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Pilates para el dolor lumbar
Tiê P Yamato, Christopher G Maher, Bruno T Saragiotto, Mark J Hancock, Raymond WJG Ostelo, Cristina MN Cabral, Luciola C Menezes Costa, Leonardo OP Costa | 2 julio 2015

Respuestas clínicas Cochrane

Topics

Temas

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Back School versus no treatment, Outcome 1 Pain.
Figuras y tablas -
Analysis 1.1

Comparison 1 Back School versus no treatment, Outcome 1 Pain.

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Comparison 1 Back School versus no treatment, Outcome 2 Disability.
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Analysis 1.2

Comparison 1 Back School versus no treatment, Outcome 2 Disability.

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Comparison 2 Back School versus medical care, Outcome 1 Pain.
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Analysis 2.1

Comparison 2 Back School versus medical care, Outcome 1 Pain.

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Comparison 2 Back School versus medical care, Outcome 2 Disability.
Figuras y tablas -
Analysis 2.2

Comparison 2 Back School versus medical care, Outcome 2 Disability.

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Comparison 3 Back School versus passive physiotherapy, Outcome 1 Pain.
Figuras y tablas -
Analysis 3.1

Comparison 3 Back School versus passive physiotherapy, Outcome 1 Pain.

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Comparison 3 Back School versus passive physiotherapy, Outcome 2 Disability.
Figuras y tablas -
Analysis 3.2

Comparison 3 Back School versus passive physiotherapy, Outcome 2 Disability.

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Comparison 4 Back school versus exercise, Outcome 1 Pain.
Figuras y tablas -
Analysis 4.1

Comparison 4 Back school versus exercise, Outcome 1 Pain.

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Comparison 4 Back school versus exercise, Outcome 2 Disability.
Figuras y tablas -
Analysis 4.2

Comparison 4 Back school versus exercise, Outcome 2 Disability.

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Summary of findings for the main comparison. Back School compared with no treatment for low back pain

Back School compared with no treatment for low back pain

Patient or population: people with low back pain

Intervention: Back School

Comparison: no treatment

Outcomes

lIIustrative comparative risks (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk*

No treatment

Back School

Pain: short‐term follow‐up (< 3 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at short‐term follow‐up ranged across control groups from 31.8 to 68 points.

The mean pain (short term) in the intervention groups was 6.10 lower (10.18 lower to 2.01 lower).

MD ‐6.10 (‐10.18 to ‐2.01)

647 participants (6 studies)

⊕⊝⊝⊝
very low2,3,4

Pain: intermediate‐term follow‐up (3 to 6 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at intermediate‐term follow‐up ranged across control groups from 26 to 65 points.

The mean pain (intermediate term) in the intervention groups was 4.34 lower (14.37 lower to 5.68 higher).

MD ‐4.34 (‐14.37 to 5.68)

257 participants (4 studies)

⊕⊝⊝⊝
very low1,2,4

Pain: long‐term follow‐up (> 6 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at long‐term follow‐up ranged across control groups from 38 to 58 points.

The mean pain (long term) in the intervention groups was 12.16 lower (29.14 lower to 4.83 higher).

MD ‐12.16 (‐29.14 to 4.38)

244 participants (3 studies)

⊝⊝⊝⊝
very low1,2,3,4

Disability: short‐term follow‐up (< 3 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at short‐term follow‐up ranged across control groups from 29.3 to 60 points.

The mean disability (short term) in the intervention groups was 3.83 lower (6.70 lower to 0.05 lower).

MD ‐3.38 (‐6.70 to ‐0.05)

426 participants (3 studies)

⊕⊝⊝⊝
very low2,3,4

Disability: intermediate‐term follow‐up (3 to 6 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at intermediate‐term follow‐up ranged across control groups from 39 to 53 points.

The mean disability (intermediate term) in the intervention groups was 5.92 lower (12.80 lower to 0.23 higher).

MD ‐5.92 (‐12.08 to 0.23)

181 participants (3 studies)

⊕⊝⊝⊝
very low1,2,4

Disability: long‐term follow‐up (> 6 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability long‐term follow‐up ranged across control groups from 48 to 51 points.

The mean disability (long term) in the intervention
groups was 7.36 lower (22.05 lower to 7.34 higher).

MD ‐7.36 (‐22.05 to 7.34)

124 participants (2 studies)

⊕⊝⊝⊝
very low1,2,4

Adverse events Not reported

Work status Not reported

The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; MD: mean difference

GRADE Working Group grades of evidence

High‐quality evidence: There are consistent findings among at least 75% of randomised controlled trials with low risk of bias; consistent, direct, and precise data; and no known or suspected publication biases. Further research is unlikely to change either the estimate or our confidence in the results.

Moderate‐quality evidence: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐quality evidence: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐quality evidence: We are very uncertain about the results.
No evidence: We identified no randomised controlled trials that addressed this outcome.

1Downgraded one level due to imprecision (fewer than 400 participants in total).
2Downgraded one level due to risk of bias (> 25% of the participants were from studies with a high risk of bias).
3Downgraded one level due to clear inconsistency of results.
4Downgraded one level due to publication bias.

Figuras y tablas -
Summary of findings for the main comparison. Back School compared with no treatment for low back pain
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Summary of findings 2. Back School compared with medical care for low back pain

Back School compared with medical care for low back pain

Patient or population: people with low back pain

Intervention: Back School

Comparison: medical care

Outcomes

Illustrative comparative risks (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk*

Medical care

Back School

Pain: short‐term follow‐up (< 3 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at short‐term follow‐up ranged across control groups from 17 to 73 points.

The mean pain (short term) in the intervention groups was 10.16 lower (19.11 lower to 1.22 lower).

MD ‐10.16 (‐19.11 to ‐1.22)

249 participants (3 studies)

⊕⊝⊝⊝
very low1,2,4

Pain: intermediate‐term follow‐up (3 to 6 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at intermediate‐term follow‐up ranged across control groups from 12 to 76 points.

The mean pain (intermediate term) in the intervention groups was 9.65 lower (22.46 lower to 3.15 higher).

MD ‐9.65 (‐22.46 to 3.15)

545 participants (5 studies)

⊕⊝⊝⊝
very low2,3,4

Pain: long‐term follow‐up (> 6 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at long‐term follow‐up ranged across control groups from 12 to 65 points.

The mean pain (long term) in the intervention groups was 5.71 lower (20.27 lower to 8.84 higher).

MD ‐5.71 (‐20.27 to 8.84)

406 participants (3 studies)

⊕⊝⊝⊝
very low2,3,4

Disability: short‐term follow‐up (< 3 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at short‐term follow‐up ranged across control groups from 24.8 to 41.2 points.

The mean disability at short‐term follow‐up in the intervention groups was 1.19 lower (7.02 lower to 4.64 higher).

MD ‐1.19 (‐7.02 to 4.64)

130 participants (2 studies)

⊕⊝⊝⊝
very low1,2,4

Disability: intermediate‐term follow‐up (3 to 6 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at intermediate‐term follow‐up ranged across control groups from 25.8 to 43.3 points.

The mean disability at intermediate‐term follow‐up in the intervention groups was 6.34 lower (10.89 lower to 1.79 lower).

MD ‐6.34 (‐10.89 to ‐1.79)

331 participants (3 studies)

⊕⊝⊝⊝
very low1,2,4

Disability: long‐term follow‐up (> 6 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at long‐term follow‐up was 32.9 points.

The mean disability at long‐term follow‐up in the intervention groups was 0.40 lower (7.33 lower to 6.53 higher).

MD ‐0.40 (‐7.33 to 6.53)

201 participants (1 study)

⊕⊝⊝⊝
very low1,2,4

Adverse events Two workers in the Back School group (n=98) reported a strong increase in low back pain (Heymans 2006).

Work status Not reported

The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; MD: mean difference

GRADE Working Group grades of evidence

High‐quality evidence: There are consistent findings among at least 75% of randomised controlled trials with low risk of bias; consistent, direct, and precise data; and no known or suspected publication biases. Further research is unlikely to change either the estimate or our confidence in the results.

Moderate‐quality evidence: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐quality evidence: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐quality evidence: We are very uncertain about the results.
No evidence: We identified no randomised controlled trials that addressed this outcome.

1Downgraded one level due to imprecision (fewer than 400 participants in total).
2Downgraded one level due to risk of bias (> 25% of the participants were from studies with a high risk of bias).
3Downgraded one level due to clear inconsistency of results.
4Downgraded one level due to publication bias.

Figuras y tablas -
Summary of findings 2. Back School compared with medical care for low back pain
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Summary of findings 3. Back School compared with passive physiotherapy for low back pain

Back School compared with passive physiotherapy for low back pain

Patient or population: people with low back pain.

Intervention: Back School

Comparison: passive physiotherapy

Outcomes

Illustrative comparative risks (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk*

Passive physiotherapy

Back School

pain: short‐term follow‐up (< 3
months)
Multiple scales: scale from 0 to 100 (worse pain)

The mean pain at short‐term follow‐up ranged across control groups from 7.1 to 88 points.

The mean pain (short‐ term) in the intervention groups was 1.96 higher (9.51 lower to 13.43 higher).

MD 1.96 (‐9.51 to
13.43)

290
participants
(3 studies)

⊝⊝⊝⊝
very low1,2,3,4

pain ‐ intermediate‐term follow up (3‐6 months)

Multiple scales: scale from 0 to 100 (worse pain)

The mean pain at intermediate‐term follow‐up ranged across control
groups from 13.3 to 65 points.

The mean pain (intermediate‐term) in the intervention groups was 16.89 lower (66.56 lower to 32.79 higher).

MD ‐16.89 (‐66.56
to 32.79)

290
participants
(3 studies)

⊝⊝⊝⊝
very low1,2,3,4

pain ‐ long‐term follow‐up (>6 months)

Multiple scales: scale from 0 to 100 (worse pain)

The mean pain at long‐term follow‐up ranged across control groups from 11.6 to 60.5 points.

The mean pain (long‐ term) in the intervention groups was 12.86 lower (61.22 lower to 35.50 higher).

MD ‐12.86 (‐61.22
to 35.50)

291
participants
(3 studies)

⊝⊝⊝⊝
very low1,2,3,4

Disability ‐ short‐term follow‐up (<3 months)

Multiple scales:
scale from 0 to 100
(worse disability)

The mean disability at short‐term follow‐up ranged across control groups from 9.1 to 60 points.

The mean disability at short‐term follow‐up in the intervention groups was 2.57 higher (15.88 lower to 21.01 higher).

MD 2.57
(‐15.88 to
21.01)

180
participants
(2 studies)

⊝⊝⊝⊝
very low1,2,3,4

Disability ‐ intermediate‐term follow up (3‐6 months)

Multiple scales:
scale from 0 to 100
(worse disability)

The mean disability at intermediate‐term follow‐up
ranged across control groups from 10.4 to 53 points.

The mean disability at short‐term follow‐up in the intervention groups was 6.88 higher (‐4.86 lower to 18.63 higher).

MD 6.88
(‐4.86 to
18.63).

180
participants
(2 studies)

⊕⊝⊝⊝
very low1,2,4

Disability ‐ long‐term follow‐up (>6 months)

Multiple scales:
scale from 0 to 100
(worse disability)

The mean disability at long‐term follow‐up ranged across
control groups from 10.4 to 46 points.

The mean disability at long‐term follow‐up in the intervention groups was 9.60 higher (3.65 higher to 15.54 higher).

MD 9.60
(3.65 to 15.54)

180
participants
(2 studies)

⊕⊝⊝⊝
very low1,2,4

Adverse events Not reported

Work status Not reported

The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; MD: mean difference

GRADE Working Group grades of evidence

High‐quality evidence: There are consistent findings among at least 75% of randomised controlled trials with low risk of bias; consistent, direct, and precise data; and no known or suspected publication biases. Further research is unlikely to change either the estimate or our confidence in the results.

Moderate‐quality evidence: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐quality evidence: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐quality evidence: We are very uncertain about the results.
No evidence: We identified no randomised controlled trials that addressed this outcome.

1 Downgraded one level due to imprecision (fewer than 400 participants, in total).
2 Downgraded one level due to risk of bias (> 25% of the participants were from studies with a high risk of bias).
3 Downgraded one level due to clear inconsistency of results.
4 Downgraded one level due to publication bias.

Figuras y tablas -
Summary of findings 3. Back School compared with passive physiotherapy for low back pain
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Summary of findings 4. Back School compared with exercise for low back pain

Back School compared with exercise for low back pain

Patient or population: people with low back pain

Intervention: Back School

Comparison: exercise

Outcomes

Illustrative comparative risks (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk*

Exercise

Back School

Pain: short‐term follow‐up (< 3 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at short‐term follow‐up ranged across control groups from 25 to 40 points.

The mean pain (short term) in the intervention groups was 2.06 lower (14.58 lower to 10.45 higher).

MD ‐2.06 (‐14.58 to 10.45)

416 participants (5 studies)

⊕⊝⊝⊝
very low2,3,4

Pain: intermediate‐term follow‐up (3 to 6 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at intermediate‐term follow‐up ranged across control groups from 11.2 to 40 points.

The mean pain (intermediate term) in the intervention groups was 4.46 lower (19.44 lower to 10.52 higher).

MD ‐4.46 (‐19.44 to 10.52)

619 participants (4 studies)

⊕⊕⊝⊝
low3,4

Pain: long‐term follow‐up (> 6 months)

Multiple scales: scale from 0 to 100
(worse pain)

The mean pain at long‐term follow‐up ranged across control groups from 8.6 to 50.9 points.

The mean pain (long term) in the intervention groups was 4.58 higher (0.20 lower to 9.36 higher).

MD 4.58 (‐0.20 to 9.36)

461 participants (3 studies)

⊕⊕⊝⊝
low3,4

Disability: short‐term follow‐up (< 3 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at short‐term follow‐up ranged across control groups from 4.5 to 29.1 points.

The mean disability at short‐term follow‐up in the intervention groups was 1.65 lower (8.66 lower to 5.37 higher).

MD ‐1.65 (‐8.66 to 5.37)

471 participants (6 studies)

⊕⊝⊝⊝
very low2,3,4

Disability: intermediate‐term follow‐up (3 to 6 months)

Multiple scales: scale from 0 to 100 (worse disability)

The mean disability at intermediate‐term follow‐up ranged across control groups from 2.87 to 29.5 points.

The mean disability at intermediate‐term follow‐up in the intervention groups was 1.57 higher (3.86 lower to 7.00 higher).

MD 1.57 (‐3.86 to 7.00)

766 participants (6 studies)

⊕⊝⊝⊝
very low2,3,4

Disability: long‐term follow‐up (> 6 months)

Multiple scales: scale from 0 to 100 (worse disability

The mean disability at long‐term follow‐up ranged across control groups from 3.3 to 28.3 points.

The mean disability at long‐term follow‐up in the intervention groups was 4.54 higher (4.44 lower to 13.52 higher).

MD 4.54 (‐4.44 to 13.52)

556 participants (4 studies)

⊕⊝⊝⊝
very low2,3,4

Adverse events One participant in the Back School group reported a temporary exacerbation of pain (Garcia 2013) and 5 patients in exercise group experienced worsening of leg pain (Dufour 2010)

Work status Not reported

The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; MD: mean difference

GRADE Working Group grades of evidence

High‐quality evidence: There are consistent findings among at least 75% of randomised controlled trials with low risk of bias; consistent, direct, and precise data; and no known or suspected publication biases. Further research is unlikely to change either the estimate or our confidence in the results.

Moderate‐quality evidence: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐quality evidence: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐quality evidence: We are very uncertain about the results.
No evidence: We identified no randomised controlled trials that addressed this outcome.

1Downgraded one level due to imprecision (fewer than 400 participants in total).
2Downgraded one level due to risk of bias (> 25% of the participants were from studies with a high risk of bias).
3Downgraded one level due to clear inconsistency of results.
4Downgraded one level due to publication bias.

Figuras y tablas -
Summary of findings 4. Back School compared with exercise for low back pain
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Table 1. Sources of risk of bias

Bias domain

Source of bias

Possible answers

Selection

(1) Was the method of randomization adequate?

Yes/no/unsure

Selection

(2) Was the treatment allocation concealed?

Yes/no/unsure

Performance

(3) Was the patient blinded to the intervention?

Yes/no/unsure

Performance

(4) Was the care provider blinded to the intervention?

Yes/no/unsure

Detection

(5) Was the outcome assessor blinded to the intervention?

Yes/no/unsure

Attrition

(6) Was the drop‐out rate described and acceptable?

Yes/no/unsure

Attrition

(7) Were all randomized participants analyzed in the group to which they were allocated?

Yes/no/unsure

Reporting

(8) Are reports of the study free of suggestion of selective outcome reporting?

Yes/no/unsure

Selection

(9) Were the groups similar at baseline regarding the most important prognostic indicators?

Yes/no/unsure

Performance

(10) Were co‐interventions avoided or similar?

Yes/no/unsure

Performance

(11) Was the compliance acceptable in all groups?

Yes/no/unsure

Detection

(12) Was the timing of the outcome assessment similar in all groups?

Yes/no/unsure

Other

(13) Are other sources of potential bias unlikely?

Yes/no/unsure

Furlan 2015

Figuras y tablas -
Table 1. Sources of risk of bias
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Table 2. Criteria for a judgment of ‘‘yes’’ for the sources of risk of bias

1

A random (unpredictable) assignment sequence. Examples of adequate methods are coin toss (for studies with 2 groups), rolling a dice (for studies with 2 or more groups), drawing of balls of different colours, drawing of ballots with the study group labels from a dark bag, computer‐generated random sequence, preordered sealed envelopes, sequentially‐ordered vials, telephone call to a central office, and preordered list of treatment assignments. Examples of inadequate methods are: alternation, birth date, social insurance/security number, date in which they are invited to participate in the study, and hospital registration number.

2

Assignment generated by an independent person not responsible for determining the eligibility of the patients. This person has no information about the persons included in the trial and has no influence on the assignment sequence or on the decision about eligibility of the patient.

3

Index and control groups are indistinguishable for the patients or if the success of blinding was tested among the patients and it was successful.

4

Index and control groups are indistinguishable for the care providers or if the success of blinding was tested among the care providers and it was successful.

5

Adequacy of blinding should be assessed for each primary outcome separately. This item should be scored ‘‘yes’’ if the success of blinding was tested among the outcome assessors and it was successful or:

  • for patient‐reported outcomes in which the patient is the outcome assessor (e.g., pain, disability): the blinding procedure is adequate for outcome assessors if participant blinding is scored ‘‘yes’’

  • for outcome criteria assessed during scheduled visit and that supposes a contact between participants and outcome assessors (e.g., clinical examination): the blinding procedure is adequate if patients are blinded, and the treatment or adverse effects of the treatment cannot be noticed during clinical examination

  • for outcome criteria that do not suppose a contact with participants (e.g., radiography, magnetic resonance imaging): the blinding procedure is adequate if the treatment or adverse effects of the treatment cannot be noticed when assessing the main outcome

  • for outcome criteria that are clinical or therapeutic events that will be determined by the interaction between patients and care providers (e.g., co‐interventions, hospitalization length, treatment failure), in which the care provider is the outcome assessor: the blinding procedure is adequate for outcome assessors if item ‘‘4’’ (caregivers) is scored ‘‘yes’’

  • for outcome criteria that are assessed from data of the medical forms: the blinding procedure is adequate if the treatment or adverse effects of the treatment cannot be noticed on the extracted data

6

The number of participants who were included in the study but did not complete the observation period or were not included in the analysis must be described and reasons given. If the percentage of withdrawals and drop‐outs does not exceed 20% for short‐term follow‐up and 30% for long‐term follow‐up and does not lead to substantial bias a ‘‘yes’’ is scored. (N.B. these percentages are arbitrary, not supported by literature).

7

All randomized patients are reported/analyzed in the group they were allocated to by randomization for the most important moments of effect measurement (minus missing values) irrespective of noncompliance and co‐interventions.

8

All the results from all prespecified outcomes have been adequately reported in the published report of the trial. This information is either obtained by comparing the protocol and the report, or in the absence of the protocol, assessing that the published report includes enough information to make this judgment.

9

Groups have to be similar at baseline regarding demographic factors, duration and severity of complaints, percentage of patients with neurological symptoms, and value of main outcome measure(s).

10

If there were no co‐interventions or they were similar between the index and control groups.

11

The reviewer determines if the compliance with the interventions is acceptable, based on the reported intensity, duration, number and frequency of sessions for both the index intervention and control intervention(s). For example, physiotherapy treatment is usually administered for several sessions; therefore it is necessary to assess how many sessions each patient attended. For single‐session interventions (e.g., surgery), this item is irrelevant.

12

Timing of outcome assessment should be identical for all intervention groups and for all primary outcome measures.

13

Other types of biases. For example:

  • When the outcome measures were not valid. There should be evidence from a previous or present scientific study that the primary outcome can be considered valid in the context of the present.

  • Industry‐sponsored trials. The conflict of interest (COI) statement should explicitly state that the researchers have had full possession of the trial process from planning to reporting without funders with potential COI having any possibility to interfere in the process. If, for example, the statistical analyses have been done by a funder with a potential COI, usually ‘‘unsure’’ is scored.

Furlan 2015

Figuras y tablas -
Table 2. Criteria for a judgment of ‘‘yes’’ for the sources of risk of bias
Ir a la tabla de la revisión
Comparison 1. Back School versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

7

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 short‐term follow‐up (<3 months)

6

647

Mean Difference (IV, Random, 95% CI)

‐6.10 [‐10.18, ‐2.01]

1.2 intermediate‐term follow up (3‐6 months)

4

257

Mean Difference (IV, Random, 95% CI)

‐4.34 [‐14.37, 5.68]

1.3 long‐term follow‐up (>6 months)

3

244

Mean Difference (IV, Random, 95% CI)

‐12.16 [‐29.14, 4.83]

2 Disability Show forest plot

4

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 short‐term follow‐up (<3 months)

3

426

Mean Difference (IV, Random, 95% CI)

‐3.38 [‐6.70, ‐0.05]

2.2 intermediate‐term follow up (3‐6 months)

3

181

Mean Difference (IV, Random, 95% CI)

‐5.92 [‐12.08, 0.23]

2.3 long‐term follow‐up (>6 months)

2

124

Mean Difference (IV, Random, 95% CI)

‐7.36 [‐22.05, 7.34]
Figuras y tablas -
Comparison 1. Back School versus no treatment
Ir a la tabla de la revisión
Comparison 2. Back School versus medical care

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

5

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 short‐term follow‐up (<3 months)

3

249

Mean Difference (IV, Random, 95% CI)

‐10.16 [‐19.11, ‐1.22]

1.2 intermediate‐term follow up (3‐6 months)

5

545

Mean Difference (IV, Random, 95% CI)

‐9.65 [‐22.46, 3.15]

1.3 long‐term follow‐up (>6 months)

3

406

Mean Difference (IV, Random, 95% CI)

‐5.71 [‐20.27, 8.84]

2 Disability Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 short‐term follow‐up (<3 months)

2

130

Mean Difference (IV, Random, 95% CI)

‐1.19 [‐7.02, 4.64]

2.2 intermediate‐term follow up (3‐6 months)

3

331

Mean Difference (IV, Random, 95% CI)

‐6.34 [‐10.89, ‐1.79]

2.3 long‐term follow‐up (>6 months)

1

201

Mean Difference (IV, Random, 95% CI)

‐0.40 [‐7.33, 6.53]
Figuras y tablas -
Comparison 2. Back School versus medical care
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Comparison 3. Back School versus passive physiotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 short‐term follow‐up (<3 months)

3

290

Mean Difference (IV, Random, 95% CI)

1.96 [‐9.51, 13.43]

1.2 intermediate‐term follow up (3‐6 months)

3

290

Mean Difference (IV, Random, 95% CI)

‐16.89 [‐66.56, 32.79]

1.3 long‐term follow‐up (>6 months)

3

291

Mean Difference (IV, Random, 95% CI)

‐12.86 [‐61.22, 35.50]

2 Disability Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 short‐term follow‐up (<3 months)

2

180

Mean Difference (IV, Random, 95% CI)

2.57 [‐15.88, 21.01]

2.2 intermediate‐term follow up (3‐6 months)

2

180

Mean Difference (IV, Random, 95% CI)

6.88 [‐4.86, 18.63]

2.3 long‐term follow‐up (>6 months)

2

180

Mean Difference (IV, Random, 95% CI)

9.60 [3.65, 15.54]
Figuras y tablas -
Comparison 3. Back School versus passive physiotherapy
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Comparison 4. Back school versus exercise

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

6

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 short‐term follow‐up (<3 months)

5

416

Mean Difference (IV, Random, 95% CI)

‐2.06 [‐14.58, 10.45]

1.2 intermediate‐term follow up (3‐6 months)

4

619

Mean Difference (IV, Random, 95% CI)

‐4.46 [‐19.44, 10.52]

1.3 long‐term follow‐up (>6 months)

3

461

Mean Difference (IV, Random, 95% CI)

4.58 [‐0.20, 9.36]

2 Disability Show forest plot

8

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 short‐term follow‐up (<3 months)

6

471

Mean Difference (IV, Random, 95% CI)

‐1.65 [‐8.66, 5.37]

2.2 intermediate‐term follow up (3‐6 months)

6

766

Mean Difference (IV, Random, 95% CI)

1.57 [‐3.86, 7.00]

2.3 long‐term follow‐up (>6 months)

4

556

Mean Difference (IV, Random, 95% CI)

4.54 [‐4.44, 13.52]
Figuras y tablas -
Comparison 4. Back school versus exercise
Ir a la tabla de la revisión