Evidence map›Paper›PMID 40244434›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Comparative effectiveness of six biophysical agents on neck pain rehabilitation: a systematic review and network meta-analysis.

Jie Hao, Zhengting He, Biying Huang, Yanfei Li, Andréas Remis, Zixuan Yao, Yaogeng Tang, Yuxiao Sun, Kangchao Wu

Abstract readComparative StudySystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Review
  6. Review
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

9 authors.

Jie HaoDepartment of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, USA. jie.hao.unmc@outlook.com.ORCID 0000-0002-1602-4686
Zhengting HeDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA. zhe33@jhu.edu.ORCID 0000-0003-4781-3757
Biying HuangNanjing University of Chinese Medicine, Nanjing, USA.
Yanfei LiDuke University, Durham, USA.
Andréas RemisDuke University Health System, Durham, USA.
Zixuan YaoBeijing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yaogeng TangWashington University in St. Louis, St Louis, USA.
Yuxiao SunWest China Hospital of Sichuan University, Chengdu, China.
Kangchao WuThe University of Sydney, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review and network meta-analysis aims to investigate the comparative effectiveness of six biophysical agents, including Transcutaneous electrical nerve stimulation (TENS), interferential current (IFC), extracorporeal shockwave therapy (ESWT), therapeutic ultrasound, low-level laser therapy (LLLT), and high-intensity laser therapy (HILT) on neck pain rehabilitation.

methodsThree bibliographic databases, PubMed, Embase, and Scopus were searched from inception to July 30, 2024. Randomized controlled trials comparing a single biophysical agent with placebo control or another biophysical agent on neck pain intensity as an outcome were selected. Two independent reviewers independently conducted study selection, data extraction, and quality assessment. The methodological quality of included randomized controlled trials was assessed using the Physiotherapy Evidence Database scale.

resultsA total of 34 randomized controlled trials with 2141 patients with neck pain were included, and all included studies had good or above quality. A random-effects frequentist network meta-analysis, assuming a common random-effects standard deviation for all comparisons in the network. Effects of biophysical agents on neck pain intensity were estimated as mean differences with 95% confidence intervals. League tables were created to display the relative degree of neck pain for all comparisons among the six biophysical agents.

conclusionThis study suggests that rehabilitation of neck pain using biophysical agents should be prioritized in the following ranks: HILT, ESWT, IFC, TENS, LLLT, and therapeutic ultrasound. The results clarified how different biophysical agents may influence neck pain outcomes and provided proper evidence to inform clinicians to select biophysical agents prudently for neck pain management.

Indexed as

Neck PainTranscutaneous Electric Nerve StimulationExtracorporeal Shockwave TherapyHumansLow-Level Light TherapyRandomized Controlled Trials as TopicUltrasonic TherapyCervical spineModalityPhysical agentPhysiotherapyRehabilitation

Identifiers

PMID40244434

What OpenQuestion holds

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Registered trials

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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.