Appendix I. Summary Tables of Treatment Outcomes
Table A. Acute Low Back Pain: Evidence Summary of Treatments up to Six Weeks
Reference
line
Treatment or system
Number of
study arm
observations
Studies used (see Appendix 2)
Patients
observations
at start
Patient
observations
at study's end
g (95% CI)
pB
Evidential
support over
shamc
0.79 (-1.12 to 2.71)
0.50
b
Single therapies
1
Osteopathic SMT
7
12
153
151
2
Physical therapist SMT
11
3 4 5 6 7 8 9 10
655
581
2.04 (0.93 to 3.15)
0.91
b
3
6
11 12 13 14 15 16 17 18
408
407
1.48 (-1.16 to 4.12)
0.61
b
NA
NA
NA
NA
NA
NA
5
Chiropractic SMT
Chiropractic FlexionDistraction
Medical SMT
6
19 20 21 22
91
91
0.97 (-0.73 to 2.68)
0.51
b
6
Mixed SMT
3
23 24 25
65
65
2.57 (0.32 to 4.83)
1.00
b
7
Back school classes
7
3 4 12 14 23 24
377
266
2.70 (-1.17 to 6.56)
0.86
b
8
Usual medical and analgesic
Attended physiotherapy
modalities
Self care
6
7 10 16 19
148
148
0.76 (-0.79 o 2.31)
0.21
b
16
3 5 6 7 8 10 1113 14 15 16 17 22
837
734
1.83 (-0.35 to 4.01)
0.75
b
11
2 4 13 15 16
325
325
0.65 (-2.70 to 3.99)
0.33
b
9
1 7 16 11 18 21 22 26
256
250
1.40 (0.06 to 2.75)
0.68
Comparison
NA
NA
NA
NA
NA
NA
1 4 9 13 15
233
231
0.69 (-5.00 to 6.36)
0.39
b
NA
NA
NA
NA
NA
NA
NA
4
9
10
11
12
13
14
NA
Sham treatments
No treatment: waiting list
control
Unattended physiotherapy
modalities
Bonesetting
NA
6
Therapies categories
15
All manipulation groups
30
1 2 3 4 5 6 7 8 9 10 11 12 13 14
15 16 18 19 20 21 22 23 24 25
1085
1074
1.56 (1.22 to 4.34)
0.72
b
16
All control groups combined
10
1 7 11 16 20 21 25
354
247
1.92 (0.26 to 3.59)
0.80
b
17
All medical management
combined
15
7 10 16 19
411
411
0.75 (-2.15 to 3.65)
0.32
b
958
880
1.65 (-1.84 to 5.14)
0.65
b
18
Combined physiotherapies
19
1 3 4 5 6 7 8 9 10 11 13 14 15 16
18 22
19
Exercise and back school
9
3 4 12 14 23 24
416
305
2.31 (-1.06 to 5.68)
0.78
b
20
Whole system care
6
678
274
274
1.21 (0.06 to 2.35)
0.76
b
c
a
NA = no studies available for these conditions
b
Evidence equal to or favoring sham
Evidential support interpretation: -1 is weak, -2 moderate,
-3 strong, -4 extremely strong evidence favoring treatment
Table B. Acute Low Back Pain: Evidence Summary of Treatments after Six Weeks and Up to One Year
Reference
line
Number of
study arm
observations
Treatment or system
Studies used (see Appendix 2)
Patients
observations
at start
Patient
observations
at study's end
g (95% CI)
pB
Evidential
support
over shamc
Single therapies
1
Osteopathic SMT
2
1 25
157
154
2.76 (0.71 to 4.81)
0.68
b
2
Physical therapist SMT
3
7 10 11
276
276
2.27 (2.06 to 2.47)
0.69
b
3
Chiropractic SMT
8
11 14 16 17 18 27 28
551
551
1.50 (-2.03 to 5.03)
0.80
b
4
Chiropractic FlexionDistraction
NA
NA
NA
NA
NA
NA
5
Medical SMT
1
29 30 31
48
48
2.98 (1.82 to 4.14)
1.00
b
6
Mixed SMT
4
32
1150
1013
0.59 (-2.73 to 3.90)
0.13
b
7
Back school
6
4 14 16 32
663
663
1.53 (-0.48 to 3.54)
0.59
b
8
Usual/Analgesic
8
7 10 16 29 30
264
264
1.82 (-0.20 to 3.85)
0.68
b
9
Attended physiotherapy
modalities
10
7 10 11 14 16 18 28
604
592
2.01 (0.20 to 3.81)
0.85
b
10
Self-care
3
4 16
215
215
1.24 (-0.27 to 2.76)
0.79
b
11
Sham treatments
8
1 7 16 17 31
225
226
1.64 (-0.01 to 3.29)
0.59
Comparison
NA
NA
NA
NA
NA
NA
1 4 27
233
226
1.78 (-3.47 to 7.04)
0.94
b
NA
NA
NA
NA
NA
NA
NA
12
13
14
NA
No treatment: Waiting list
control
Unattended physiotherapy
modalities
NA
3
Bonesetting
Therapy categories
15
All manipulation groups
16
1 7 10 11 14 16 18 26 27 28 29 30
31 32
1076
1073
2.34 (-1.10 to 5.79)
0.84
b
16
All control groups combined
7
1 7 16 31
177
178
1.78 (-0.05 to 3.60)
0.65
b
17
All medical management
combined
10
7 10 16 26 29 30
438
438
1.78 (-0.25 to 3.80)
0.77
b
18
Combined physiotherapies
12
1 4 7 10 11 14 16 18 28
783
764
2.08 (-0.70 to 4.86)
0.93
b
19
Exercise and back school
6
4 14 16 32
663
663
1.53 (-0.48 to 3.54)
0.59
b
20
Whole system care
10
7 32
1754
1617
0.59 (0.37 to 0.82)
0.13
b
c
a
NA = no studies available for these conditions
b
Evidence equal to or favoring sham
Evidential support interpretation: -1 is weak, -2 moderate,
-3 strong, -4 extremely strong evidence favoring treatment
Table C. Chronic Low Back Pain: Evidence Summary of Treatments up to Six Weeks
Reference
line
Treatment or system
Number of
study arm
observations
Studies used (see Appendix 2)
Patients
observations
at start
Patient
observations
at study's end
g (95% CI)
pB
Evidential
support
over shamc
55
55
-0.02 (-0.60 to 0.56)
0.00
b
Single therapies
1
Osteopathic SMT
1
33 34
2
Physical therapist SMT
1
35
8
8
4.24 (4.05 to 4.44)
1.00
-0.81
3
Chiropractic SMT
4
16 36 37 38
197
177
1.02 (-1.17 to 3.22)
0.63
-0.34
4
Chiropractic Flexion-Distraction
3
39 40
333
318
0.85 (-0.58 to 2.28)
0.53
-0.17
5
Medical SMT
2
20 41
52
52
1.04 (0.69 to 1.39)
0.83
-0.62
a
a
a
a
a
NAa
6
Mixed SMT
0
NA
NA
NA
NA
NA
7
Back school
6
16 35 37 39 42 43
251
220
0.58 (-2.91 to 4.06)
0.15
b
8
Usual/Analgesic
2
16 36
67
58
1.34 (-0.10 to 2.79)
1.00
-0.80
9
Attended physiotherapy modalities
3
16 42 43
85
83
0.84 (-2.45 to 4.13)
0.67
-0.40
10
Self-care
1
35
10
10
0.20 (-1.41 to 1.80)
0.01
b
11
Sham treatments
6
16 20 33 34 37 38 41
160
152
0.85 (-1.03 to 2.72)
0.45
Comparison
12
No treatment: Waiting list control
1
33 34
34
34
-0.62 (-1.40 to 0.15)
0.00
NAa
13
Unattended physiotherapy
modalities
2
40
188
188
0.59 (0.16 to 1.01)
0.11
b
14
Bonesetter SMT
2
42 43
89
83
0.88 (-2.97 to 4.72)
0.57
-0.24
Therapy categories
a
15
All manipulation groups
6
16 20 33 34 35 37 38 41 42 43
140
137
1.54 (-0.63 to 3.70)
0.70
-0.44
16
All control groups
4
16 25 33 34 37 38 41
81
73
1.09 (-1.36 to 3.54)
0.65
-0.38
17
Medical management
1
16 36
15
15
1.14 (-1.10 to 3.37)
1.00
-0.80
18
Modalities
5
16 40 42 43
270
270
0.83 (-1.05 to 2.71)
0.52
-0.16
19
Exercise and back school
6
16 35 37 39 42 43
395
369
0.65 (-2.22 to 3.53)
0.17
b
20
SMT with clinical management
8
41 42 43
308
295
0.70 (0.01 to 1.40)
0.42
b
NA = no studies available for these conditions
b
c
Evidence equal to or favors sham
Evidential support interpretation: -1 is weak, -2 moderate,
-3 strong, -4 extremely strong evidence favoring treatment
Table D. Chronic Low Back Pain: Evidence Summary of Treatments after Six Weeks and Up to One Year
Reference
line
Treatment or system
Number of
study arm
observations
Studies used (see Appendix
2)
Patients
observatio
ns at start
Patient
observations
at study's end
g (95% CI)
pB
Evidential
support over
shamc
-0.09
Single therapies
1
Osteopathic SMT
2
33 34 44
63
63
1.31 (-0.64 to 3.27)
0.50
2
Physical therapist SMT
1
45
50
50
0.72 (-1.23 to 2.68)
0.20
b
3
4
16 46
95
95
1.07 (-0.88 to 3.03)
0.64
-0.33
3
39 40
219
192
0.85 (-1.10 to 2.81)
0.40
b
5
Chiropractic SMT
Chiropractic FlexionDistraction
Medical SMT
1
41
40
40
1.41 (-0.54 to 3.37)
1.00
-0.78
6
Mixed SMT
2
47
96
96
1.44 (-0.51 to 3.40)
1.00
-0.78
7
Back school classes
7
16 39 43 45
392
320
2.29 (0.33 to 4.25)
0.64
-0.33
8
Usual medical and analgesic
Attended physiotherapy
modalities
Self care
6
16 36 46 47
169
169
1.23 (-0.72 to 3.19)
0.61
-0.28
4
16 43 45
101
98
1.12 (-0.83 to 3.08)
0.51
-0.12
0
a
NA
Sham treatments
No treatment: waiting list
control
Unattended physiotherapy
modalities
Bonesetting
5
4
9
10
11
12
13
14
a
a
a
a
NA
NA
NA
NA
NA
2 33 34 44 47
95
95
0.77 (0.37 to 1.16)
0.46
Comparison
2
33 34 45
84
84
-0.13 (-2.09 to 1.82)
0.00
b
1
40
78
78
1.28 (-0.68 to 3.24)
0.10
b
1
43
44
44
0.76 (-1.19 to 2.72)
0.23
b
Therapy categories
15
All manipulation groups
11
16 33 34 41 42 43 44 45 46
663
600
1.07 (-0.04 to 2.18)
0.61
-0.42
16
All control groups combined
7
16 33 34 41 44 45
179
179
0.51 (-1.45 to 2.47)
0.54
-0.16
17
All medical management
combined
5
16 36 46 47
158
158
0.57 (-1.38 to 2.53)
0.53
-0.14
18
Combined physiotherapies
6
16 40 43 45
101
98
1.05 (-0.90 to 3.01)
0.54
-0.17
19
Exercise plus back school
8
16 39 43 45
470
398
2.08 (0.12 to 4.04)
0.65
-0.35
20
Whole systems
5
41 43 46
194
189
0.70 (-0.18. to 1.54)
0.30
b
c
a
NA = no studies available for these conditions
b
Evidence equal to or favoring sham
Evidential support interpretation: -1 is weak, -2 moderate,
-3 strong, -4 extremely strong evidence favoring treatment
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