| dc.description.abstract | INTRODUCTION: Low Back Pain (LBP) is one of the most common health problems in adults. The impact of LBP on the individual can cause loss of health status and function related to pain in the back. To reduce the impact of LBP on adults, drug therapy is the most frequently recommended intervention but over the last decade, a substantial number of randomized clinical trials of non-pharmacological intervention for LBP have been published.
OBJECTIVE: To determine the effectiveness of non-pharmacological intervention in therapies for the treatment of chronic nonspecific low back pain in Iran
STUDY DESIGN: Systematic review and meta-analysis
METHODS: A systematic literature search was completed without date restrictions up to May 2013. Five databases (Medline, CINAHL, Science Direct, CAJ Full-text Database, and Cochrane databases) were searched for articles published up to 2013. The eligibility criteria were randomized trials and double-blind controlled trials of all forms of non-pharmacological for CNLBP in subjects who were aged at least 18 years old, published in Persian or English. Two independent reviewers extracted the data. The quality of the papers was assessed using the Cochrane Back Review Risk of Bias criteria.
RESULTS: Initial searches revealed 415 papers, 382 of which were excluded on the basis of abstract alone. After excluding 23 papers due to duplication, the remaining 10 trial papers were subjected to a more detailed analysis of the full text, which resulted in three being excluded. The seven remaining trials had a lack of methodological and clinical homogeneity met the inclusion criteria: acupuncture (n=3), acupressure (n=1) and chiropractic (n=3). The trials used different comparators with regards to the primary outcomes, the number of treatments, the duration of treatment and the duration of follow-up. There was observed significance association between acupuncture treatments given to the patients than to the NSAIDs medicine in the two weeks follow up [SMD pooled= -1.25 (95% CI: (-2.05,-0.45)]. Furthermore, in the sixth weeks follow up was seen statistically significance difference. [SMD pooled= -2.5 (95% CI: (-4.40,-0.60)]. Chiropractic treatments compare to physiotherapy in the intervals of one follow up in the diminishing of pain observed statistically significant. [SMD pooled= -3 (95% CI:(-4.80,-1.20)].
Chiropractic treatments than physiotherapy in the intervals of one week’s follow up in reduce of disability observed statistically significant [SMD pooled= - 1.06 (95%CI: (-1.85,-0.30)].
CONCLUSION: This systematic review demonstrates that acupuncture, acupressure and chiropractic may have a favorable effect on self-reported pain and functional limitations on NSCLBP. However, the results should be interpreted in the context of the limitations identified, particularly in relation to the heterogeneity in the study characteristics and the low methodological quality in many of the included studies. | en_US |
