Department of Physical Therapy, University of Valencia, Valencia, Spain; IRIMED Joint Research Unit (La Fe - UV), Valencia, Spain.
Department of Physical Therapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group, Department of Human Physiology (Chropiver), Vrije Universiteit, Brussels, Belgium.
Braz J Phys Ther. 2021 Mar-Apr;25(2):117-134. doi: 10.1016/j.bjpt.2020.07.007. Epub 2020 Aug 4.
To determine the effectiveness of mechanical diagnosis and therapy (MDT) in patients with chronic low back pain (CLBP) compared to other traditional physical therapy interventions.
Randomized controlled trials investigating the effect of MDT compared to other traditional physical therapy interventions in individuals with CLBP were considered eligible. For the purpose of this review, MDT was compared to active and passive physical therapy interventions. Independent reviewers assessed the eligibility of studies, extracted data, and assessed the risk of bias. The primary outcomes investigated were pain and disability.
Fourteen studies were included in the review. Of these, 11 provided data to be included in the meta-analyses. Our findings showed that MDT was no more effective in decreasing pain (standardized mean difference [SMD]=0.01, 95% confidence interval [CI]: -0.44, 0.46) and disability (SMD=0.08, 95% CI: -0.53, 0.68) than other active treatments. Similar results were found when comparing MDT to other passive treatments for pain (SMD=-0.39, 95% CI: -0.90, 0.11) and disability (SMD=-0.13, 95% CI: -0.29, 0.03).
There is low to moderate quality evidence that MDT is not superior than other traditional physical therapy interventions in improving pain and disability in people with CLBP.
比较机械诊断和治疗（MDT）与其他传统物理治疗干预措施在慢性下背痛（CLBP）患者中的疗效。
我们考虑纳入比较 MDT 与其他传统物理治疗干预措施对 CLBP 患者影响的随机对照试验。在本次综述中，MDT 与主动和被动物理治疗干预措施进行了比较。独立评审员评估了研究的合格性、提取数据并评估了偏倚风险。主要结局指标为疼痛和残疾。
共纳入 14 项研究。其中 11 项研究提供了可纳入荟萃分析的数据。我们的研究结果表明，MDT 在减轻疼痛（标准化均数差 [SMD]=0.01，95%置信区间 [CI]：-0.44，0.46）和残疾（SMD=0.08，95%CI：-0.53，0.68）方面并不优于其他主动治疗。将 MDT 与其他被动治疗方法进行比较时，疼痛（SMD=-0.39，95%CI：-0.90，0.11）和残疾（SMD=-0.13，95%CI：-0.29，0.03）也得到了相似的结果。
低至中等质量的证据表明，MDT 在改善 CLBP 患者的疼痛和残疾方面并不优于其他传统物理治疗干预措施。
