Cited by 160Musculoskeletal pain and rehabilitationHealth Systems, Economic Evaluations, Quality of LifeHealthcare cost, quality, practices

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Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis

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Miyamoto, Gisela Cristiane, Lin, Chung-Wei Christine, Cabral, Cristina Maria Nunes, van Dongen, Johanna M, van Tulder, Maurits W·2019·British Journal of Sports Medicine

DOI 10.1136/bjsports-2017-098765

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Abstract

Objective: To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain. Design: Systematic review of economic evaluations. Data sources: The search was performed in 5 clinical and 3 economic electronic databases. Eligibility criteria for selecting studies: We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed. Results: Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain. Conclusions: Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed. Registration: PROSPERO, CRD42017059025.

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Authors: Miyamoto, G. C., Lin, C.-W. C., Cabral, C. M. N., van Dongen, J. M., & van Tulder, M. W.
Affiliations: Universidade Cidade de São Paulo (BR)
The University of Sydney (AU)
Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Noord-Holland, The Netherlands
Corresponding author: Miyamoto, Gisela Cristiane
ORCID: Miyamoto, Gisela Cristiane
Lin, Chung-Wei Christine
Cabral, Cristina Maria Nunes
Venue: British Journal of Sports Medicine
Publisher: BMJ
Published: 2018-04-20
Volume: 53
Issue: 3
Pages: 172-181
ISSN: 0306-3674 (ISSN-L)
1473-0480
DOI: 10.1136/bjsports-2017-098765
OpenAlex: W2802922258
Cited by: 155
References: 65
Citations by year: 2026: 10 · 2025: 18 · 2024: 37 · 2023: 20 · 2022: 18 · 2021: 28 · 2020: 16 · 2019: 3 · 2018: 5
FWCI: 1.52
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: British Journal of Sports Medicine (publishedVersion)
PubMed (publishedVersion)
VU Research Portal (publishedVersion, other-oa)
HighWire Press Open Archive (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: National Health and Medical Research Council
Fundação de Amparo à Pesquisa do Estado de São Paulo
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
Keywords: exercise therapy, cost-effectiveness, non-specific neck pain, low back pain, chronic low back pain, subacute low back pain, acute low back pain, quality-adjusted life years, incremental cost-utility ratio, usual care comparison, economic evaluation
MeSH terms: Cost-Benefit Analysis, Exercise Therapy, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Low Back Pain, Quality-Adjusted Life Years, Neck Pain, Physical Therapy Modalities

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Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis

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