Evidence map›Paper›PMID 25694111›Full record

SynthesisBMJ (Clinical research ed.)2015

Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis.

Steven J Kamper, A T Apeldoorn, A Chiarotto, R J E M Smeets, R W J G Ostelo, J Guzman, M W van Tulder

9 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 9 registered trials, which are not on this map. Cited by 430 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
430citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02884466 nacompletednot on this mapstarted 2016, after this paper: background citation

Comparison of Two Multidisciplinary Rehabilitation Interventions in Patients With Chronic Low Back Pain - A Randomised Controlled Clinical Trial

TypeinterventionalSponsorSanoRan2016 to 2019Enrolled165ConditionsLow Back PainArmsMultidisciplinary rehabilitation intervention
NCT03819907 nacompletednot on this mapstarted 2019, after this paper: background citation

The Use of Virtual Reality for Lumbar Pain Management in an Outpatient Spine Clinic: An Exploratory Comparative Randomized Trial

TypeinterventionalSponsorSpaulding Rehabilitation HospitalRan2019 to 2019Enrolled45ConditionsChronic Low Back PainArmsAudiovisual Guided Relaxation, Virtual Reality Guided Relaxation
NCT03835182 nacompletednot on this mapstarted 2018, after this paper: background citation

Efficacy of Ultrasound Versus Short Wave Diathermy in the Treatment of Lumbar Disc Herniation: a Randomised Control Study

TypeinterventionalSponsorBaskent UniversityRan2018 to 2021Enrolled82ConditionsRadiculopathy, Low Back Pain, Mechanical, Herniated Disk LumbarArmsUltrasound group, Short wave diathermy group, Control group
NCT03902132 nacompletednot on this mapstarted 2018, after this paper: background citation

Effects of Core Stability Exercises on Lower Back Pain and Quality of Life in Post-menopausal Women.

TypeinterventionalSponsorRiphah International UniversityRan2018 to 2018Enrolled24ConditionsBackache, LowArmsCore Stability exercises group, Traditional low back physical therapy group
NCT04719130 nacompletednot on this mapstarted 2021, after this paper: background citation

Effectiveness of Multimodal Circuit Exercises for Chronic Musculoskeletal Pain in Older Adults: a Randomized Controlled Trial Protocol

TypeinterventionalSponsorUniversity of BrasiliaRan2021 to 2022Enrolled113ConditionsMusculoskeletal Pain, Chronic PainArmsMultimodal circuit exercise, Multidisciplinary lectures
NCT05194722 nacompletednot on this mapstarted 2022, after this paper: background citation

Optimizing Implementation of Mental Health Intervention Within Orthopedic Care

TypeinterventionalSponsorWashington University School of MedicineRan2022 to 2022Enrolled30ConditionsAnxiety, Depression, Back Pain, Neck PainArmsWysa mobile app
NCT05736393 nacompletednot on this mapstarted 2024, after this paper: background citation

Translation of Robotic Apparel for Alleviating Low Back Pain: Back Pain Consortium (BACPAC)

TypeinterventionalSponsorBoston University Charles River CampusRan2024 to 2025Enrolled44ConditionsLow Back PainArmsBack Exosuit
NCT07081737 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The Future of Pain Management: Can Person-centred and Precision AI-Based Decision Support Enhance Interdisciplinary Rehabilitation for Chronic Pain?

TypeinterventionalSponsorBjorn AngRan2026 to 2029Enrolled400ConditionsPain, Chronic, Chronic Pain, Widespread, Pain ManagementArmsInterdisciplinary treatment (IDT) + Clinical Decision Support System (CDSS), Interdisciplinary treatment (IDT)
NCT07482527 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Thoracic Mobility Versus Hip Mobility Exercises to Core Stabilization in Lumbar Spondylitis

TypeinterventionalSponsorCairo UniversityRan2026 to 2026Enrolled60ConditionsIndividuals With Lumbar SpondylosisArmsGroup A : Core stabilization exercises (control group), Group B: Thoracic Mobility Exercises (1st experimental group only), Group C: Hip Mobility Exercises (2nd experimental group only)
3 · Its place in the literature

Who cites it

430 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  9. Rehabilitation of sick-listed LBP patients in occupational health with collaboration of the workplace.International journal of occupational medicine and environmental health · 2024
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370 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Steven J KamperMusculoskeletal Division, George Institute, University of Sydney, Sydney 2050, NSW, Australia Department of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands skamper@george.org.au.
A T ApeldoornDepartment of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands.
A ChiarottoDepartment of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands.
R J E M SmeetsRehabilitation Medicine Department, Maastricht University Medical Centre, Maastricht 6200MD, Netherlands.
R W J G OsteloDepartment of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam 1081HV, Netherlands.
J GuzmanUniversity of British Columbia, Vancouver, Canada V6T 1Z3.
M W van TulderDepartment of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam 1081HV, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the long term effects of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain.

designSystematic review and random effects meta-analysis of randomised controlled trials. DATA SOURCES: Electronic searches of Cochrane Back Review Group Trials Register, CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to February 2014, supplemented by hand searching of reference lists and forward citation tracking of included trials. STUDY SELECTION CRITERIA: Trials published in full; participants with low back pain for more than three months; multidisciplinary rehabilitation involved a physical component and one or both of a psychological component or a social or work targeted component; multidisciplinary rehabilitation was delivered by healthcare professionals from at least two different professional backgrounds; multidisciplinary rehabilitation was compared with a non- multidisciplinary intervention.

resultsForty one trials included a total of 6858 participants with a mean duration of pain of more than one year who often had failed previous treatment. Sixteen trials provided moderate quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.21, 95% confidence interval 0.04 to 0.37; equivalent to 0.5 points in a 10 point pain scale) and disability (0.23, 0.06 to 0.40; equivalent to 1.5 points in a 24 point Roland-Morris index) compared with usual care. Nineteen trials provided low quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.51, -0.01 to 1.04) and disability (0.68, 0.16 to 1.19) compared with physical treatments, but significant statistical heterogeneity across trials was present. Eight trials provided moderate quality evidence that multidisciplinary rehabilitation improves the odds of being at work one year after intervention (odds ratio 1.87, 95% confidence interval 1.39 to 2.53) compared with physical treatments. Seven trials provided moderate quality evidence that multidisciplinary rehabilitation does not improve the odds of being at work (odds ratio 1.04, 0.73 to 1.47) compared with usual care. Two trials that compared multidisciplinary rehabilitation with surgery found little difference in outcomes and an increased risk of adverse events with surgery.

conclusionsMultidisciplinary biopsychosocial rehabilitation interventions were more effective than usual care (moderate quality evidence) and physical treatments (low quality evidence) in decreasing pain and disability in people with chronic low back pain. For work outcomes, multidisciplinary rehabilitation seems to be more effective than physical treatment but not more effective than usual care.

Indexed as

Back PainChronic DiseaseHumansOccupational TherapyPsychotherapyRandomized Controlled Trials as TopicSocial Support

Identifiers

PMID25694111
PMCPMC4353283

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 3 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.