Primary and secondary prevention of musculoskeletal pain and disability in chiropractic, osteopathy, and physiotherapy: A scoping review

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Osteopathic Medicine Pub Date : 2024-05-14 DOI:10.1016/j.ijosm.2024.100725
Jerry Draper-Rodi , Tristan Delion , Andrew MacMillan , Alexander I. Storey , Jonathan Spadaccini , Wahida Jebi , Oliver P. Thomson , David Hohenschurz-Schmidt
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Abstract

Background

Musculoskeletal prevention is a key priority in public health and for national health systems due to the increasing number of people living with persistent conditions, including musculoskeletal (MSK) complaints. There is no robust review of the evidence on COP interventions and MSK prevention, such as what the current state of conceptual debate is about a possible role of COP interventions in prevention, where and how this has been studied, and what the evidence for effectiveness is.

Objectives

A scoping review was conducted to chart and appraise the available evidence regarding primary and secondary prevention in MSK care in the chiropractic, osteopathic and physiotherapy (COP) professions.

Methods

The review was prospectively registered (https://osf.io/bqe5x/). Studies were eligible if they were primary quantitative research on COP interventions for primary and secondary prevention, delivered in clinical settings, and to patients of any age who were asymptomatic or had any MSK pain or disability. Screening, data extraction, and risk of bias assessment were conducted in duplicate by independent reviewers. The data was synthesised narratively.

Results

Twenty-one articles were included in the final synthesis: 17 randomized controlled trials, 3 cross sectional studies, and 1 experimental study. Studies were mostly moderate-quality clinical trials (n = 17) on manual therapy (n = 14) for low back pain (n = 10) that measured prevention by assessing healthcare use (n = 14) or symptom recurrence (n = 11). Heterogeneity of methods, low numbers, and mixed quality did not allow for conclusions about the effectiveness of COP interventions in preventing MSK complaints.

Conclusions

The evidence base is heterogeneous and of moderate quality making clinical recommendations challenging, but future research priorities have been identified, including a need for further research into primary, but mostly in secondary and tertiary prevention in COP; future research in COP should be designed in line with best practices and existing guidelines; and a need for the development and validation of reliable tools to stratify risks and management options.

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脊骨神经科、整骨疗法和物理疗法中肌肉骨骼疼痛和残疾的一级和二级预防:范围界定综述
背景肌肉骨骼预防是公共卫生和国家卫生系统的一个重要优先事项,因为越来越多的人患有持续性疾病,包括肌肉骨骼(MSK)疾病。目前还没有关于脊骨神经科干预和MSK预防的有力证据综述,例如关于脊骨神经科干预在预防中可能发挥的作用的概念辩论现状如何,在哪里以及如何对此进行研究,有效性的证据是什么等。目的 通过范围界定综述,对脊骨神经科、整骨疗法和物理疗法(COP)专业中MSK护理的一级和二级预防方面的现有证据进行梳理和评估。符合条件的研究应是在临床环境中针对无症状或有任何 MSK 疼痛或残疾的任何年龄段患者进行的 COP 一级和二级预防干预的主要定量研究。筛选、数据提取和偏倚风险评估由独立审稿人重复进行。结果21篇文章被纳入最终综述:17项随机对照试验、3项横断面研究和1项实验研究。研究多为中等质量的临床试验(17 项),涉及腰背痛的手法治疗(14 项)(10 项),通过评估医疗保健的使用(14 项)或症状复发(11 项)来衡量预防效果。由于方法不一、数量较少且质量参差不齐,因此无法就慢性阻塞性肺病干预措施在预防 MSK 病症方面的有效性得出结论。结论证据基础不一且质量中等,因此临床建议具有挑战性,但已确定了未来的研究重点,包括需要进一步研究慢性阻塞性肺病的一级预防,但主要是二级和三级预防;未来的慢性阻塞性肺病研究应根据最佳实践和现有指南进行设计;需要开发和验证可靠的工具来对风险和管理方案进行分层。
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来源期刊
CiteScore
2.20
自引率
36.80%
发文量
42
审稿时长
3 months
期刊介绍: The International Journal of Osteopathic Medicine is a peer-reviewed journal that provides for the publication of high quality research articles and review papers that are as broad as the many disciplines that influence and underpin the principles and practice of osteopathic medicine. Particular emphasis is given to basic science research, clinical epidemiology and health social science in relation to osteopathy and neuromusculoskeletal medicine. The Editorial Board encourages submission of articles based on both quantitative and qualitative research designs. The Editorial Board also aims to provide a forum for discourse and debate on any aspect of osteopathy and neuromusculoskeletal medicine with the aim of critically evaluating existing practices in regard to the diagnosis, treatment and management of patients with neuromusculoskeletal disorders and somatic dysfunction. All manuscripts submitted to the IJOM are subject to a blinded review process. The categories currently available for publication include reports of original research, review papers, commentaries and articles related to clinical practice, including case reports. Further details can be found in the IJOM Instructions for Authors. Manuscripts are accepted for publication with the understanding that no substantial part has been, or will be published elsewhere.
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