Table 3.
GRADE evidence profile of the effect of aquatic physical therapy on chronic low back pain
| Certainty assessment | number of patients | Effect | Certainty | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | APT | No APT | Absolute (95% CI) | |
| VAS | ||||||||||
| 9 | Randomized trials | serious1 | not serious2 | not serious3 | serious4 | none5 | 163 | 163 | SMD:-0.68 (-0.91, -0.46) | ⊕ ⊕ ◯◯ Low |
| VAS at rest | ||||||||||
| 2 | Randomized trials | serious1 | serious6 | not serious3 | serious4 | none5 | 65 | 66 | SMD: -0.60 (-1.42, 0.23) | ⊕ ◯◯◯ Very Low |
| physical components of SF-36 or SF-12 | ||||||||||
| 4 | Randomized trials | serious1 | not serious7 | not serious3 | serious4 | none5 | 113 | 113 | SMD: 0.63 (0.36, 0.90) | ⊕ ⊕ ◯◯ Low |
| mental components of SF-36 or SF-12 | ||||||||||
| 4 | Randomized trials | serious1 | serious8 | not serious3 | serious4 | none5 | 113 | 113 | SMD: 0.59 (0.10, 1.08) | ⊕ ◯◯◯ Very Low |
| RMDQ | ||||||||||
| 4 | Randomized trials | serious1 | not serious9 | not serious3 | serious4 | none5 | 131 | 131 | SMD: -0.42 (-0.66, -0.17) | ⊕ ⊕ ◯◯ Low |
| ODI or ODQ | ||||||||||
| 7 | Randomized trials | serious1 | serious10 | not serious3 | serious4 | none5 | 151 | 153 | SMD: -0.54 (-1.07, -0.01) | ⊕ ◯◯◯ Very Low |
VAS Visual Analogue Scale, SF-36 Quality Short-Form 36 Health Survey, SF-12 Short-Form 12, RMDQ Roland-Morris Disability Questionnaire, ODI Oswestry Disability Index, ODQ Oswestry Low Back Pain Disability Questionnaire
1We downgraded the quality of the evidence for risk of bias by one level. All included studies were at high or unclear risk of bias
2We did not downgrade for inconsistency, I2 = 41% and χ2 = 13.62, P = 0.09
3Although the studies included different types of interventions, we did not downgrade for indirectness
4We downgraded the quality of the evidence by one level because the population size was less than 400 people
5We did not downgrade publication bias, although we could not reliably assess this category due to the small number of eligible studies
6We did downgrade for inconsistency, I2 = 82% and χ2 = 5.47, P = 0.02
7We did not downgrade for inconsistency, I2 = 9% and χ2 = 3.29, P = 0.35
8We did downgrade for inconsistency, I2 = 69% and χ2 = 9.77, P = 0.02
9We did not downgrade for inconsistency, I2 = 0% and χ2 = 2.93, P = 0.40
10We did downgrade for inconsistency, I2 = 79% and χ2 = 29.00, P < 0.0001