EVALUATION OF THE EFFICACY, SAFETY, EFFECTIVENESS AND EFFICIENCY
OF ELECTROTHERAPY FOR THE TREATMENT OF BACK DISORDERS
Title.
The efficacy of Electrotherapy in the treatment
of non-specific low back pain: a systematic review of scientific
literature.
Background.
Treatment of low back pain includes a wide
range of very different treatments that differ from one setting
to another. One of the reasons for this variety could be the
uneven quality and quantity of available studies on the efficacy
and the effectiveness of the treatments used. In fact, there
are systematic reviews of scientific literature that determine
the basis (or essence) of the use of several of the usual
treatments in low back pain, such as medications, bed rest,
back schools, exercise, massage, TENS, traction, spinal manipulation,
acupuncture, behavioralist therapy and multidisciplinary rehabilitation,
neuroreflexotherapy, different kinds of injections, including
epidural, surgery for disc hernia and surgery for spondylosis.
However, a review of scientific evidence on certain treatments
commonly used in the Spanish National Health System for the
treatment of mechanical pathologies of the spine should be
available, in order to optimize their effectiveness and efficiency.
Thus, for example, except in the case of TENS, there are no
systematic reviews on the efficacy of electrotherapeutic treatments
that are commonly used in rehabilitation of patients with
non-specific low back pain in the National Health System.
Objective.
To find the existing scientific literature
on the efficacy of electrotherapy (except TENS, since that
study has already been made) for the treatment of low back
pain, to analyze its methodological quality and to summarize
its results in order to determine the scientific basis for
its use.
Methodology.
It was a systematic review with meta-analysis
of the scientific literature. All of the existing clinical
trials on the efficacy of electrotherapy procedures (except
TENS) in the treatment of non-specific low back pain.
To detect those studies, electronic and other search systems
were used in order to identify potential studies that had
not been gathered in the databases.
The methodological quality of each one of the studies found
was studied and a sensitivity analysis was conducted to explore
the possible relation between the quality and the results
of each study. The evaluation of the scientific quality of
each study included aspects of methodological quality (such
as those relating to the design of the clinical trial, in
accordance with the established standards of the international
scientific community), and clinical or technical quality (related
to the techniques of electrotherapy used in each trial).
The scientific quality of each study was appraised by two
independent reviewers in order to guarantee greater rigor
in their appraisals. In the cases where they disagreed, a
joint discussion was held and a final consensus was reached,
with the contribution of the rest of the researchers in those
cases where needed.
The characteristics of all the identified clinical trials
were described structurally and an overall appraisal of the
effect of each electrotherapy technique was made by means
of the OR (odds ratio) or when the studied effects were very
frequent, using the RR (relative risk), calculated by means
of the Revman or Stata programs. Both the absolute measures
of the effect as well as the necessary number of patients
to treat in order to observe the desired effect (NNT) were
calculated.
Participants, along with the Foundation's
Science Department.
Cochrane IberoAmerican Center and the Department
of Rheumatology Rehabilitation at the Hospital Ramón
y Cajal.
The study was co-funded by the Funds for Health Research
(FIS) and the Kovacs Foundation.
Status.
In progress.
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