2.
| Motor control exercise compared with manual therapy for chronic low back pain | |||||
|
Patient or population: patients with non‐specific chronic low back pain Settings: primary or tertiary care Intervention: motor control exercise Comparison: manual therapy | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | ||||
| Manual therapy | Motor control exercise | ||||
|
Pain VAS (0 to 100) Short‐term follow‐up (< 3 months from randomisation) |
The mean pain ranged across control groups from 27.2 to 41 points |
The mean pain in the intervention groups was
4.36 points lower (9.52 lower to 0.81 higher) |
282 participants (3 studies) | ⊕⊕⊕⊝ moderate1 | — |
|
Pain VAS (0 to 100) Intermediate follow‐up (> 3 months and < 12 months) |
The mean pain ranged across control groups from 26.7 to 43 points |
The mean pain in the intervention groups was
7.05 points lower (14.20 lower to 0.11 higher) |
485 participants (4 studies) | ⊕⊕⊕⊝ moderate2 | — |
|
Pain VAS (0 to 100) Long‐term follow‐up (> 12 months from randomisation) |
The mean pain ranged across control groups from 26.2 to 49 points |
The mean pain in the intervention groups was
3.67 points lower (9.28 lower to 1.94 higher) |
406 participants (4 studies) | ⊕⊕⊕⊕ high | — |
|
Disability Multiple scales (0 to 100) Short‐term follow‐up (< 3 months from randomisation) |
The mean disability ranged across control groups from 14 to 32.9 points |
The mean disability in the intervention groups was
2.79 points lower (6.60 lower to 1.02 higher) |
282 participants (3 studies) | ⊕⊕⊕⊝ moderate1 | — |
|
Disability Multiple scales (0 to 100) Intermediate follow‐up (> 3 months and < 12 months) |
The mean disability ranged across control groups from 14 to 33.3 points |
The mean disability in the intervention groups was
3.28 points lower (6.97 lower to 0.40 higher) |
485 participants (4 studies) | ⊕⊕⊕⊕ high | — |
|
Disability Multiple scales (0 to 100) Long‐term follow‐up (> 12 months from randomisation) |
The mean disability ranged across control groups from 14.3 to 38.3 points |
The mean disability in the intervention groups was
3.40 points lower (7.87 lower to 1.07 higher) |
406 participants (4 studies) | ⊕⊕⊕⊕ high | — |
| Adverse events | See comment | See comment | — | See comment | None of the included trials reported any relevant adverse events |
| *The basis for the assumed risk (e.g. the median control group risk across studies) 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; VAS: visual analogue scale | |||||
| GRADE Working Group grades of evidence High quality We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: 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 quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | |||||
1Downgraded due to imprecision.
2Downgraded due to inconsistency.