Use the Back button in your browser to see the other results of your search or to select another record.
Efficacy of directional preference management for low back pain: a systematic review [with consumer summary] |
Surkitt LD, Ford JJ, Hahne AJ, Pizzari T, McMeeken JM |
Physical Therapy 2012 May;92(5):652-665 |
systematic review |
BACKGROUND: Providing specific treatment based on symptom response for people with low back pain (LBP) and a directional preference (DP) is a widely used treatment approach. The efficacy of treatment using the principles of directional preference management (DPM) for LBP is unclear. OBJECTIVE: The purpose of this study was to determine the efficacy of treatment using the principles of DPM for people with LBP and a DP. METHODS: Computer databases were searched for randomized controlled trials (RCTs) published in English up to January 2010. Only RCTs investigating DPM for people with LBP and a DP were included. Outcomes for pain, back specific function, and work participation were extracted. RESULTS: Six RCTs were included in this review. Five were considered high quality. Clinical heterogeneity of the included trials prevented meta-analysis. GRADE quality assessment revealed mixed results; however, moderate evidence was identified that DPM was significantly more effective than a number of comparison treatments for pain, function, and work participation at short-term, intermediate-term, and long-term follow-ups. No trials found that DPM was significantly less effective than comparison treatments. CONCLUSIONS: Although this systematic review showed mixed results, some evidence was found supporting the effectiveness of DPM when applied to participants with a DP, particularly at short-term and intermediate-term follow-ups. Further high-quality RCTs are warranted to evaluate the effect of DPM applied to people with LBP and a DP. A brief summary and a critical assessment of this review may be available at DARE |