Evidence map›Paper›PMID 36348309›Full record

Trial reportBMC musculoskeletal disorders2022

Comparison of supervised exercise therapy with or without biopsychosocial approach for chronic nonspecific low back pain: a randomized controlled trial.

Antonija Hrkać, Darko Bilić, Edita Černy-Obrdalj, Ivan Baketarić, Livia Puljak

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04023162 (Controlled, Randomized, Blind Trial Therapy Exercises and Operant Conditioning for Chronic Nonspecific Low Back Pain), which is not on this map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 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.

NCT04023162 nacompletednot on this map

Controlled, Randomized, Blind Trial Therapy Exercises and Operant Conditioning for Chronic Nonspecific Low Back Pain

TypeinterventionalSponsorAntonija HrkaćRan2019 to 2020Enrolled180ConditionsChronic Nonspecific Low Back PainArmsGraded Activity, Group-based Therapy Exercise, Back School
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Antonija HrkaćFaculty of Health Studies, University of Mostar, Mostar, Bosnia and Herzegovina.ORCID https://orcid.org/0000-0001-9513-9977
Darko BilićFaculty of Health Studies, University of Mostar, Mostar, Bosnia and Herzegovina.ORCID https://orcid.org/0000-0003-1123-5545
Edita Černy-ObrdaljSchool of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.ORCID https://orcid.org/0000-0002-1445-1393
Ivan BaketarićRehabilitation Center "Život", Mostar, Bosnia and Herzegovina.ORCID https://orcid.org/0000-0002-3460-7746
Livia PuljakCenter for Evidence-Based Medicine and Health Care, Catholic University of Croatia, 10 000, Zagreb, Croatia. livia.puljak@gmail.com.ORCID https://orcid.org/0000-0002-8467-6061

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA biopsychosocial rehabilitation is recommended for chronic nonspecific low back pain (CNLBP); however, its effectiveness compared to the traditional supervised exercise therapy of CNLBP treatment is still unclear.

methodsThis was a parallel-group randomized controlled clinical trial. The sample consisted of 180 participants of both sexes, aged ≥18 years, with CNLBP for ≥3 months. Using web randomization and concealed allocation, they were assigned to three groups; graded activity receiving cognitive-behavioral therapy, group-based combined exercise therapy and education (GA; n = 59), supervised group-based combined exercise therapy and education (SET; n = 63), and a control group receiving usual care (n = 58). Interventions were administered for 4 weeks (8 sessions). The primary outcome was pain intensity. Outcome measures were collected baseline, after interventions (4 weeks), and during two follow-up periods (3 and 6 months).

resultsAfter the intervention, GA had a significant large effect on pain reduction compared to the control group (MD of 22.64 points; 95% CI = 16.10 to 29.19; p < 0.0001; Cohen's d = 1.70), as well as SET compared with the control group (MD of 21.08 points; 95% CI = 14.64 to 27.52; p < 0.0001; Cohen's d = 1.39), without significant difference between two intervention groups. At 3 and 6 months of follow-up, GA had a statistically significantly better effect in reducing pain, disability and fear-avoidance beliefs, and improving spinal extensor endurance, range of extension and quality of life compared to SET and the control group. A statistically significantly better effect of SET compared with the control group was found in reducing pain, disability, fear-avoidance beliefs, and improving the physical component of quality of life. Harms were not reported.

conclusionThis study suggests that graded activity and group-based supervised exercise therapy have beneficial effects over the control group in the treatment of CNLBP. The graded activity was more beneficial than supervised group-based exercise therapy only during the follow-up.

trial registrationClinicaltrials.gov (NCT04023162; registration date: 17/07/2019).

Indexed as

Chronic PainLow Back PainAdolescentAdultExerciseExercise TherapyFemaleHumansMalePain MeasurementQuality of LifeChronicEducationGraded activityLow back painNonspecificPhysical therapySupervised exercise

Identifiers

PMID36348309
PMCPMC9641911

What OpenQuestion holds

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Registered trials

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.