Lou Tianwei, Chen Qiang, Tian Meng
Department of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China.
College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
BMJ Open. 2025 Apr 30;15(4):e096099. doi: 10.1136/bmjopen-2024-096099.
Kinesiophobia is a significant factor which influences the prognosis of patients with chronic non-specific low back pain (CNLBP). The restriction of functional training can severely impede functional recovery and contribute to negative emotional states (including anxiety and depression) and a heightened risk of insomnia while exacerbating the economic burden on patients. Although several randomised controlled trials have evaluated the effects of various non-pharmacological interventions on kinesiophobia in CNLBP, their relative efficacy and potential adverse effects remain ambiguous. This study will conduct a systematic review and network meta-analysis to identify which non-pharmacological intervention may represent the most effective treatment for kinesiophobia in patients with CNLBP.
Comprehensive searches will be conducted across English and Chinese databases (including The Cochrane Library, PubMed, Scopus, Springer, Embase, Wanfang Data, the Chongqing VIP Database and China National Knowledge Infrastructure) from the date of their inception to 20 November 2024. Only Chinese or English studies will be considered for analysis. The primary outcomes will include a significant reduction in secondary movement phobia associated with CNLBP, pain alleviation and enhancement of the functional status of the lumbar muscles. The Cochrane Bias Risk Assessment Tool will be used to conduct a bias risk assessment.Pairwise meta-analysis will be performed by Review Manager V.5.3 software, Stata V.16.0 and Open BUGS V.3.2.3 software will be used to conduct a network meta-analysis. The Grading of Recommendations, Assessment, Development and Evaluation framework will be employed to assess the quality of evidence.
All of the data included in this study will be derived from the literature; therefore, ethical approval is not necessary. The findings will be disseminated via peer-reviewed journals and academic conferences.
CRD42024605343.
运动恐惧是影响慢性非特异性下腰痛（CNLBP）患者预后的重要因素。功能训练受限会严重阻碍功能恢复，导致负面情绪状态（包括焦虑和抑郁），增加失眠风险，同时加重患者的经济负担。尽管多项随机对照试验评估了各种非药物干预对CNLBP患者运动恐惧的影响，但其相对疗效和潜在不良反应仍不明确。本研究将进行系统评价和网络荟萃分析，以确定哪种非药物干预可能是治疗CNLBP患者运动恐惧的最有效方法。
将从各数据库创建之日至2024年11月20日，在英文和中文数据库（包括Cochrane图书馆、PubMed、Scopus、Springer、Embase、万方数据、重庆维普数据库和中国知网）中进行全面检索。仅纳入英文或中文研究进行分析。主要结局将包括与CNLBP相关的继发性运动恐惧显著减轻、疼痛缓解以及腰椎肌肉功能状态改善。将使用Cochrane偏倚风险评估工具进行偏倚风险评估。采用Review Manager V.5.3软件进行成对荟萃分析，使用Stata V.16.0以及Open BUGS V.3.2.3软件进行网络荟萃分析。将采用推荐分级、评估、制定和评价框架来评估证据质量。
本研究纳入的所有数据均来自文献，因此无需伦理批准。研究结果将通过同行评审期刊和学术会议进行传播。
PROSPERO注册号：CRD42024605343。
