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Lumbar supports for prevention and treatment of low back pain.

Abstract

BACKGROUND

Lumbar supports are used in the treatment of low back pain patients to make the impairment and disability vanish or decrease. Lumbar supports are also used to prevent the onset of low back pain (primary prevention) or to prevent recurrences of a low back pain episode (secondary prevention).

OBJECTIVES

The objective of this systematic review was to assess the effects of lumbar supports for prevention and treatment of non-specific low back pain.

SEARCH STRATEGY

We searched the Medline, Cinahl and Current Contents databases and the Cochrane Controlled Trials Register up to September 1999, and the Embase database up to September 1998. We also screened references given in relevant reviews and identified controlled trials, and used Science Citation Index to identify additional controlled trials.

SELECTION CRITERIA

Controlled clinical trials that reported on any type of lumbar supports as preventive or therapeutic intervention for non-specific low back pain were included.

DATA COLLECTION AND ANALYSIS

One reviewer extracted data from the trials considering characteristics of the study population, characteristics of the interventions and the final results for each outcome measure. The reviewer compared these findings to data regarding the same characteristics of the same studies published already in other reviews. The methodological quality was independently assessed by two reviewers. Because it was not possible to perform a quantitative analysis, a qualitative meta-analysis was performed in which the strength of evidence on the effectiveness of lumbar supports was classified as being strong, moderate, limited or conflicting, and no evidence.

MAIN RESULTS

Five randomized and two nonrandomized controlled preventive trials and six randomized therapeutic trials were included in our review. Overall the methodological quality of the studies included in our review was rather low. Only four of the thirteen studies scored positive on 50% or more of the the internal validity items. There was moderate evidence that for primary prevention lumbar supports are not more effective than other types of treatment or no intervention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, while it is still unclear if lumbar supports are more effective than other interventions for treatment of low back pain.

REVIEWER'S CONCLUSIONS

There is still a need for high quality randomised trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realisation of an adequate compliance.

Authors+Show Affiliations

Institute for Research in Extramural Medicine, Vrije Universiteit, van der Boechorststraat 7, Amsterdam, Netherlands. mw.van tulder.emgo@med.vu.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

10908512

Citation

Van Tulder, M W., et al. "Lumbar Supports for Prevention and Treatment of Low Back Pain." The Cochrane Database of Systematic Reviews, 2000, p. CD001823.
Van Tulder MW, Jellema P, van Poppel MN, et al. Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev. 2000.
Van Tulder, M. W., Jellema, P., van Poppel, M. N., Nachemson, A. L., & Bouter, L. M. (2000). Lumbar supports for prevention and treatment of low back pain. The Cochrane Database of Systematic Reviews, (3), CD001823.
Van Tulder MW, et al. Lumbar Supports for Prevention and Treatment of Low Back Pain. Cochrane Database Syst Rev. 2000;(3)CD001823. PubMed PMID: 10908512.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lumbar supports for prevention and treatment of low back pain. AU - Van Tulder,M W, AU - Jellema,P, AU - van Poppel,M N, AU - Nachemson,A L, AU - Bouter,L M, PY - 2000/7/25/pubmed PY - 2001/7/6/medline PY - 2000/7/25/entrez SP - CD001823 EP - CD001823 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 3 N2 - BACKGROUND: Lumbar supports are used in the treatment of low back pain patients to make the impairment and disability vanish or decrease. Lumbar supports are also used to prevent the onset of low back pain (primary prevention) or to prevent recurrences of a low back pain episode (secondary prevention). OBJECTIVES: The objective of this systematic review was to assess the effects of lumbar supports for prevention and treatment of non-specific low back pain. SEARCH STRATEGY: We searched the Medline, Cinahl and Current Contents databases and the Cochrane Controlled Trials Register up to September 1999, and the Embase database up to September 1998. We also screened references given in relevant reviews and identified controlled trials, and used Science Citation Index to identify additional controlled trials. SELECTION CRITERIA: Controlled clinical trials that reported on any type of lumbar supports as preventive or therapeutic intervention for non-specific low back pain were included. DATA COLLECTION AND ANALYSIS: One reviewer extracted data from the trials considering characteristics of the study population, characteristics of the interventions and the final results for each outcome measure. The reviewer compared these findings to data regarding the same characteristics of the same studies published already in other reviews. The methodological quality was independently assessed by two reviewers. Because it was not possible to perform a quantitative analysis, a qualitative meta-analysis was performed in which the strength of evidence on the effectiveness of lumbar supports was classified as being strong, moderate, limited or conflicting, and no evidence. MAIN RESULTS: Five randomized and two nonrandomized controlled preventive trials and six randomized therapeutic trials were included in our review. Overall the methodological quality of the studies included in our review was rather low. Only four of the thirteen studies scored positive on 50% or more of the the internal validity items. There was moderate evidence that for primary prevention lumbar supports are not more effective than other types of treatment or no intervention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, while it is still unclear if lumbar supports are more effective than other interventions for treatment of low back pain. REVIEWER'S CONCLUSIONS: There is still a need for high quality randomised trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realisation of an adequate compliance. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/10908512/Lumbar_supports_for_prevention_and_treatment_of_low_back_pain_ L2 - https://doi.org/10.1002/14651858.CD001823 DB - PRIME DP - Unbound Medicine ER -