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3 results on '"International IPD-SMT group"'

1. Moderators of the Effect of Spinal Manipulative Therapy on Pain Relief and Function in Patients with Chronic Low Back Pain: An Individual Participant Data Meta-analysis

Author

de Zoete, A, de Boer, MR, Rubinstein, SM, van Tulder, MW, Underwood, M, Hayden, JA, Buffart, LM, Ostelo, R, and International IPD-SMT group

Subjects
Manipulation, Spinal, Adult, Male, Data Analysis, 0903 Biomedical Engineering, 1103 Clinical Sciences, Recovery of Function, Middle Aged, Orthopedics, Treatment Outcome, Humans, Pain Management, Female, Chronic Pain, Low Back Pain, Pain Measurement, Randomized Controlled Trials as Topic
Abstract

Study designIndividual participant data (IPD) meta-analysis.ObjectiveThe aim of this study was to identify which participant characteristics moderate the effect of spinal manipulative therapy (SMT) on pain and functioning in chronic LBP.Summary of backgroundThe effects of SMT are comparable to other interventions recommended in guidelines for chronic low back pain (LBP); however, it is unclear which patients are more likely to benefit from SMT compared to other therapies.MethodsIPD were requested from randomized controlled trials (RCTs) examining the effect of SMT in adults with chronic LBP for pain and function compared to various other therapies (stratified by comparison). Potential patient moderators (n = 23) were a priori based on their clinical relevance. We investigated each moderator using a one-stage approach with IPD and investigated this interaction with the intervention for each time point (1, 3, 6, and 12 months).ResultsWe received IPD from 21 of 46 RCTs (n = 4223). The majority (12 RCTs, n = 2249) compared SMT to recommended interventions. The duration of LBP, baseline pain (confirmatory), smoking, and previous exposure to SMT (exploratory) had a small moderating effect across outcomes and follow-up points; these estimates did not represent minimally relevant differences in effects; for example, patients with ConclusionWe did not identify any moderators that enable clinicians to identify which patients are likely to benefit more from SMT compared to other treatments.Level of Evidence: 2.

Published
2021

2. Spinal manipulative therapy in older adults with chronic low back pain: an individual participant data meta-analysis.

Author

Jenks, Alan, de Zoete, Annemarie, van Tulder, Maurits, Rubinstein, Sidney M., International IPD-SMT group, Bronfort, G, Cecchi, F, Ferreira, ML, Gudavalli, MR, Hidalgo, B, Hondras, MA, Hsieh, CJ, Petersen, T, Rasmussen-Barr, E, and Skillgate, E

Abstract

Purpose: Many systematic reviews have reported on the effectiveness of spinal manipulative therapy (SMT) for low back pain (LBP) in adults. Much less is known about the older population regarding the effects of SMT. Objective: To assess the effects of SMT on pain and function in older adults with chronic LBP in an individual participant data (IPD) meta-analysis. Setting: Electronic databases from 2000 until June 2020, and reference lists of eligible trials and related reviews. Design and subjects: Randomized controlled trials (RCTs) which examined the effects of SMT in adults with chronic LBP compared to interventions recommended in international LBP guidelines. Methods: Authors of trials eligible for our IPD meta-analysis were contacted to share data. Two review authors conducted a risk of bias assessment. Primary results were examined in a one-stage mixed model, and a two-stage analysis was conducted in order to confirm findings. Main outcomes and measures: Pain and functional status examined at 4, 13, 26, and 52 weeks. Results: 10 studies were retrieved, including 786 individuals, of which 261 were between 65 and 91 years of age. There is moderate-quality evidence that SMT results in similar outcomes at 4 weeks (pain: mean difference [MD] − 2.56, 95% confidence interval [CI] − 5.78 to 0.66; functional status: standardized mean difference [SMD] − 0.18, 95% CI − 0.41 to 0.05). Second-stage and sensitivity analysis confirmed these findings. Conclusion: SMT provides similar outcomes to recommended interventions for pain and functional status in the older adult with chronic LBP. SMT should be considered a treatment for this patient population. [ABSTRACT FROM AUTHOR]

Published
2022
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