TY - JOUR
T1 - Individual Patient Education for Managing Acute and/or Subacute Low Back Pain
T2 - Little Additional Benefit for Pain and Function Compared to Placebo. A Systematic Review With Meta-analysis of Randomized Controlled Trials
AU - Piano, Leonardo
AU - Ritorto, Valentina
AU - Vigna, Irene
AU - Trucco, Marco
AU - Lee, Hopin
AU - Chiarotto, Alessandro
N1 - Publisher Copyright:
Copyright © 2022 JOSPT®, Inc
PY - 2022/7
Y1 - 2022/7
N2 - OBJECTIVE: To evaluate the effects of individual patient education for managing acute and/or subacute low back pain (LBP), compared to no intervention/placebo education, non-educational interventions, or other type of education.DESIGN: Systematic review with meta-analysis of randomised trials.LITERATURE SEARCH: PubMed, CINAHL, PEDro, Embase, Scopus and CENTRAL (up to 30 September 2020); reference lists of previous systematic reviews.STUDY SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating individual education for patients with acute and/or subacute LBP.DATA SYNTHESIS: Random effects meta-analysis for clinically homogeneous RCTs. Certainty of evidence was assessed using the GRADE approach.RESULTS: We included 13 RCTs. There was moderate certainty of evidence that individual patient education was more effective than placebo education for pain at medium term (MD=-0.79; 95%CI =-1.52 to -0.07), and physical function at short- (SMD=-0.25; 95%CI =-0.47 to -0.02) and medium term (SMD=-0.26; 95%CI =-0.48 to -0.04), but with no clinically relevant effects. There was low-to-moderate certainty of evidence that individual patient education was superior to non-educational interventions on short-term quality of life (MD -12,00, 95%CI -20.05 to -3.95) and medium-term sick leave (OR 0.32, 95%CI 0.11 to 0.88). We found no clinically relevant between-group effects for any other comparison (low-to-high certainty of evidence) at any follow up.CONCLUSION: One or two hours of individual patient education probably makes little to no difference in pain and functional outcomes compared with placebo for patients with acute/subacute LBP. Considering its effects on other outcomes (e.g. reassurance) and patients' desire for information about their condition, it is reasonable to retain patient education as part of a first-line approach when managing acute and subacute LBP.
AB - OBJECTIVE: To evaluate the effects of individual patient education for managing acute and/or subacute low back pain (LBP), compared to no intervention/placebo education, non-educational interventions, or other type of education.DESIGN: Systematic review with meta-analysis of randomised trials.LITERATURE SEARCH: PubMed, CINAHL, PEDro, Embase, Scopus and CENTRAL (up to 30 September 2020); reference lists of previous systematic reviews.STUDY SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating individual education for patients with acute and/or subacute LBP.DATA SYNTHESIS: Random effects meta-analysis for clinically homogeneous RCTs. Certainty of evidence was assessed using the GRADE approach.RESULTS: We included 13 RCTs. There was moderate certainty of evidence that individual patient education was more effective than placebo education for pain at medium term (MD=-0.79; 95%CI =-1.52 to -0.07), and physical function at short- (SMD=-0.25; 95%CI =-0.47 to -0.02) and medium term (SMD=-0.26; 95%CI =-0.48 to -0.04), but with no clinically relevant effects. There was low-to-moderate certainty of evidence that individual patient education was superior to non-educational interventions on short-term quality of life (MD -12,00, 95%CI -20.05 to -3.95) and medium-term sick leave (OR 0.32, 95%CI 0.11 to 0.88). We found no clinically relevant between-group effects for any other comparison (low-to-high certainty of evidence) at any follow up.CONCLUSION: One or two hours of individual patient education probably makes little to no difference in pain and functional outcomes compared with placebo for patients with acute/subacute LBP. Considering its effects on other outcomes (e.g. reassurance) and patients' desire for information about their condition, it is reasonable to retain patient education as part of a first-line approach when managing acute and subacute LBP.
KW - low back/lumbar spine
KW - pain
KW - systematic review/meta-analysis
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U2 - 10.2519/jospt.2022.10698
DO - 10.2519/jospt.2022.10698
M3 - Review article
C2 - 35584025
SN - 0190-6011
VL - 52
SP - 432
EP - 445
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 7
ER -