Efficacy of conservative therapy in older people with nonspecific low back pain: A systematic review with meta-analysis and GRADE recommendations

Archives of Gerontology and Geriatrics
Lorena K B AmaralVinicius Cunha Oliveira

Abstract

This systematic review aimed to investigate the effectiveness of conservative therapy in older people with nonspecific low back pain. Searches were conducted on Medline, Amed, Embase, Cochrane, Psycinfo and Pedro databases up to 2020. Risk of bias were assessed using the 0-10 PEDro scale. Weighted mean differences (WMDs) or mean differences (MDs) with 95 % confidence intervals (CIs) were reported for each conservative therapy, and strength of the current evidence was assessed using the GRADE approach. Eleven original trials were included investigating effects on disability, pain, coping, quality of life, strength, balance, depression, falls, sleep quality, mobility, body mass index, percentage body fat, trunk muscle mass and waist-to-hip ratio. Moderate quality evidence showed short-term effects of trigger point acupuncture on disability (WMD = 5.0 points [95 % CI 3.5-6.4] on a 25-point scale) and pain (WMD = 35.9 points [95 % CI 22.2-49.7] on a 101-point scale), and of exercise on disability (WMD = 1.7 points [95 % CI 0.3-3.0]) when compared with control (placebo, sham, waiting list or no intervention). Moderate quality evidence showed no short-term effect of exercise on coping (95 % CI -5.0 to 14.6). Moreover, evidence for ot...Continue Reading

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