Effectiveness of conservative therapy on pain, disability and quality of life for low back pain in pregnancy: A systematic review of randomized controlled trials.

Abstract

BACKGROUND\nEfficacy of conservative therapy for low back pain in pregnancy (PLBP) is unclear.\n\n\nOBJECTIVE\nTo investigate the efficacy of conservative therapy on pain, disability, and quality of life in PLBP.\n\n\nMETHODS\nThe protocol of this systematic review was prospectively registered at PROSPERO (CRD42020164640). Search strategy was conducted on six databases up to August 24nd 2020 without date or language restrictions. Minimal intervention (i.e., placebo, sham, waiting list or no intervention) was the comparator of interest. Selection of randomized controlled trials, data extraction and methodological quality assessment of included trials were conducted independently by two reviewers. The PEDro scale (0-10) was used to assess methodological quality. Effect sizes for specific therapies were pooled when possible, using random-effects models. The quality of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.\n\n\nRESULTS\nTen included trials provide uncertain evidence (low to very low quality) about the effects of auriculotherapy, education, exercise, exercise plus education, oil treatment, and osteopathy in pain, disability, and quality of life at short- and long-term. At short-term, mean differences (MDs) and 95% confidence intervals (CI) on a 0-10 points pain intensity scale were: for oil treatment, 2.8 points (2.6, 3.1) (n\xa0=\xa0one trial, 114 participants); for auriculotherapy, 1.6 points (1.2, 2.0) (n\xa0=\xa0one trial, 112 participants); for exercise, 2.2 points (-1.8, 6.2) (n\xa0=\xa0three trials, 297 participants).\n\n\nCONCLUSION\nThere is an urgent need for larger high-quality trials investigating effects of conservative therapy in pain, disability, and quality of life in this population.