Summary of findings 3. McKenzie therapy compared with other interventions for (sub)acute low back pain.
| McKenzie therapy compared with other interventions for acute and subacute low back pain | |||||
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Patient or population: patients with non‐specific acute and subacute low back pain Settings: primary care Intervention: McKenzie therapy Comparison: back massage and standard back care advice | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | No of participants (trials) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | ||||
| Non‐specific back massage and standard back care advice | McKenzie therapy | ||||
| Pain intensity: short‐term (closest to 2 weeks) | See comment | See comment | ‐ | ‐ | None of the included trials measured pain at short‐term follow‐up. |
| Pain intensity: intermediate‐term (closest to 3 months) | See comment | See comment | ‐ | ‐ | None of the included trials measured pain at intermediate‐term follow‐up. |
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Disability: short‐term (closest to 2 weeks) ODI (scale from 0‐100, 0 is no disability) |
The mean disability in the control group was 34.00 pointsa | The mean disability in the intervention group was 4.00 points worse (15.44 points better to 23.44 worse) | 30 participants (1 trial) |
⊕⊝⊝⊝ Verylowb,c | The evidence is very uncertain about the effect of McKenzie on disability at short‐term. |
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Disability: intermediate‐term (closest to 3 months) ODI (scale from 0‐100, 0 is no disability) |
The mean disability in the control group was 20.00 pointsa | The mean disability in the intervention group was 10.00 points worse (8.95 points better to 28.95 worse) | 25 participants (1 trial) |
⊕⊝⊝⊝ Verylowb,c | The evidence is very uncertain about the effect of McKenzie on disability at intermediate‐term. |
| Adverse events | See comment | See comment | ‐ | ‐ | None of the included trials measured adverse events. |
| *The basis for the assumed risk is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; ODI: Oswestry Disability Index. | |||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | |||||
aMean value in other interventions group (back massage and standard back care advice) at short‐ and intermediate‐term follow‐up from Gillan 1998. bDowngraded by two levels due to risk of bias (lack of allocation concealment, lack of blinding of outcome assessment, incomplete outcome data, and lack of intention‐to‐treat analysis). cDowngraded by one level due to imprecision (wide 95% CI, including the possibility of a small or no effect and important benefit).