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Cited by 33Musculoskeletal pain and rehabilitationAcupuncture Treatment Research StudiesSpine and Intervertebral Disc Pathology

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

Amaral, Lorena K.B., Souza, Mateus B., Campos, Mariana G.M., Mendonça, Vanessa A., Bastone, Alessandra, Pereira, Leani S.M., Mascarenhas, Rodrigo O., Oliveira, Vinicius C.·2020·Archives of Gerontology and Geriatrics
DOI 10.1016/j.archger.2020.104177
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Abstract

Purpose This systematic review aimed to investigate the effectiveness of conservative therapy in older people with nonspecific low back pain.Materials and methods 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.Results 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 other important outcomes in older people is scarce and we did not find any trial investigating pharmacological therapies.Conclusion Findings support partially exercise and trigger point acupuncture to improve disability and/or pain. Future trials with appropriate sample sizes are likely to impact on the estimates and need to clarify medium- and long-term effects.

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  • Reviews on conservative interventions and local heat application reported that conclusions could not be drawn about the effectiveness of interventions either due to low quality or insufficient data for the population of interest.

    “The reviews on conservative interventions103 104 and local heat application97 reported that conclusions could not be drawn about the effectiveness of interventions either due to low quality or insufficient data for the population of interest.”

    From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [103]

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Authors
Amaral, L. K. B., Souza, M. B., Campos, M. G. M., Mendonça, V. A., Bastone, A., Pereira, L. S. M., Mascarenhas, R. O., & Oliveira, V. C.
Affiliations
  • Universidade Federal dos Vales do Jequitinhonha e Mucuri (BR)
  • Universidade Federal de Minas Gerais (BR)
ORCID
Venue
Archives of Gerontology and Geriatrics
Publisher
Elsevier BV
Published
2020-09
Volume
90
Pages
104177
ISSN
0167-4943 (ISSN-L)
DOI
10.1016/j.archger.2020.104177
OpenAlex
W3041101826
Cited by
33
References
52
Citations by year
2026: 4 · 2025: 7 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 2 · 2020: 2
FWCI
0.52
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Archives of Gerontology and Geriatrics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Complementary and alternative medicine › Acupuncture Treatment Research Studies
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords
non-specific low back pain, older adults, conservative treatment, exercise therapy, disability, pain, quality of life, falls, depression, mobility (physical function), body composition
MeSH terms
Conservative Treatment, Aged, Aged, 80 and over, Exercise Therapy, Humans, Quality of Life, Exercise, Low Back Pain

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