Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada.
Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada.
Chiropr Man Therap. 2024 May 8;32(1):14. doi: 10.1186/s12998-024-00538-z.
A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking.
To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population.
Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach.
We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1-2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified.
Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed.
CRD42019135009 (PROSPERO).
相当一部分儿童和青少年经历过背痛。然而，缺乏对康复干预措施有效性的全面系统评价。
评估针对儿童非特异性下腰痛（LBP）或胸脊柱疼痛的康复干预措施的益处和危害。
从建库至 2023 年 6 月 16 日，我们检索了 7 个电子文献数据库。此外，还检索了相关研究和系统评价的参考文献列表、3 个目标网站以及世卫组织国际临床试验注册平台。配对审查员独立进行筛选、评估偏倚风险，并提取与研究特征、方法、对象和结果相关的数据。根据 GRADE 方法评估证据确定性。
我们筛选了 8461 条引文和 307 篇全文文章。纳入了 10 项定量研究（即 8 项随机对照试验、2 项非随机临床试验）和 1 项定性研究。基于非常低到中等确定性证据，在患有 LBP 的青少年中，与单独运动相比，每周 1-2 次脊柱推拿（12 周）加运动可能更有可能使疼痛明显减轻；而 8 周的团体运动（2 项 RCT 和 1 项非随机试验）可能会减轻疼痛强度。定性研究发现，提供的教育/建议信息和治疗的依从性与有效治疗有关。未发现经济学研究或针对胸脊柱疼痛的研究。
脊柱推拿和团体运动可能有益于减轻青少年的 LBP 强度。教育应作为护理方案的一部分提供。总体证据稀少。需要进行方法学严谨的研究。
CRD42019135009（PROSPERO）。
