Riley Sean P, Swanson Brian T, Dyer Elizabeth
Doctor of Physical Therapy Program, Sacred Heart University, Fairfield, CT, USA.
Library Services, University of New England, Portland, ME, USA.
J Man Manip Ther. 2019 Feb;27(1):5-14. doi: 10.1080/10669817.2018.1532693. Epub 2018 Oct 17.
: The purpose of this systematic review was to determine if movement-based classification (MBC) systems are more effective than therapeutic exercise or guideline-based care (GBC) in improving outcomes in patients with low back pain (LBP) based upon randomized clinical trials (RCT) with moderate to high methodological quality and low to moderate risk of bias. : The search strategy was developed by a librarian experienced in systematic review methodology and peer reviewed by a second research librarian. The following databases were searched from their inception to May 17, 2018: PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform. The identified RCTs with a PEDro score of ≥6 were screened and assessed for risk of bias by two blinded individual reviewers using Covidence. : Seven studies were identified that had moderate-to-high methodological quality. One of the studies was identified as having a high risk of bias. Of the six studies that remained, only one study reported finding a statistically significant difference at the immediate follow-up that was not clinically significant. There was no significance at 6 and 12 months. : There is a paucity of moderate to high methodological quality RCTs with similar methodology that compare MBC to standard of care treatments for patients with LBP. Studies with moderate to high methodological quality that have a low risk of bias do not support MBCs as being superior to general exercise or GBC in the treatment of nonradicular LBP. : 1a.
本系统评价的目的是，基于方法学质量为中到高且偏倚风险为低到中度的随机临床试验（RCT），确定基于运动的分类（MBC）系统在改善腰痛（LBP）患者的预后方面是否比治疗性运动或基于指南的护理（GBC）更有效。
检索策略由一位具有系统评价方法经验的图书馆员制定，并由另一位研究图书馆员进行同行评审。检索了以下数据库，从其创建到2018年5月17日：PubMed、Embase、Cochrane对照试验中央注册库、ClinicalTrials.gov和世界卫生组织国际临床试验注册平台。两名独立的盲法评审员使用Covidence对已识别的PEDro评分为≥6的RCT进行筛选和偏倚风险评估。
共识别出7项方法学质量为中到高的研究。其中1项研究被确定为具有高偏倚风险。在其余6项研究中，只有1项研究报告在即时随访时发现有统计学显著差异，但无临床意义。在6个月和12个月时无显著性差异。
缺乏方法学质量为中到高且采用类似方法将MBC与LBP患者的标准护理治疗进行比较的RCT。方法学质量为中到高且偏倚风险低的研究不支持MBC在治疗非根性LBP方面优于一般运动或GBC。
1a。
