The short-, mid- and long-term effect of back orthoses on pain and related disability in adults with non-specific, mechanical back pain : an overview of systematic reviews
Thesis (MScPhysio)--Stellenbosch University, 2019.
ENGLISH SUMMARY : Background: Non-specific, mechanical low back pain is one of the most prevalent musculoskeletal conditions that commonly results in disability in adults younger than 45 years, second only to arthritis in those aged 46 to 65 years. In industrialized countries, LBP accounts for 20% to 30% of all lost time claims in the workplace, costing the world billions every year. Conflicting opinions exists amongst clinicians regarding the use of back orthoses as a management and prevention tool for non-specific, mechanical LBP. Given the contradicting evidence for the use of back orthoses, that it is common practice for patients to use back orthoses, regardless of the presence of LBP and that many systematic reviews exist on this topic, all current evidence can be collated in an attempt to derive an overview for clinicians and the general population regarding the evidencefor the use of back orthoses for non-specific, mechanical LBP as prophylactic treatment or actual treatment. Method: A comprehensive search of the electronic databases was conducted between August 2017 and March 2018 at PubMed, Medline, Cochrane, Science direct and Elsevier. The following search terms were used and combined using Boolean terms to build electronic search strategies for each database: lowback pain,back pain,mechanical low back pain, lumbar support, corset, orthoses, pain, and disability. Systematic reviews investigating the effect of back orthoses on related pain and disabilities among adultswith non-specific, mechanical LBP were sought and reviewed. Studies were limited to those published in the English language. The Critical Appraisal Skills Program (CASP) were used to appraise the included studies. The results for each review were classified as either positive (for the use of orthoses), negative (against the use of orthoses) or neutral (neither for nor against the use of orthoses) and used to derive a useful and concise overview of the literature. Result: Fourteen systematic reviews were found appropriate for inclusion in this review. Three studies were of high quality, eight studies showed moderate quality and three studies showed low quality. The included systematic reviews were conducted between 1997 and 2018. The total sample size for the included studies was approximately 116,443. Both male and female adults, aged over 18 years, were included in the included studies. The majority of the participants were workers. The majority (50%) of the included studies were against the use of back orthoses while three studies showed neutral result and four studies showed a positive result. Conclusion: The main finding of this review regarding the effect of back orthoses as either a management strategy or prophylactic treatment on pain and related disability in adults with non-specific, mechanical LBP in the short-, mid- and long term, was that the use of back orthoses is generally not suggested.
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