Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus

Xue-Qiang Wang; Yu-Ling Wang; Jeremy Witchalls; Jia Han; Zhi-Jie Zhang; Phillip Page; Yu-Lian Zhu; Carla Stecco; Jian-Hua Lin; Doa El-Ansary; Quan-Sheng Ma; Qi Qi; Jae-Seop Oh; Wei-Ming Zhang; Adrian Pranata; Li Wan; Kui Li; Ming Ma; Lin-Rong Liao; Yu-Lian Zhu; Jing-Wei Guo; Pei-Jie Chen

doi:10.1177/02692155241229398

Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus

Xue-Qiang Wang, Yu-Ling Wang, Jeremy Witchalls, Jia Han, Zhi-Jie Zhang, Phillip Page, Yu-Lian Zhu, Carla Stecco, Jian-Hua Lin, Doa El-Ansary, Quan-Sheng Ma, Qi Qi, Jae-Seop Oh, Wei-Ming Zhang, Adrian Pranata, Li Wan, Kui Li, Ming Ma, Lin-Rong Liao, Yu-Lian ZhuJing-Wei Guo, Pei-Jie Chen

Physiotherapy

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions.

DATA SOURCES: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years.

REVIEW METHODS: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts.

RESULTS: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain.

CONCLUSIONS: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.

Original language	English
Pages (from-to)	1-17
Number of pages	17
Journal	Clinical Rehabilitation
DOIs	https://doi.org/10.1177/02692155241229398
Publication status	E-pub ahead of print - 5 Feb 2024

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10.1177/02692155241229398

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Wang, X-Q., Wang, Y-L., Witchalls, J., Han, J., Zhang, Z-J., Page, P., Zhu, Y-L., Stecco, C., Lin, J-H., El-Ansary, D., Ma, Q-S., Qi, Q., Oh, J-S., Zhang, W-M., Pranata, A., Wan, L., Li, K., Ma, M., Liao, L-R., ... Chen, P-J. (2024). Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus. Clinical Rehabilitation, 1-17. https://doi.org/10.1177/02692155241229398

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title = "Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus",

abstract = "OBJECTIVE: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions.DATA SOURCES: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years.REVIEW METHODS: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts.RESULTS: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain.CONCLUSIONS: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.",

keywords = "Physical therapy, exercise, expert consensus, low back pain, manual therapy",

author = "Xue-Qiang Wang and Yu-Ling Wang and Jeremy Witchalls and Jia Han and Zhi-Jie Zhang and Phillip Page and Yu-Lian Zhu and Carla Stecco and Jian-Hua Lin and Doa El-Ansary and Quan-Sheng Ma and Qi Qi and Jae-Seop Oh and Wei-Ming Zhang and Adrian Pranata and Li Wan and Kui Li and Ming Ma and Lin-Rong Liao and Yu-Lian Zhu and Jing-Wei Guo and Pei-Jie Chen",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = feb,

day = "5",

doi = "10.1177/02692155241229398",

language = "English",

pages = "1--17",

journal = "Clinical Rehabilitation",

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Wang, X-Q, Wang, Y-L, Witchalls, J, Han, J, Zhang, Z-J, Page, P, Zhu, Y-L, Stecco, C, Lin, J-H, El-Ansary, D, Ma, Q-S, Qi, Q, Oh, J-S, Zhang, W-M, Pranata, A, Wan, L, Li, K, Ma, M, Liao, L-R, Zhu, Y-L, Guo, J-W & Chen, P-J 2024, 'Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus', Clinical Rehabilitation, pp. 1-17. https://doi.org/10.1177/02692155241229398

TY - JOUR

T1 - Physical therapy for acute and sub-acute low back pain

T2 - A systematic review and expert consensus

AU - Wang, Xue-Qiang

AU - Wang, Yu-Ling

AU - Witchalls, Jeremy

AU - Han, Jia

AU - Zhang, Zhi-Jie

AU - Page, Phillip

AU - Zhu, Yu-Lian

AU - Stecco, Carla

AU - Lin, Jian-Hua

AU - El-Ansary, Doa

AU - Ma, Quan-Sheng

AU - Qi, Qi

AU - Oh, Jae-Seop

AU - Zhang, Wei-Ming

AU - Pranata, Adrian

AU - Wan, Li

AU - Li, Kui

AU - Ma, Ming

AU - Liao, Lin-Rong

AU - Zhu, Yu-Lian

AU - Guo, Jing-Wei

AU - Chen, Pei-Jie

PY - 2024/2/5

Y1 - 2024/2/5

N2 - OBJECTIVE: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions.DATA SOURCES: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years.REVIEW METHODS: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts.RESULTS: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain.CONCLUSIONS: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.

AB - OBJECTIVE: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions.DATA SOURCES: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years.REVIEW METHODS: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts.RESULTS: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain.CONCLUSIONS: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.

KW - Physical therapy

KW - exercise

KW - expert consensus

KW - low back pain

KW - manual therapy

UR - http://www.scopus.com/inward/record.url?scp=85184444576&partnerID=8YFLogxK

U2 - 10.1177/02692155241229398

DO - 10.1177/02692155241229398

M3 - Article

C2 - 38317586

SN - 0269-2155

SP - 1

EP - 17

JO - Clinical Rehabilitation

JF - Clinical Rehabilitation

ER -

Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus

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