Overall confidence in the results of systematic reviews on exercise therapy for chronic low back pain: a cross-sectional analysis using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) 2 tool

Overall confidence in the results of systematic reviews on exercise therapy for chronic low back pain: a cross-sectional analysis using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) 2 tool

•Overall confidence of reviews of exercise for low back pain was very low.•Higher confidence was found in Cochrane reviews and reviews with registered protocol.•Confidence in the results is important to generate unbiased clinical recommendations. To evaluate the overall confidence in the results of...

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Bibliographic Details
Published in:Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 24; no. 2; pp. 103 - 117
Main Authors: Almeida, Matheus Oliveira, Yamato, Tiê Parma, Parreira, Patricia do Carma Silva, Costa, Leonardo Oliveira Pena, Kamper, Steven, Saragiotto, Bruno Tirotti
Format: Journal Article
Language:English
Published: Brazil Elsevier Editora Ltda 01-03-2020
Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Subjects:
Decision-making
Methodological quality
Musculoskeletal pain
Physical therapy
Systematic Review
Decision-making
Musculoskeletal pain
Methodological quality
Physical therapy
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Summary:•Overall confidence of reviews of exercise for low back pain was very low.•Higher confidence was found in Cochrane reviews and reviews with registered protocol.•Confidence in the results is important to generate unbiased clinical recommendations. To evaluate the overall confidence in the results of systematic reviews of exercise therapy for chronic non-specific low back pain using the AMSTAR 2 tool. PubMed, Embase, Cochrane Database of Systematic Reviews, PEDro and CINAHL was searched up to February 2017. Two independent reviewers selected systematic reviews of randomized controlled trials that investigated exercise therapy in patients with low back pain. AMSTAR 2 assessment was performed by pairs of reviewers, and the overall confidence in the results of the systematic reviews were rated as ‘High’, ‘Moderate’, ‘Low’ and ‘Critically low’. Descriptive analysis was used to summarize the characteristics of included systematic reviews. The percentage of systematic reviews achieving each item from the AMSTAR 2 and the overall confidence in the results were tabulated. The search identified 38 systematic reviews. Most of the reviews included a median of 10 clinical trials and total sample size of 813 participants per review. Five of 38 (13%) reviews were Cochrane reviews, and 8 (21%) systematic reviews had a protocol published or registered prospectively. The overall confidence in the results of 28 reviews (74%) was rated as ‘Critically low’, 6 (16%) as ‘Low’, 1 (2%) as Moderate, while 3 of 38 reviews (8%) were rated as ‘High’. The results demonstrate very low confidence in the results of most systematic reviews of exercise in chronic non-specific low back pain. Clinicians are more likely to deliver the most efficacious interventions to patients by critically appraising systematic reviews using AMSTAR 2 before making their decisions.
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ISSN:1413-3555
1809-9246
DOI:10.1016/j.bjpt.2019.04.004