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Journal of Occupational Rehabilitation
Published in: Journal of Occupational Rehabilitation 4/2023

Open Access 22-11-2023 | Systematic Review

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Needling Therapies for Chronic Primary Low Back Pain in Adults

Authors: Hainan Yu, Dan Wang, Leslie Verville, Danielle Southerst, André Bussières, Douglas P. Gross, Paulo Pereira, Silvano Mior, Andrea C. Tricco, Christine Cedraschi, Ginny Brunton, Margareta Nordin, Heather M. Shearer, Jessica J. Wong, Gaelan Connell, Danny Myrtos, Sophia da Silva-Oolup, James J. Young, Martha Funabashi, Andrew Romanelli, Joyce G. B. Lee, Kent Stuber, Brett Guist, Javier Muñoz Laguna, Léonie Hofstetter, Kent Murnaghan, Cesar A. Hincapié, Carol Cancelliere

Published in: Journal of Occupational Rehabilitation | Issue 4/2023

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Abstract

Purpose

Evaluate benefits and harms of needling therapies (NT) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.

Methods

Electronic databases were searched for randomized controlled trials (RCTs) assessing NT compared with placebo/sham, usual care, or no intervention (comparing interventions where the attributable effect could be isolated). We conducted meta-analyses where indicated and graded the certainty of evidence.

Results

We screened 1831 citations and 109 full text RCTs, yeilding 37 RCTs. The certainty of evidence was low or very low across all included outcomes. There was little or no difference between NT and comparisons across most outcomes; there may be some benefits for certain outcomes. Compared with sham, NT improved health-related quality of life (HRQoL) (physical) (2 RCTs; SMD = 0.20, 95%CI 0.07; 0.32) at 6 months. Compared with no intervention, NT reduced pain at 2 weeks (21 RCTs; MD = − 1.21, 95%CI − 1.50; − 0.92) and 3 months (9 RCTs; MD = − 1.56, 95%CI − 2.80; − 0.95); and reduced functional limitations at 2 weeks (19 RCTs; SMD = − 1.39, 95%CI − 2.00; − 0.77) and 3 months (8 RCTs; SMD = − 0.57, 95%CI − 0.92; − 0.22). In older adults, NT reduced functional limitations at 2 weeks (SMD = − 1.10, 95%CI − 1.71; − 0.48) and 3 months (SMD = − 1.04, 95%CI − 1.66; − 0.43). Compared with usual care, NT reduced pain (MD = − 1.35, 95%CI − 1.86; − 0.84) and functional limitations (MD = − 2.55, 95%CI − 3.70; − 1.40) at 3 months.

Conclusion

Based on low to very low certainty evidence, adults with CPLBP experienced some benefits in pain, functioning, or HRQoL with NT; however, evidence showed little to no differences for other outcomes.
Appendix
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Metadata
Title
Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Needling Therapies for Chronic Primary Low Back Pain in Adults
Authors
Hainan Yu
Dan Wang
Leslie Verville
Danielle Southerst
André Bussières
Douglas P. Gross
Paulo Pereira
Silvano Mior
Andrea C. Tricco
Christine Cedraschi
Ginny Brunton
Margareta Nordin
Heather M. Shearer
Jessica J. Wong
Gaelan Connell
Danny Myrtos
Sophia da Silva-Oolup
James J. Young
Martha Funabashi
Andrew Romanelli
Joyce G. B. Lee
Kent Stuber
Brett Guist
Javier Muñoz Laguna
Léonie Hofstetter
Kent Murnaghan
Cesar A. Hincapié
Carol Cancelliere
Publication date
22-11-2023
Publisher
Springer US
Published in
Journal of Occupational Rehabilitation / Issue 4/2023
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-023-10125-3

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