Chronic low back pain (CLBP) significantly impacts individuals and healthcare systems globally, characterized by persistent pain and discomfort. Its multifactorial nature necessitates multidisciplinary interventions. This study compares the effectiveness of exercise therapy (ET) and multidisciplinary biopsychosocial rehabilitation (MBR) in managing CLBP.
A systematic literature review across several databases, including MEDLINE, PEDro, Embase, CINAHL, CENTRAL, and PsycINFO, aimed to evaluate the effects of ET and MBR on CLBP. Adhering to PRISMA guidelines, the study focused on the integrative approaches of ET and MBR and their respective treatment modalities, with usual care and minimal intervention used as control treatments. Randomized controlled trials were included, with pain and disability as primary outcomes. Statistical analyses employed both meta-analyses and network meta-analyses to assess outcomes across different time frames, with thorough exploration of heterogeneity and additional subgroup and meta-regression analyses.
The research offers insights into the complex nature of CLBP interventions, though it does not establish a definitively superior treatment modality. It highlights the effectiveness of ET and MBR over usual care and minimal intervention, with MBR having a slight edge in improving outcomes and high heterogeneity observed between treatments.
The findings suggest that both ET and MBR are valuable in CLBP management, with MBR showing a minor advantage. The inclusion of network meta-analysis provides a more definitive comparison, advocating for a personalized, integrated treatment approach. This research enriches the understanding of CLBP treatment modalities, setting a foundation for future investigations into personalized care strategies.
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