The Effectiveness of Classification-Specific Physical Therapy for People with Low Back pain Within Dominant Movement-Based Schemes: A Systematic Review
نویسندگان
1 PhD Candidate, Physical Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran
2 Assistant Professor, Department of Physiotherapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
3 Assistant Professor of Biostatistics, Department of Biostatistics and Epidemiology, School of public health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4 Professor, Physical Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, IR Iran
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چکیده
Background: Identification of homogenous subgroups of patients with low back pain (LBP) and classification-based treatmenthave been recommended by some researchers and primary care clinicians. However, evidence regarding the effectiveness of thisapproach is not conclusive; one reason for this controversy appears to be the heterogeneity of trials in this context.Methods: The aim of this study was to determine the effectiveness of classification-specific physical therapy in patients with LBP. Theincluded trials were investigated in more homogeneous categories with respect to their classification scheme. Electronic databasesincluding Medline, Cochrane, Ovid, Scopus, and PEDro were searched systematically for English-language randomized controlledtrials (RCTs), published from 1980 to October 3, 2015. We included studies on LBP cases, which aimed to compare classificationspecificphysical therapies with non-specific treatments lacking patient classification. PEDro scoring was used to check the qualityof the included trials, and the GRADE approach was used to evaluate the overall quality of evidence. Data on participants’ characteristics,sample size, and inclusion/exclusion criteria were extracted to obtain an overview of the included RCTs.Results: A total of 12 RCTs were identified and categorized into four classification schemes. Some evidence supporting classificationspecifictreatment was found in each of the schemes. However, the reported evidence was conflicting predominantly due to differencesin the study design. Also, GRADE quality assessment indicated the low quality of evidence for both approaches.Conclusions: Categorization of trials based on their classification scheme to investigate the efficacy of classification-based physicaltherapy could reduce the heterogeneity of trials and allow researchers to understand the contradictory results in this context.
