Article

Providing specific treatment based on symptom response for people
with low back pain (LBP) and a directional preference (DP) is a widely used
treatment approach. The efficacy of treatment using the principles of directional
preference management (DPM) for LBP is unclear.
The purpose of this
study was to determine the efficacy of treatment using the principles of DPM for
people with LBP and a DP. METHODS: Computer databases were searched for
randomized controlled trials (RCTs) published in English up to January 2010. Only
RCTs investigating DPM for people with LBP and a DP were included. Outcomes for
pain, back specific function, and work participation were extracted. RESULTS: Six
RCTs were included in this review. Five were considered high quality. Clinical
heterogeneity of the included trials prevented meta-analysis. GRADE quality
assessment revealed mixed results; however, moderate evidence was identified that
DPM was significantly more effective than a number of comparison treatments for
pain, function, and work participation at short-term, intermediate-term, and
long-term follow-ups. No trials found that DPM was significantly less effective
than comparison treatments. CONCLUSIONS: Although this systematic review showed
mixed results, some evidence was found supporting the effectiveness of DPM when
applied to participants with a DP, particularly at short-term and
intermediate-term follow-ups. Further high-quality RCTs are warranted to evaluate
the effect of DPM applied to people with LBP and a DP.

Langue : ANGLAIS