:</b> Individual patient education provided a clinically relevant effect on long-term disability when compared to noneducational interventions. There were no other clinically relevant effects of individual patient education for CLBP. <i>J Orthop Sports Phys Ther 2025;55(5):1-13. Epub 20 March 2025. doi:10.2519/jospt.2025.12794</i>.</p>\",\"PeriodicalId\":50099,\"journal\":{\"name\":\"Journal of Orthopaedic & Sports Physical Therapy\",\"volume\":\"55 5\",\"pages\":\"331-343\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic & Sports Physical Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2519/jospt.2025.12794\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic & Sports Physical Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2519/jospt.2025.12794","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的:与不干预、安慰剂、非教育干预或其他类型的教育相比,评估个体教育对慢性腰痛(CLBP)患者的有效性。设计:随机对照试验(RCTs)荟萃分析的干预系统评价。文献检索:PubMed, CINAHL, PEDro, Embase和Scopus(截止到2024年1月14日);Web of Science的引文跟踪、灰色文献和以往系统综述的参考文献列表。研究选择标准:我们纳入了评估成人CLBP患者个体教育干预措施的随机对照试验。数据综合:临床均质随机对照试验的随机效应荟萃分析。我们使用Cochrane risk of bias 2.0评估偏倚风险,并采用GRADE (Grading of Recommendations Assessment, Development and Evaluation)方法评估证据的确定性。结果:我们纳入17项随机对照试验(n = 1893)。有中等确定性的证据表明,与非教育干预相比,患者个体教育对长期残疾有临床相关的影响(标准化平均差异,-0.23;95%置信区间[CI]: -1.13, 0.66)。有中等确定性的证据表明,与不进行干预相比,患者个人教育对短期健康相关生活质量没有影响(平均差异为-0.003;95% CI: -0.04, 0.04),对中期残疾无影响(SMD, 0.10;95% CI: -0.37, 0.57)和长期疼痛强度(平均差值-2.20;95% CI: -14.43, 10.03)。结论:与非教育干预相比,患者个体教育对长期残疾有临床相关的影响。对患者进行CLBP个体化教育没有其他临床相关效果。[J] .中华体育杂志,2015;55(5):1-13。2025年3月20日。doi: 10.2519 / jospt.2025.12794。
Individual Education for Patients With Chronic Low Back Pain: Likely a Clinically Relevant Effect for Long-term Disability Compared to Noneducational Interventions. A Systematic Review With Meta-Analysis.
OBJECTIVE: To assess the effectiveness of individual education for patients with chronic low back pain (CLBP), compared to no intervention, placebo, noneducational interventions, or other type of education. DESIGN: Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). LITERATURE SEARCH: PubMed, CINAHL, PEDro, Embase, and Scopus (up to January 14, 2024); citation tracking in Web of Science, grey literature and reference lists of previous systematic reviews. STUDY SELECTION CRITERIA: We included RCTs that evaluated individual patient education interventions for adults with CLBP. DATA SYNTHESIS: Random-effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of Bias 2.0, and applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the certainty of evidence. RESULTS: We included 17 RCTs (n = 1893). There was moderate-certainty evidence that individual patient education had a clinically relevant effect compared to noneducational interventions on long-term disability (standardized mean difference, -0.23; 95% confidence interval [CI]: -1.13, 0.66). There was moderate-certainty evidence that individual patient education had no effect on short-term health-related quality of life compared to no intervention (mean difference, -0.003; 95% CI: -0.04, 0.04), and no effect on medium-term disability (SMD, 0.10; 95% CI: -0.37, 0.57) and long-term pain intensity (mean difference, -2.20; 95% CI: -14.43, 10.03) compared to noneducational interventions. CONCLUSION: Individual patient education provided a clinically relevant effect on long-term disability when compared to noneducational interventions. There were no other clinically relevant effects of individual patient education for CLBP. J Orthop Sports Phys Ther 2025;55(5):1-13. Epub 20 March 2025. doi:10.2519/jospt.2025.12794.
期刊介绍:
The Journal of Orthopaedic & Sports Physical Therapy® (JOSPT®) publishes scientifically rigorous, clinically relevant content for physical therapists and others in the health care community to advance musculoskeletal and sports-related practice globally. To this end, JOSPT features the latest evidence-based research and clinical cases in musculoskeletal health, injury, and rehabilitation, including physical therapy, orthopaedics, sports medicine, and biomechanics.
With an impact factor of 3.090, JOSPT is among the highest ranked physical therapy journals in Clarivate Analytics''s Journal Citation Reports, Science Edition (2017). JOSPT stands eighth of 65 journals in the category of rehabilitation, twelfth of 77 journals in orthopedics, and fourteenth of 81 journals in sport sciences. JOSPT''s 5-year impact factor is 4.061.