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• W1782749242 abstract "Background Low back pain (LBP) is responsible for considerable personal suffering worldwide. Those with persistent disabling symptoms also contribute to substantial costs to society via healthcare expenditure and reduced work productivity. While there are many treatment options, none are universally endorsed. The idea that chronic LBP is a condition best understood with reference to an interaction of physical, psychological and social influences, the 'biopsychosocial model', has received increasing acceptance. This has led to the development of multidisciplinary biopsychosocial rehabilitation (MBR) programs that target factors from the different domains, administered by healthcare professionals from different backgrounds. Objectives To review the evidence on the effectiveness of MBR for patients with chronic LBP. The focus was on comparisons with usual care and with physical treatments measuring outcomes of pain, disability and work status, particularly in the long term. Search methods We searched the CENTRAL, MEDLINE, EMBASE, PsycINFO and CINAHL databases in January and March 2014 together with carrying out handsearches of the reference lists of included and related studies, forward citation tracking of included studies and screening of studies excluded in the previous version of this review. Selection criteria All studies identified in the searches were screened independently by two review authors; disagreements regarding inclusion were resolved by consensus. The inclusion criteria were published randomised controlled trials (RCTs) that included adults with non‐specific LBP of longer than 12 weeks duration; the index intervention targeted at least two of physical, psychological and social or work‐related factors; and the index intervention was delivered by clinicians from at least two different professional backgrounds. Data collection and analysis Two review authors extracted and checked information to describe the included studies, assessed risk of bias and performed the analyses. We used the Cochrane risk of bias tool to describe the methodological quality. The primary outcomes were pain, disability and work status, divided into the short, medium and long term. Secondary outcomes were psychological functioning (for example depression, anxiety, catastrophising), healthcare service utilisation, quality of life and adverse events. We categorised the control interventions as usual care, physical treatment, surgery, or wait list for surgery in separate meta‐analyses. The first two comparisons formed our primary focus. We performed meta‐analyses using random‐effects models and assessed the quality of evidence using the GRADE method. We performed sensitivity analyses to assess the influence of the methodological quality, and subgroup analyses to investigate the influence of baseline symptom severity and intervention intensity. Main results From 6168 studies identified in the searches, 41 RCTs with a total of 6858 participants were included. Methodological quality ratings ranged from 1 to 9 out 12, and 13 of the 41 included studies were assessed as low risk of bias. Pooled estimates from 16 RCTs provided moderate to low quality evidence that MBR is more effective than usual care in reducing pain and disability, with standardised mean differences (SMDs) in the long term of 0.21 (95% CI 0.04 to 0.37) and 0.23 (95% CI 0.06 to 0.4) respectively. The range across all time points equated to approximately 0.5 to 1.4 units on a 0 to 10 numerical rating scale for pain and 1.4 to 2.5 points on the Roland Morris disability scale (0 to 24). There was moderate to low quality evidence of no difference on work outcomes (odds ratio (OR) at long term 1.04, 95% CI 0.73 to 1.47). Pooled estimates from 19 RCTs provided moderate to low quality evidence that MBR was more effective than physical treatment for pain and disability with SMDs in the long term of 0.51 (95% CI ‐0.01 to 1.04) and 0.68 (95% CI 0.16 to 1.19) respectively. Across all time points this translated to approximately 0.6 to 1.2 units on the pain scale and 1.2 to 4.0 points on the Roland Morris scale. There was moderate to low quality evidence of an effect on work outcomes (OR at long term 1.87, 95% CI 1.39 to 2.53). There was insufficient evidence to assess whether MBR interventions were associated with more adverse events than usual care or physical interventions. Sensitivity analyses did not suggest that the pooled estimates were unduly influenced by the results from low quality studies. Subgroup analyses were inconclusive regarding the influence of baseline symptom severity and intervention intensity. Authors' conclusions Patients with chronic LBP receiving MBR are likely to experience less pain and disability than those receiving usual care or a physical treatment. MBR also has a positive influence on work status compared to physical treatment. Effects are of a modest magnitude and should be balanced against the time and resource requirements of MBR programs. More intensive interventions were not responsible for effects that were substantially different to those of less intensive interventions. While we were not able to determine if symptom intensity at presentation influenced the likelihood of success, it seems appropriate that only those people with indicators of significant psychosocial impact are referred to MBR." @default.
• W1782749242 created "2016-06-24" @default.
• W1782749242 creator A5017907201 @default.
• W1782749242 creator A5057690689 @default.
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• W1782749242 creator A5090412482 @default.
• W1782749242 creator A5090490801 @default.
• W1782749242 date "2014-09-02" @default.
• W1782749242 modified "2023-10-02" @default.
• W1782749242 title "Multidisciplinary biopsychosocial rehabilitation for chronic low back pain" @default.
• W1782749242 cites W113928389 @default.
• W1782749242 cites W140357810 @default.
• W1782749242 cites W1456018149 @default.
• W1782749242 cites W1494873001 @default.
• W1782749242 cites W1507320532 @default.
• W1782749242 cites W1529374511 @default.
• W1782749242 cites W1538700548 @default.
• W1782749242 cites W1541686221 @default.
• W1782749242 cites W1550805440 @default.
• W1782749242 cites W1552086541 @default.
• W1782749242 cites W1558137534 @default.
• W1782749242 cites W1585714896 @default.
• W1782749242 cites W1670476077 @default.
• W1782749242 cites W1969121058 @default.
• W1782749242 cites W1969352284 @default.
• W1782749242 cites W1970648960 @default.
• W1782749242 cites W1971198473 @default.
• W1782749242 cites W1971872144 @default.
• W1782749242 cites W1975222334 @default.
• W1782749242 cites W1975431933 @default.
• W1782749242 cites W1975710821 @default.
• W1782749242 cites W1976680554 @default.
• W1782749242 cites W1980654041 @default.
• W1782749242 cites W1983677579 @default.
• W1782749242 cites W1987182668 @default.
• W1782749242 cites W1987413582 @default.
• W1782749242 cites W1988038060 @default.
• W1782749242 cites W1989052942 @default.
• W1782749242 cites W1991092998 @default.
• W1782749242 cites W1991227430 @default.
• W1782749242 cites W1992171347 @default.
• W1782749242 cites W1992274723 @default.
• W1782749242 cites W1992746917 @default.
• W1782749242 cites W1992896125 @default.
• W1782749242 cites W1993751573 @default.
• W1782749242 cites W1994951646 @default.
• W1782749242 cites W1996122546 @default.
• W1782749242 cites W1997239994 @default.
• W1782749242 cites W1998816243 @default.
• W1782749242 cites W2000326062 @default.
• W1782749242 cites W2003527782 @default.
• W1782749242 cites W2007212129 @default.
• W1782749242 cites W2008217906 @default.
• W1782749242 cites W2010177974 @default.
• W1782749242 cites W2010392710 @default.
• W1782749242 cites W2011511373 @default.
• W1782749242 cites W2014467466 @default.
• W1782749242 cites W2015458109 @default.
• W1782749242 cites W2016580348 @default.
• W1782749242 cites W2016690595 @default.
• W1782749242 cites W2016980175 @default.
• W1782749242 cites W2017033206 @default.
• W1782749242 cites W2018538192 @default.
• W1782749242 cites W2019029960 @default.
• W1782749242 cites W2020229129 @default.
• W1782749242 cites W2022841933 @default.
• W1782749242 cites W2023196035 @default.
• W1782749242 cites W2024354092 @default.
• W1782749242 cites W2024397552 @default.
• W1782749242 cites W2024713065 @default.
• W1782749242 cites W2025616740 @default.
• W1782749242 cites W2026577087 @default.
• W1782749242 cites W2026828530 @default.
• W1782749242 cites W2028100234 @default.
• W1782749242 cites W2030083017 @default.
• W1782749242 cites W2032079752 @default.
• W1782749242 cites W2032098756 @default.
• W1782749242 cites W2033147270 @default.
• W1782749242 cites W2033566624 @default.
• W1782749242 cites W2036057471 @default.
• W1782749242 cites W2041385229 @default.
• W1782749242 cites W2042252954 @default.
• W1782749242 cites W2043984812 @default.
• W1782749242 cites W2044038302 @default.
• W1782749242 cites W2045083414 @default.
• W1782749242 cites W2048696551 @default.
• W1782749242 cites W2050635556 @default.
• W1782749242 cites W2051385875 @default.
• W1782749242 cites W2053250476 @default.
• W1782749242 cites W2054215964 @default.
• W1782749242 cites W2054460815 @default.
• W1782749242 cites W2055556081 @default.
• W1782749242 cites W2056262978 @default.
• W1782749242 cites W2056626132 @default.
• W1782749242 cites W2057795080 @default.
• W1782749242 cites W2058095798 @default.
• W1782749242 cites W2060367033 @default.
• W1782749242 cites W2061689924 @default.

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