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. 2020 Apr 16;2020(4):CD013581. doi: 10.1002/14651858.CD013581

Szpalski 1990.

Methods RCT; use of randomisation table
Follow‐up time: 14 days (clinical assessment at days 0 and 14)
Participants Population: 110 participants, 51 women, 59 men. Mean age (SD): 40.2 (13.7) years
Setting: an outpatient department (October 1988 to March 1999), conducted in Belgium
Inclusion criteria: acute LBP, pain present < 2 weeks, asymptomatic period of at least 4 months
Exclusion criteria: LBP related to industrial accident covered by insurance, specific (spinal) pathology, such as disc protrusion or spinal trauma
Interventions NSAID (i): tenoxicam 20 mg, 1 tablet daily (14 days), and bedrest (7 days strict, 7 days intermittent; (N = 49)
 Reference treatment (ii): bedrest, (7 days strict, 7 days intermittent; (N = 50)
Outcomes Mean % improvement (SD) between baseline and 14 days in ROM (i) 123 (24), (ii) 114 (23); significant (P < 0.05)
After 14 days of treatment: 86% (i) versus 70% (ii) no need for further treatment
Adverse events: (i) 2 participants (2 withdrew)
Funding Not mentioned
Notes Physical examination only outcome. Outcome presented as percentages, baseline values not presented.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk A randomisation table was used
Allocation concealment (selection bias) High risk Not possible by study design; no placebo control
Blinding of participants and personnel (performance bias) 
 All outcomes ‐ participants High risk Not blinded
Blinding of participants and personnel (performance bias) 
 All outcomes ‐ careproviders High risk Not blinded
Blinding of outcome assessment (detection bias) 
 All outcomes ‐ outcome assessors High risk Not blinded
Incomplete outcome data (attrition bias) 
 All outcomes ‐ dropouts Low risk Low dropout rate: 10% (11/110)
Incomplete outcome data (attrition bias) 
 All outcomes ‐ ITT analysis Unclear risk Not mentioned
Selective reporting (reporting bias) Unclear risk No study protocol
Similarity at baseline characteristics Unclear risk Baseline characteristics similar, but only age and sex mentioned, no other baseline values presented.
Co‐interventions avoided or similar Unclear risk Not mentioned
Compliance acceptable Unclear risk Not mentioned
Timing outcome assessments similar Low risk Timing similar
Other bias Low risk None