A SYSTEMATIC REVIEW OF CLINICAL PRACTICE GUIDELINES FOR PERSONS WITH NON-SPECIFIC LOW BACK PAIN WITH AND WITHOUT RADICULOPATHY
 
   

A Systematic Review of Clinical Practice Guidelines for Persons
With Non-specific Low Back Pain With and Without Radiculopathy:
Identification of Best Evidence for Rehabilitation to Develop
the WHO's Package of Interventions for Rehabilitation

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:     Frankp@chiro.org
 
   

FROM:   Arch Phys Med Rehabil 2023 (Mar 23) [EPUB] ~ FULL TEXT

  OPEN ACCESS   

Fabio Zaina, MD, Pierre Côté, PhD, Carolina Cancelliere, PhD, Leslie Verville, MHSc, Stefano Negrini, MD, PhD, Margareta Nordin, Dr Med Sci

ISICO (Italian Scientific Spine Institute),
Milan, Italy.

Faculty of Health Sciences,
Ontario Tech University,
Oshawa, Ontario, Canada;


FROM:   Lancet 2021

Objective:   To Identify evidence-based rehabilitation interventions for persons with non-specific low back pain (LBP) with and without radiculopathy and to develop recommendations from high-quality clinical practice guidelines (CPGs) to inform the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR).

Data source:   We searched MEDLINE, EMBASE, CINAHL, PsycINFO, National Health Services Economic Evaluation Database, Health Technology Assessment Database, PEDro, the Trip Database, the Index to Chiropractic Literature and the gray literature.

Study selection:   Eligible guidelines were (1) published between 2009 and 2019 in English, French, Italian, or Swedish; (2) included adults or children with non-specific LBP with or without radiculopathy; and (3) assessed the benefits of rehabilitation interventions on functioning. Pairs of independent reviewers assessed the quality of the CPGs using AGREE II.

Data synthesis:   We identified 4 high-quality CPGs. Recommended interventions included

(1)   education about recovery expectations, self-management strategies, and maintenance of usual activities;

(2)   multimodal approaches incorporating education, exercise, and spinal manipulation;

(3)   nonsteroidal anti-inflammatory drugs combined with education in the acute stage; and

(4)   intensive interdisciplinary rehabilitation that includes exercise and cognitive/behavioral interventions for persistent pain.

We did not identify high-quality CPGs for people younger than 16 years of age.

Conclusion:   We developed evidence-based recommendations from high-quality CPGs to inform the WHO PIR for people with LBP with and without radiculopathy. These recommendations emphasize the potential benefits of education, exercise, manual therapy, and cognitive/behavioral interventions.

Keywords:   Education; Quality of life; Rehabilitation; Sciatica.


From the FULL TEXT Article:





Supplementary Material

HERE

List of abbreviations:

CPG = (clinical practice guideline),
LBP = (low back pain),
NICE = (National Institute for Health and Clinical Excellence),
NSAID = (nonsteroidal anti-inflammatory drug),
PIR = (Package of Interventions for Rehabilitation),
WHO = (World Health Organization)

Disclosure statement

S.N. owns stock of ISICO and is the inventor of the patent no. 102019000003045, 4-2-2021 and patent no. 102020000003991, 24/3/2022. P.C. holds a Research Chair in Knowledge Translation in the Faculty of Health Sciences at Ontario Tech University, funded by the Canadian Chiropractic Research Foundation (CCRF). L.V. is supported by the CCRF. C.C. holds a Research Chair in Knowledge Translation in the Faculty of Health Sciences at Ontario Tech University, funded by the Canadian Chiropractic Research Foundation (CCRF). The other authors have no conflict of interest.

This work was supported and funded, in part, by the Italian Ministry of Health—Ricerca Corrente [2022] to Professor Stefano Negrini, Full Professor in Physical and Rehabilitation Medicine (PRM) at University “La Statale”, Milan. Alexandra Rauch works for the World Health Organization (WHO) in Head Quarters, Geneva. She alone is responsible for the views expressed in this publication and they do not necessarily represent the views, decisions, or policies of WHO.

Footnotes

This research was undertaken, in part, thanks to funding from the Canada Research Chairs Program to Professor Pierre Côté, Canada Research Chair in Disability Prevention and Rehabilitation at Ontario Tech University.


References:

  1. World Health Organization.
    Universal health coverage (UHC) n.d. Available at:
    https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
    Accessed May 3, 2022.

  2. ReWorld Health Organization.
    Rehabilitation 2030: a call for action n.d. Available at:
    https://www.who.int/initiatives/rehabilitation-2030
    Accessed May 3, 2022.

  3. Rauch A Negrini S Cieza A.
    Toward strengthening rehabilitation in health systems:
    methods used to develop a WHO Package of Rehabilitation Interventions.
    Arch Phys Med Rehabil. 2019; 100: 2205-2211

  4. Zaina F Balagué F Battié M Karppinen J Negrini S.
    Low back pain rehabilitation in 2020:
    new frontiers and old limits of our understanding.
    Eur J Phys Rehabil Med. 2020; 56: 212-219

  5. Cieza A Causey K Kamenov K Hanson SW Chatterji S Vos T.
    Global estimates of the need for rehabilitation based on the Global Burden
    of Disease study 2019: a systematic analysis for the
    Global Burden of Disease Study 2019.
    Lancet. 2020; 396: 2006-2017

  6. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J et al.
    What Low Back Pain Is and Why We Need to Pay Attention
    Lancet. 2018 (Jun 9); 391 (10137): 2356–2367
    This is the second of 4 articles in the remarkable Lancet Series on Low Back Pain

  7. National Institute for Health and Care Excellence (NICE):
    Low Back Pain and Sciatica in Over 16s:
    Assessment and Management       (PDF)
    NICE Guideline, No. 59 2016 (Nov): 1–1067

  8. Negrini S Zaina F.
    The chimera of low back pain etiology: a clinical rehabilitation perspective.
    Am J Phys Med Rehabil. 2013; 92: 93-97

  9. Wu A March L Zheng X et al.
    Global Low Back Pain Prevalence and Years Lived
    with the Global Burden of Disease Study 2017
    Annals of Translational Medicine 2020 (Mar); 8 (6): 299

  10. Heliövaara M Knekt P Aromaa A.
    Incidence and risk factors of herniated lumbar intervertebral
    disc or sciatica leading to hospitalization.
    J Chronic Dis. 1987; 40: 251-258

  11. Heliövaara M.
    Occupation and risk of herniated lumbar intervertebral disc
    or sciatica leading to hospitalization.
    J Chronic Dis. 1987; 40: 259-264

  12. Kelsey JL Githens PB Walter SD et al.
    An epidemiological study of acute prolapsed cervical intervertebral disc.
    J Bone Joint Surg Am. 1984; 66: 907-914

  13. Kelsey JL Hardy RJ.
    Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc.
    Am J Epidemiol. 1975; 102: 63-73

  14. Leino-Arjas P Kaila-Kangas L Kauppinen T Notkola V Keskimäki I Mutanen P.
    Occupational exposures and inpatient hospital care for
    lumbar intervertebral disc disorders among Finns.
    Am J Ind Med. 2004; 46: 513-520

  15. Saftic R Grgic M Ebling B Splavski B.
    Case-control study of risk factors for lumbar intervertebral
    disc herniation in Croatian island populations.
    Croat Med J. 2006; 47: 593-600

  16. Seidler A Bolm-Audorff U Siol T et al.
    Occupational risk factors for symptomatic lumbar disc herniation;
    a case-control study.
    Occup Environ Med. 2003; 60: 821-830

  17. Heliovaara M.
    Body height, obesity, and risk of herniated lumbar intervertebral disc.
    Spine (Phila Pa 1976). 1987; 12: 469-472

  18. Kelsey JL Githens PB O'Conner T et al.
    Acute prolapsed lumbar intervertebral disc. An epidemiologic study
    with special reference to driving automobiles and cigarette smoking.
    Spine (Phila Pa 1976). 1984; 9: 608-613

  19. Kelsey JL Greenberg RA Hardy RJ Johnson MF.
    Pregnancy and the syndrome of herniated lumbar
    intervertebral disc; an epidemiological study.
    Yale J Biol Med. 1975; 48: 361-368

  20. Jhawar BS Fuchs CS Colditz GA Stampfer MJ.
    Cardiovascular risk factors for physician-diagnosed lumbar disc herniation.
    Spine J. 2006; 6: 684-691

  21. Malfliet A Ickmans K Huysmans E et al.
    Best evidence rehabilitation for chronic pain part 3: low back pain.
    J Clin Med. 2019; 8: 1063

  22. Page MJ McKenzie JE Bossuyt PM et al.
    The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
    BMJ. 2021; 372: n71

  23. World Health Organization.
    Rehabilitation n.d. Available at:
    https://www.who.int/news-room/fact-sheets/detail/rehabilitation
    Accessed May 3, 2022.

  24. Arienti C Patrini M Pollock A Lazzarini SG Oral A Negrini S.
    A comparison and synthesis of rehabilitation definitions used by consumers
    (Google), major Stakeholders (survey) and researchers
    (Cochrane Systematic Reviews): a terminological analysis.
    Eur J Phys Rehabil Med. 2020; 56: 682-689

  25. Brouwers M Kho ME Browman GP Burgers JS Cluzeau F Feder G Fervers B Graham ID Grimshaw J Hanna S Littlejohns P Makarski J
    Zitzelsberger L for the AGREE Next Steps Consortium.
    AGREE II: Advancing guideline development,
    reporting and evaluation in healthcare.
    Can Med Assoc J. 2010; 182: E839-E842

  26. Campbell M McKenzie JE Sowden A et al.
    Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline.
    BMJ. 2020; 368: l6890

  27. D Thorson, R Campbell, M Massey, et al.,
    Low back pain, adult acute and subacute
    Bloomington, MN:
    Institute for Clinical Systems Improvement.
    https://www.icsi.org/_asset/bjvqrj/LBP.pdf
    Accessed April 12, 2023.

  28. Bussieres AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Haskett D, Hincapie C, et al.
    Spinal Manipulative Therapy and Other Conservative Treatments
    for Low Back Pain: A Guideline From the Canadian
    Chiropractic Guideline Initiative
    J Manipulative Physiol Ther. 2018 (May); 41 (4): 265–293

  29. Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, et al.
    Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation
    for Low Back Pain: An Evidence-based Clinical Practice
    Guideline From the American Pain Society
    Spine (Phila Pa 1976). 2009 (May 1); 34 (10): 1066–1077

  30. Adult acute and subacute low back pain:
    health care guideline - NLM Catalog - NCBI n.d. Available at:
    https://www.ncbi.nlm.nih.gov/nlmcatalog/101669932
    Accessed July 20, 2022.

  31. Cheng L Lau KK Lam W et al.
    Evidence-based guideline on prevention and management of
    low back pain in working population in primary care.
    Hong Kong Practitioner. 2012; 34: 106-115

  32. Qaseem A, Wilt TJ, McLean RM, Forciea MA;
    Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain:
    A Clinical Practice Guideline From the American College of Physicians
    Annals of Internal Medicine 2017 (Apr 4); 166 (7): 514–530

  33. Delitto A George SZ Van Dillen L et al.
    Low back pain.
    J Orthop Sports Phys Ther. 2012; 42: A1-57

  34. Scottish Intercollegiate Guidelines Network (SIGN)
    Management of Chronic Pain: A National Clinical Guideline
    Scottish Intercollegiate Guidelines Network (SIGN),
    Edinburgh, Scotland 2013

  35. Brosseau L Wells GA Poitras S et al.
    Ottawa Panel evidence-based clinical practice guidelines
    on therapeutic massage for low back pain.
    J Bodyw Mov Ther. 2012; 16: 424-455

  36. NASS Diagnosis And Treatment Of Lumbar Disc Herniation With Radiculopathy Guideline Summary.
    Guideline Central n.d. Available at:
    https://www.guidelinecentral.com/guideline/9905
    Accessed May 3, 2022.

  37. Zhao H Liu Z Xie L Zhu Y Li S.
    [Interpretation of Clinical Practice Guideline for Low Back Pain Treated with Acupuncture and Moxibustion].
    Zhongguo Zhen Jiu. 2015; 35: 1065-1068

  38. National Institute for Health and Care Excellence (NICE 2009)
    Early Management of Persistent Non-specific Low Back Pain
    Royal College of General Practitioners   Published date: May 2009

  39. Nordin M Hiebert R Pietrek M Alexander M Crane M Lewis S.
    Association of comorbidity and outcome in episodes of
    nonspecific low back pain in occupational populations.
    J Occup Environ Med. 2002; 44: 677-684

  40. Kreiner DS Matz P Bono CM et al.
    Guideline summary review: an evidence-based clinical
    guideline for the diagnosis and treatment of low back pain.
    Spine J. 2020; 20: 998-1024

  41. Wong JJ, Côté P, Sutton DA, et al.
    Clinical Practice Guidelines for the Noninvasive Management of
    Low Back Pain: A Systematic Review by the Ontario Protocol
    for Traffic Injury Management (OPTIMa) Collaboration
    European J Pain 2017 (Feb); 21 (2): 201–216

  42. Schreijenberg M Luijsterburg PAJ Van Trier YDM et al.
    Efficacy of paracetamol, diclofenac and advice for acute low back pain
    in general practice: design of a randomized controlled trial (PACE Plus).
    BMC Musculoskelet Disord. 2017; 18: 56

Return to LOW BACK PAIN

Return to LOW BACK GUIDELINES

 Since 4-28-2023
                  © 1995–2023 ~ The Chiropractic Resource Organization ~ All Rights Reserved