针对低收入和中等收入国家慢性非特异性下腰痛成年患者的物理治疗自我管理计划的有效性：系统评价与荟萃分析方案

Effectiveness of a physiotherapy self-management programme for adult patients with chronic non-specific low back pain in low- and middle-income countries: protocol for a systematic review and meta-analysis.

作者信息

Motha Sergant Given, Naidoo Niri, Moyo-Chilufya Maureen, Musekiwa Alfred, Kgarosi Kabelo, Mostert Karien

机构信息

Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng, South Africa

Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Rondebosch, Western Cape, South Africa.

出版信息

BMJ Open. 2024 Jul 31;14(7):e073916. doi: 10.1136/bmjopen-2023-073916.

DOI:10.1136/bmjopen-2023-073916

PMID:39089717

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11293417/

Abstract

INTRODUCTION

Chronic non-specific low back pain (CNLBP) is among the most common musculoskeletal system conditions reported worldwide; however, few studies are available from low- and middle-income countries (LMICs). Self-management is a set of tasks performed by the patient aiming at managing their symptoms and interference in activities, mood and relationships due to pain. A physiotherapy-guided self-management programme (SMP) following a biopsychosocial approach has been reported as effective and affordable in the management of CNLBP in high-income countries. The objective of this systematic review is to determine the overall effectiveness of SMPs for adults with CNLBP in LMICs.

METHODS AND ANALYSIS

In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocol (PRISMA-P) guidelines will be followed. A three-step search strategy will be used to search the electronic databases (PubMed, MEDLINE, SPORTDiscus, Scopus and CINAHL, Academic Search Complete and PEDro) for randomised controlled trials assessing the effectiveness of physiotherapy-guided self-management for CNLBP among adult participants in LMICs. The processes of screening search results for eligible studies, extracting data from included studies and appraising will be done independently by at least two review authors. Random effects meta-analysis will be used to synthesise results and heterogeneity will be assessed using the I test statistic and χ test.

ETHICS AND DISSEMINATION

Ethics clearance was obtained for the broader PhD study on the development of a physiotherapy-guided SMP for adult people with CNLBP in Limpopo Province, South Africa. The results of the manuscript for this protocol will be published in peer-reviewed journals and also presented at conferences, symposia, and congresses.

PROSPERO REGISTRATION NUMBER

CRD42023399572.

摘要

引言

慢性非特异性下腰痛（CNLBP）是全球报告的最常见的肌肉骨骼系统疾病之一；然而，低收入和中等收入国家（LMICs）的相关研究较少。自我管理是患者为管理其症状以及疼痛对活动、情绪和人际关系的干扰而执行的一系列任务。据报道，在高收入国家，采用生物心理社会方法的物理治疗指导的自我管理计划（SMP）在CNLBP的管理中有效且经济实惠。本系统评价的目的是确定SMPs对LMICs中患有CNLBP的成年人的总体有效性。

方法与分析

在本系统评价中，将遵循系统评价和Meta分析的首选报告项目-方案（PRISMA-P）指南。将使用三步搜索策略在电子数据库（PubMed、MEDLINE、SPORTDiscus、Scopus和CINAHL、学术搜索完整版和PEDro）中搜索随机对照试验，以评估物理治疗指导的自我管理对LMICs成年参与者中CNLBP的有效性。筛选合格研究的搜索结果、从纳入研究中提取数据以及进行评估的过程将由至少两名综述作者独立完成。将使用随机效应Meta分析来综合结果，并使用I检验统计量和χ检验来评估异质性。