Assessing the effects of manual therapy on pain in patients living with persistent non-specific low back pain (PNSLBP): Which evaluation criteria and measurement tools are used in randomised controlled clinical trials? A systematic review

Objective: To identify the evaluation criteria and measurement tools that are used in Randomised Controlled Trials (RCT) to assess the effects of manual therapy on pain in adults living with PNSLBP. Methods: RCT were included if: participants were adults (18-65 years old) with PNSLBP, experimental group received manual therapies (osteopathy, physiotherapy and chiropractic) and they had been published in English or French since 2010. The search was conducted between May 2021 and April 2023, using the Cochrane Library, Ebscohost, EMBASE, MEDLINE Pubmed, PEDro, ScienceDirect and Scopus databases. Three independent reviewers have checked eligibility. The PEDro scale have been used for quality appraisal. Results: In the 29 studies included, 131 measurement tools were identified in three main areas: 76 % of the measurement tools were related to life impact (which 24 % related to pain intensity and 23 % to functional difficulties) and 24 % were related to pathophysiological manifestations (which 8 % related to Range of motion). Conclusion: Most measurement tools focus on pain intensity and physical functioning using scales and questionnaires. Two perspectives must be considered: responding to current recommendations by standardizing the measurement tools relating to life impact and physiopathological manifestations, and using biomechanical markers making it possible to evaluate patients in daily life situations.