Effect of Cognitive Behavioural Therapy in Treatment of Chronic Non-Specific Low Back Pain

Elabd, Mohamed Yehia; Youssef, Enas Fawzy; Mohamed, M. Ezzat; Mohamed, Ahmed Samir

doi:10.21608/ejhm.2021.194050

Cited by 1 publication

(19 citation statements)

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“…Two studies were excluded for the main meta-analysis due to an overall high risk of bias. 46,66 The main reason for exclusion was that treatment groups were not similar at baseline. Even though Elabd et al 66 stated that there was no significant difference between groups, we reran a twotailed t-test with pain intensity at baseline.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…46,66 The main reason for exclusion was that treatment groups were not similar at baseline. Even though Elabd et al 66 stated that there was no significant difference between groups, we reran a twotailed t-test with pain intensity at baseline. The p-value equaled 0.0148.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…The interventions (intervention and control group), mode, provider, duration and summary of the main results as well as an indication of inclusion in the metaanalysis of the included studies are presented in 59 Cognitive behavioral therapy was used in nine studies as the psychosocial component of the intervention. 46,48,50,[54][55][56][57][58]61,66 Other psychosocial elements were relaxation and education, 49 motivation, 47,51,62 acceptance and commitment, 52 pain neurophysiology education, 59,65 mindfulness and classification with behavior change. 63,64 In 11 studies the treatment components were combined in the same session.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…46,47,[62][63][64][65][49][50][51][52][54][55][56]60 The other seven studies had specific sessions divided into focusing on the exercise or the psychosocial component. 48,53,[57][58][59]61,66 All interventions were of low intensity (≤ 15 h). Ten studies had a contact time of 10 or more hours .…”

Section: Methodological Qualitymentioning

confidence: 99%

“…46,53,60,61,65 Three studies came from Italy, 48,49,57 two from Australia 54,58 and two from the UK. 50,52 The remaining studies were conducted in Austria, 47,51 Brazil, 55,56 Egypt, 66 Hong Kong, 62 Nigeria, 53 Norway, 63,64 Portugal, 59 Singapore, 46 Switzerland, 65 the Netherlands 61 and the USA. 60…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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The effectiveness of low‐dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: A systematic review with meta‐analysis

Hochheim

Ramm²,

Amelung

2023

Pain Practice

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To evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus active physical interventions on pain intensity and disability in adults with nonspecific chronic low back pain. Introduction: Research has shown that primary care biopsychosocial interventions (PCBI) can reduce pain intensity and disability. While scattered studies support low-dosed (≤ 15 treatment hours) PCBI, no systematic review exists comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP).Inclusion Criteria: Randomized controlled trials that evaluate low-dosed PCBI compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older), who suffer from CLBP were included. Not recommended interventions that feature only passive therapies, spinal surgery or pharmacological treatment, and studies with inpatient multidisciplinary-based rehabilitation (MBR) were excluded. Methods: Databases were searched from inception to December 31, 2021. Language was restricted to English or German. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" were used. Sources were CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science. Search was finished on March 08, 2022. Data appraisal, extraction and synthesis followed JBI guidance for systematic reviews of effectiveness. Risk of Bias was assessed using JBI 13-item checklist for randomized controlled trials. The GRADE approach for grading the certainty of evidence was followed. Systematic Review Registration Number: PROSPERO 2022 CRD42022302771. Results: Eighteen RCTs were found eligible and 15 trials comprising a total of 1531 participants suffering from CLBP were entered in the meta-analyses. Risk of Bias was low. Overall evidence was moderate. Significant effects in favor of PCBI were found for pain intensity post-treatment (standardized mean difference (SMD) = −1.09, 95% confidence interval (CI) = −1.84 to −0.34, I 2 = 97%, p = 0.004) as well as at short-term (SMD = −0.23, 95% CI = −0.39 to −0.08, I 2 = 0%, p = 0.004), long term (SMD = −0.79, 95% CI = −1.42 to −0.17, I 2 = 96%, p = 0.01) and very long-term (SMD = −1.13, 95% CI = −1.93 to −0.33, I 2 = 94%, p = 0.005) follow-up. Significant effects in favor of PCBI for physical function were found post-treatment (SMD = −1.33, 95% CI = −2.17 to −0.49, I 2 = 97%, p = 0.002) atThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Methodological Qualitymentioning

confidence: 99%