低剂量门诊生物心理社会干预与积极的身体干预对非特异性慢性下腰痛成人疼痛和残疾的效果比较：系统评价和荟萃分析方案。

The effectiveness of low-dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: A protocol for a systematic review with meta-analysis.

机构信息

Institute of Epidemiology, Social Medicine and Health System Research, Medizinische Hochschule Hannover (MHH), Hannover, Germany.

Generali Health Solutions GmbH (GHS), Köln, Germany.

出版信息

PLoS One. 2022 Sep 1;17(9):e0273983. doi: 10.1371/journal.pone.0273983. eCollection 2022.

DOI:10.1371/journal.pone.0273983

PMID:36048791

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9436074/

Abstract

BACKGROUND

Best outpatient treatment of nonspecific chronic low back pain is high-dosed exercise that is maintained after therapy. Primary care biopsychosocial intervention (PCBI) is an outpatient multicomponent intervention that includes an active component (exercise, physical activity, or physiotherapy) and at least one psychological, social, or occupational component. Research has shown that PCBI can reduce pain intensity and disability. While scattered studies support low-dosed (<15 treatment hours) PCBI, there is no systematic review comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP).

INCLUSION CRITERIA

Randomised controlled trials that evaluate low-dosed outpatient biopsychosocial interventions compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older) who suffer from nonspecific CLBP will be included.

METHODS

A comprehensive search of multiple databases will be used to find relevant studies. The databases will be searched from inception to December 2021, with English or German language restrictions imposed. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" will be used. Sources will include CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science.

DISCUSSION

To our knowledge, this will be the first systematic review and meta-analysis of narrowly defined low- dosed PCBI across populations with nonspecific chronic low back pain. The objective of this review is to evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus physical active interventions on pain intensity and disability in adults with CLBP. This study will provide evidence that could improve treatment options for patients with nonspecific CLBP.

TRAIL REGISTRATION

Systematic review registration number: PROSPERO 2022 CRD42022302771. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022302771.

摘要

背景

非特异性慢性下腰痛的最佳门诊治疗是维持治疗后的高剂量运动。初级保健生物心理社会干预（PCBI）是一种门诊多组分干预措施，包括一个主动成分（运动、身体活动或物理治疗）和至少一个心理、社会或职业成分。研究表明，PCBI 可以减轻疼痛强度和残疾。虽然分散的研究支持低剂量（<15 个治疗小时）PCBI，但没有系统评价比较低剂量 PCBI 治疗与非特异性慢性下腰痛（CLBP）成人的传统身体活动干预的有效性。

纳入标准

将纳入评价低剂量门诊生物心理社会干预与物理治疗（如运动、身体活动或常规物理治疗）的随机对照试验，这些治疗针对患有非特异性 CLBP 的成年参与者（18 岁或以上）。

方法

将使用全面的多数据库搜索来查找相关研究。将从数据库建立之初到 2021 年 12 月进行搜索，并限制使用英语或德语。将使用“慢性背痛”、“运动干预”、“认知行为疗法”、“初级保健”和“随机对照试验”的关键词和派生词。来源将包括 CINAHL、Cochrane 对照试验中心注册库（CENTRAL）、Ovid Medline、物理治疗证据数据库（PEDro）、PubMed 和 Web of Science。