Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: Systematic review and update of UK evidence report

被引：108
作者：
Clar C. [1 ]
Tsertsvadze A. [1 ]
Court R. [1 ]
Hundt G.L. [2 ]
Clarke A. [1 ]
Sutcliffe P. [1 ]
机构：
[1] Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
[2] Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
来源：
Chiropractic & Manual Therapies | / 22卷 / 1期
关键词：
Bronfort; Clinical effectiveness; Manual therapy; Musculoskeletal; Systematic review;
D O I：
10.1186/2045-709X-22-12
中图分类号：
学科分类号：
摘要：
Background: This systematic review updated and extended the "UK evidence report" by Bronfort et al. (Chiropr Osteopath 18:3, 2010) with respect to conditions/interventions that received an 'inconclusive' or 'negative' evidence rating or were not covered in the report.Methods: A literature search of more than 10 general medical and specialised databases was conducted in August 2011 and updated in March 2013. Systematic reviews, primary comparative studies and qualitative studies of patients with musculoskeletal or non-musculoskeletal conditions treated with manual therapy and reporting clinical outcomes were included. Study quality was assessed using standardised instruments, studies were summarised, and the results were compared against the evidence ratings of Bronfort. These were either confirmed, updated, or new categories not assessed by Bronfort were added.Results: 25,539 records were found; 178 new and additional studies were identified, of which 72 were systematic reviews, 96 were randomised controlled trials, and 10 were non-randomised primary studies. Most 'inconclusive' or 'moderate' evidence ratings of the UK evidence report were confirmed. Evidence ratings changed in a positive direction from inconclusive to moderate evidence ratings in only three cases (manipulation/mobilisation [with exercise] for rotator cuff disorder; spinal mobilisation for cervicogenic headache; and mobilisation for miscellaneous headache). In addition, evidence was identified on a large number of non-musculoskeletal conditions not previously considered; most of this evidence was rated as inconclusive.Conclusions: Overall, there was limited high quality evidence for the effectiveness of manual therapy. Most reviewed evidence was of low to moderate quality and inconsistent due to substantial methodological and clinical diversity. Areas requiring further research are highlighted. © 2014 Clar et al.; licensee BioMed Central Ltd.
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  • [1] Hoving J.L., Koes B.W., de Vet H.C., van der Windt D.A., Assendelft W.J., Van M.H., Deville W.L., Pool J.J., Scholten R.J., Bouter L.M., Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial, Ann Intern Med, 136, pp. 713-722, (2002)
  • [2] Farrell J.P., Jensen G.M., Manual therapy: a critical assessment of role in the profession of physical therapy, Phys Ther, 72, pp. 843-852, (1992)
  • [3] Fitzgerald G.K., McClure P.W., Beattie P., Riddle D.L., Issues in determining treatment effectiveness of manual therapy, Phys Ther, 74, pp. 227-233, (1994)
  • [4] Jette A.M., Delitto A., Physical therapy treatment choices for musculoskeletal impairments, Phys Ther, 77, pp. 145-154, (1997)
  • [5] Garofalo J.P., Polatin P., Low back pain: an epidemic in industrialized countries, Psychosocial factors in pain: Critical perspectives, pp. 164-174, (1999)
  • [6] Rosen M., Breen A., Hamann W., Harker P., Jayson M.I.V., Kelly E., Report of a clinical standards advisory group committee on back pain, (1994)
  • [7] Meeker W.C., Haldeman S., Chiropractic: a profession at the crossroads of mainstream and alternative medicine, Ann Intern Med, 136, pp. 216-227, (2002)
  • [8] Kaptchuk T.J., Eisenberg D.M., Chiropractic: origins, controversies, and contributions, Arch Intern Med, 158, pp. 2215-2224, (1998)
  • [9] Ong C.K., Doll H., Bodeker G., Stewart-Brown S., Use of osteopathic or chiropractic services among people with back pain: a UK population survey, Health Soc Care Commun, 12, pp. 265-273, (2004)
  • [10] Lawrence D.J., Meeker W.C., Chiropractic and CAM utilization: a descriptive review, Chiropr Osteopat, 15, (2007)
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