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A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain

dc.contributor.authorLópez De Uralde Villanueva, Ibai Julio
dc.contributor.authorMuñoz García, Daniel
dc.contributor.authorGil Martínez, Alfonso
dc.contributor.authorPardo Montero, Joaquín
dc.contributor.authorMuñoz Plata, Rosa
dc.contributor.authorAngulo Díaz-Parreño, Santiago
dc.contributor.authorGómez Martínez, Miguel
dc.contributor.authorLa Touche, Roy
dc.date.accessioned2024-01-12T09:41:40Z
dc.date.available2024-01-12T09:41:40Z
dc.date.issued2016
dc.description.abstractObjective: Our aim was to systematically review and meta-analyze the effectiveness of graded activity (GA) or graded exposure (GEXP) for chronic nonspecific low back pain (CNSLBP). Methods: A literature search of multiple databases (MEDLINE, EMBASE, PEDro, CINAHL, and PsychINFO) was conducted to identify randomized control trials (RCTs). Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for relevant outcome measures (pain intensity, disability, quality of life, and catastrophizing). Results: Thirteen RCTs met the inclusion criteria. Only nine studies were included in the meta-analysis. GA was significantly more effective than the control group (CG) for improvements in disability in the short term (three studies: n = 254, SMD = -0.3, 95% CI -0.55 to -0.05, P = 0.02) and long term (two studies: n = 238, SMD = -0.53, 95% CI -0.79 to -0.27, P < 0.0001). GA was significantly less effective than GEXP for the improvement of disability in the short term (two studies: n = 105, SMD = 0.39, 95% CI 0.003-0.78, P = 0.048). GA was also significantly less effective than GEXP at improving catastrophizing in the short term (two studies: n = 105, SMD = 0.48, 95% CI 0.09-0.87, P = 0.02). Conclusion: Limited evidence has been found to show that GA significantly reduces disability in the short and long term when compared with the CG in CNSLBP. There is moderate evidence that GEXP more effectively decreases catastrophizing than GA in the short term. No difference was found between GA and other exercise for any variable.
dc.description.departmentSección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería)
dc.description.facultyFac. de Enfermería, Fisioterapia y Podología
dc.description.refereedTRUE
dc.description.statuspub
dc.identifier.citationLópez-de-Uralde-Villanueva I, Muñoz-García D, Gil-Martínez A, Pardo-Montero J, Muñoz-Plata R, Angulo-Díaz-Parreño S, et al. A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain. Pain Med 2016;17:172–88. https://doi.org/10.1111/pme.12882.
dc.identifier.doi10.1111/pme.12882
dc.identifier.issn1526-4637
dc.identifier.officialurlhttps://academic.oup.com/painmedicine/article/17/1/172/2240756?login=true
dc.identifier.urihttps://hdl.handle.net/20.500.14352/92694
dc.issue.number1
dc.journal.titlePain Medicine
dc.language.isoeng
dc.page.final188
dc.page.initial172
dc.publisherOxford University Press
dc.rights.accessRightsopen access
dc.subject.cdu615.8
dc.subject.keywordRecurrent Low Back Pain
dc.subject.keywordPain Catastrophizing
dc.subject.keywordCognitive Behavior Therapy
dc.subject.keywordBehavioural Graded Activity
dc.subject.keywordPhysiotherapy
dc.subject.ucmFisioterapia (Enfermería, Fisioterapia y Podología)
dc.subject.ucmFisioterapia (Medicina)
dc.subject.ucmMedicina Física y Rehabilitación
dc.subject.unesco3213.11 Fisioterapia
dc.subject.unesco3204.04 Rehabilitación (Médica)
dc.titleA Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain
dc.typejournal article
dc.type.hasVersionCVoR
dc.volume.number17
dspace.entity.typePublication
relation.isAuthorOfPublication15c7e8a4-025c-4d62-a0c4-d8ef8a5add95
relation.isAuthorOfPublication.latestForDiscovery15c7e8a4-025c-4d62-a0c4-d8ef8a5add95

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