Table 2.
General characteristics of all included studies
| Characteristics | Primary outcomes | Secondary outcomes | |||||
|---|---|---|---|---|---|---|---|
| Physical function (n=80) |
Pain intensity (n=86) |
Fear avoidance (n=37) |
HR-QoL (n=45) |
Intervention compliance (n=29) | Safety* (n=21) | ||
| Publication characteristics | |||||||
| Total number of unique studies included | 80 | 86 | 37 | 44 | 30 | 20 | |
| Publication year: | |||||||
| 1981-91 | 1 | 4 | 0 | 3 | 1 | 0 | |
| 1991-2001 | 11 | 10 | 1 | 5 | 3 | 0 | |
| 2001-11 | 26 | 24 | 11 | 10 | 7 | 7 | |
| 2011-21 | 42 | 48 | 25 | 26 | 20 | 13 | |
| Funding: | |||||||
| None | 36 | 42 | 17 | 17 | 17 | 7 | |
| Non-commercial | 41 | 37 | 18 | 25 | 10 | 12 | |
| Commercial | 2 | 4 | 2 | 0 | 2 | 1 | |
| Unclear | 1 | 1 | 0 | 2 | 1 | 0 | |
| Study design characteristics | |||||||
| Range of study sample size | 24-701 | 24-701 | 41-701 | 36-701 | 36-580 | 27-701 | |
| No of intervention arms included: | |||||||
| 2 | 70 | 68 | 33 | 36 | 24 | 19 | |
| 3 | 10 | 13 | 4 | 5 | 5 | 1 | |
| 4 | 0 | 4 | 0 | 3 | 1 | 0 | |
| 5 | 0 | 0 | 0 | 0 | 0 | 0 | |
| 6 | 0 | 1 | 0 | 0 | 0 | 0 | |
| No of studies containing the following treatment nodes: | |||||||
| Behavioural therapy | 5 | 11 | 2 | 6 | 4 | 1 | |
| Cognitive behavioural therapy | 11 | 15 | 5 | 7 | 4 | 4 | |
| Mindfulness | 2 | 3 | 1 | 2 | 0 | 1 | |
| Counselling | 2 | 2 | 2 | 1 | 0 | 0 | |
| Pain education | 9 | 6 | 4 | 6 | 3 | 2 | |
| Combined psychological approaches | 16 | 16 | 8 | 7 | 6 | 3 | |
| Behavioural therapy + physiotherapy care | 2 | 4 | 2 | 2 | 1 | 0 | |
| Cognitive behavioural therapy + physiotherapy care | 17 | 16 | 7 | 6 | 6 | 3 | |
| Mindfulness + physiotherapy care | 3 | 5 | 0 | 5 | 0 | 2 | |
| Counselling + physiotherapy care | 2 | 1 | 0 | 1 | 1 | 2 | |
| Pain education + physiotherapy care | 12 | 14 | 6 | 7 | 7 | 6 | |
| Combined psychological approaches + physiotherapy care | 16 | 13 | 11 | 8 | 9 | 2 | |
| Physiotherapy care | 27 | 33 | 16 | 18 | 18 | 10 | |
| General practitioner care | 5 | 6 | 1 | 3 | 2 | 0 | |
| Advice | 5 | 5 | 3 | 1 | 0 | 1 | |
| No intervention | 9 | 14 | 5 | 8 | 3 | 3 | |
| Usual care | 7 | 7 | 2 | 6 | 0 | 1 | |
| Other† | 2 | 3 | 1 | 1 | 0 | 0 | |
| Studies with durations of follow-up: | |||||||
| Post-intervention | 64 | 72 | 35 | 34 | 27 | 18 | |
| Short term | 28 | 34 | 15 | 20 | 13 | 11 | |
| Mid-term | 41 | 44 | 17 | 25 | 12 | 11 | |
| Long term | 16 | 16 | 6 | 11 | 3 | 1 | |
| Continent: | |||||||
| Africa | 1 | 1 | 1 | 0 | 1 | 0 | |
| Antarctica | 0 | 0 | 0 | 0 | 0 | 0 | |
| Asia | 10 | 13 | 5 | 6 | 7 | 3 | |
| Australia | 7 | 6 | 4 | 3 | 5 | 2 | |
| Europe | 41 | 40 | 17 | 22 | 7 | 10 | |
| North America | 18 | 23 | 8 | 12 | 8 | 3 | |
| South America | 3 | 3 | 2 | 1 | 2 | 2 | |
| Patient characteristics | |||||||
| Range of mean age (years); No of studies | 28.3-77.2; 76 | 35.4-77.2; 83 | 28.3-74.5; 36 | 35.4-77.2; 43 | 28.3-62.4; 30 | 39.0-74.5; 19 | |
| Range of males (%); No of studies | 0-88; 76 | 8-100; 83 | 0-88; 36 | 8-69; 43 | 0-100; 30 | 20-58; 19 | |
| Range of mean body mass index; No of studies | 23.5-31.2; 21 | 23.5-31.2; 18 | 24.4-31.1; 11 | 23.5-31.2; 10 | 24.1-27.3; 9 | 24.05-30.0; 7 | |
HR-QoL=health related quality of life.
*
Only studies providing clear information about adverse effects occurring during the intervention period have been presented.
†
For physical function, two studies compared cognitive behavioural therapy delivered with physiotherapy care to lumbar fusion. For pain intensity, two studies compared cognitive behavioural therapy delivered with physiotherapy care to lumbar fusion, and another study compared behavioural therapy with three intervention arms involving variations of hypnosis therapy. For fear avoidance, one study compared cognitive behavioural therapy delivered with physiotherapy care, with lumbar fusion.