Management approach combining prognostic screening and targeted treatment for patients with Low Back Pain compared with standard physiotherapy: a systematic review & meta-analysis

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Collins Ogbeivor, Lina Elsabbagh

King Faisal Specialist Hospital & Research Centre, Saudi Arabia
John Hopkins Aramco Healthcare, Saudi Arabia

: J Spine Neurosurg

Abstract

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Background: Research evidence suggests that a stratified care management approach is better at improving clinical and economic outcomes for low back pain (LBP) patients compared with usual care in the short-term. However, it is uncertain if these health and economic benefits are sustainable in the longer term. Objectives: To determine the effectiveness of stratified care compared with standard physiotherapy for LBP treatment. Methods: A comprehensive search was undertaken of seven electronic databases (CINAHL, MEDLINE, Pedro, EMBASE, PsycINFO, Cochrane Register for Controlled Trials and Web of Science with full text. No time limits were applied, but studies were limited to English language publications and those involving human participants. Two independent reviewers undertook study selection, data extraction and appraisal of study. Results: In total, 6,842 patients (18 years and above) were included in the 8 trials reviewed – 4 were randomised controlled trials (RCTs) and the other 4 were non-RCTs. The pooled analysis of 3 studies (n = 2,460) demonstrated a strong evidence in favour of stratified care over standard care at improving overall pain (WMD [random] 0.46 [95% CI 0.21, 0.71]; P < 0.0003), with overall effect (Z = 3.6) and (RMDQ) scores (WMD [random] 0.71 [95% CI 0.05, 1.37]; P < 0.03), with overall effect (Z = 2.11) at 3, 4- and 6-months follow-up periods. Conclusion: This current review demonstrated that a stratified care approach provides substantial clinical, economic and health related cost benefits in the medium and high-risk subgroups compared with usual care. Further research is needed for longer-term benefits. Recent Publications 1. Ogbeivor C, Elsabbagh L. Management approach combining prognostic screening and targeted treatment for patients with low back pain compared with standard physiotherapy: A systematic review & meta-analysis. Musculoskeletal Care. 2021 Dec;19(4):436-456. doi: 10.1002/msc.1541. Epub 2021 Mar 14. PMID: 33715261. 2. Ogbeivor,P and Ogbeivor C., “Lack of Motivation Among Healthcare Professionals in the National Health Service.” IOSR Journal of Nursing and Health Science (IOSR-JNHS), 10(06), 2021, pp. 45-54. 3. Taiwo J. Oyewumi, Collins Ogbeivor, Imafidon Omorotiomwan & Adebisi I. Hammed, Covid-19 Pandemic: A Physiotherapy Update in University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. IOSR Journal of Sports and Physical Education (IOSR-JSPE) e-ISSN: 2347-6737, p-ISSN: 2347-6745, Volume 8, Issue 6, (Nov. – Dec. 2021), PP 26-28. DOI: 10.9790/6737-08062628

Biography

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