Abstract:
BACKGROUND:Exercise therapy encompasses a heterogeneous group of interventions. There continues to be uncertainty about the most effective exercise approach in chronic low back pain. PURPOSE:To identify particular exercise intervention characteristics that decrease pain and improve function in adults with nonspecific chronic low back pain. DATA SOURCES:MEDLINE, EMBASE, PsychInfo, CINAHL, and Cochrane Library databases to October 2004 and citation searches and bibliographic reviews of previous systematic reviews. STUDY SELECTION:Randomized, controlled trials evaluating exercise therapy in populations with chronic (>12 weeks duration) low back pain. DATA EXTRACTION:Two reviewers independently extracted data on exercise intervention characteristics: program design (individually designed or standard program), delivery type (independent home exercises, group, or individual supervision), dose or intensity (hours of intervention time), and inclusion of additional conservative interventions. DATA SYNTHESIS:43 trials of 72 exercise treatment and 31 comparison groups were included. Bayesian multivariable random-effects meta-regression found improved pain scores for individually designed programs (5.4 points [95% credible interval (CrI), 1.3 to 9.5 points]), supervised home exercise (6.1 points [CrI, -0.2 to 12.4 points]), group (4.8 points [CrI, 0.2 to 9.4 points]), and individually supervised programs (5.9 points [CrI, 2.1 to 9.8 points]) compared with home exercises only. High-dose exercise programs fared better than low-dose exercise programs (1.8 points [CrI, -2.1 to 5.5 points]). Interventions that included additional conservative care were better (5.1 points [CrI, 1.8 to 8.4 points]). A model including these most effective intervention characteristics would be expected to demonstrate important improvement in pain (18.1 points [CrI, 11.1 to 25.0 points] compared with no treatment and 13.0 points [CrI, 6.0 to 19.9 points] compared with other conservative treatment) and small improvement in function (5.5 points [CrI, 0.5 to 10.5 points] compared with no treatment and 2.7 points [CrI, -1.7 to 7.1 points] compared with other conservative treatment). Stretching and strengthening demonstrated the largest improvement over comparisons. LIMITATIONS:Limitations of the literature, including low-quality studies with heterogeneous outcome measures and inconsistent and poor reporting; publication bias. CONCLUSIONS:Exercise therapy that consists of individually designed programs, including stretching or strengthening, and is delivered with supervision may improve pain and function in chronic nonspecific low back pain. Strategies should be used to encourage adherence. Future studies should test this multivariable model and further assess specific patient-level characteristics and exercise types.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Hayden JA,van Tulder MW,Tomlinson Gdoi
10.7326/0003-4819-142-9-200505030-00014subject
Has Abstractpub_date
2005-05-03 00:00:00pages
776-85issue
9eissn
0003-4819issn
1539-3704pii
142/9/776journal_volume
142pub_type
杂志文章,评审abstract::A severe shortage of organs greatly limits the ability to deliver the miracle of transplantation to people suffering from end-stage organ disease. Contributing to this shortage is a high rate of refusal among families who are asked for permission to remove organs from a recently deceased relative. Mandated choice offe...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-125-1-199607010-00010
更新日期:1996-07-01 00:00:00
abstract::Although thyroid nodules are common, few are malignant and require surgical treatment. A systematic approach to their evaluation is important to avoid unnecessary surgery. Fine-needle aspiration biopsy has resulted in substantial improvements in diagnostic accuracy, cost reductions, and higher malignancy yield at time...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-142-11-200506070-00011
更新日期:2005-06-07 00:00:00
abstract:BACKGROUND:The effect of physician diagnostic variability on accuracy at a population level depends on the prevalence of diagnoses. OBJECTIVE:To estimate how diagnostic variability affects accuracy from the perspective of a U.S. woman aged 50 to 59 years having a breast biopsy. DESIGN:Applied probability using Bayes'...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-0964
更新日期:2016-05-17 00:00:00
abstract::Although the efficacy of hepatitis vaccine is well documented, the duration of immunity of healthy adults after vaccination is unknown. We studied 245 hospital employees 3 years after primary vaccination with hepatitis B vaccine to determine the prevalence of immunity indicated by levels of antibody to hepatitis B sur...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-2-185
更新日期:1988-02-01 00:00:00
abstract::Under the current system of disability determination and workers' compensation for occupational lung disease, disabled workers or their survivors can reasonably count on being compensated. However, by rejecting established scientific truth in order to pay workers' compensation in circumstances where disability or deat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-6-908
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Tobacco use is the leading cause of preventable death in the United States. PURPOSE:To review the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. DATA SOURCES:5 databases and 8 organizational Web sites were searched through 1 August 2014 for systematic review...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2015-10-20 00:00:00
abstract:BACKGROUND:Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. OBJECTIVE:To assess whether APM impr...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-04-05 00:00:00
abstract::Meningitis caused by enteric gram-negative bacilli is relatively uncommon but is very difficult to treat despite susceptibility in vitro to many antimicrobics. A major problem appears to be poor entry of many drugs into the central nervous system. Moxalactam is an investigational cephalosporin that attains concentrati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-3-302
更新日期:1981-09-01 00:00:00
abstract::Bioethics has become a common course of study in medical schools, other health professional schools, and graduate and undergraduate programs. An analysis of past ethical scandals, as well as the bioethics apparatus that emerged in response to them, is often central to the discussion of bioethical questions. This histo...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
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更新日期:2016-04-19 00:00:00
abstract:BACKGROUND:Even with optimal pharmacotherapy, symptomatic heart failure is associated with substantial morbidity and mortality. PURPOSE:To determine the efficacy and safety of cardiac resynchronization therapy in adults with advanced systolic heart failure. DATA SOURCES:The Cochrane Central Register of Controlled Tri...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-141-5-200409070-00101
更新日期:2004-09-07 00:00:00
abstract::These supplemental recommendations provide guidelines for a monovalent influenza A(H1N1) vaccine for protection against a newly emerged variant of influenza that has recently caused outbreaks among children and young adults in Asia. Guidance is provided for the use of this monovalent vaccine, which contains 15 microgr...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Transitional care has been defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care in the same location. Transitional care, which primarily concerns the relatively brief time interval that begins with pre...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-141-7-200410050-00009
更新日期:2004-10-05 00:00:00
abstract::We developed a model to project morbidity, mortality, and costs attributable to type A influenza virus infections in nursing homes and to evaluate the relative benefits and costs of programs for prevention and control. Influenza vaccination was the most cost-effective intervention under various simulations in the mode...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-5-732
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Lateral epicondylitis is a common condition for which botulinum toxin has been reported to have a therapeutic role in uncontrolled studies. OBJECTIVE:To determine if an injection of botulinum toxin is more effective than placebo for reducing pain in adults with lateral epicondylitis. DESIGN:Randomized, dou...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2005-12-06 00:00:00
abstract:SOURCE CITATION:Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes: a systematic review and network meta-analysis. Ann Intern Med. 2020;173:278-86. 32598218. ...
journal_title:Annals of internal medicine
pub_type: 评论,杂志文章
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abstract::In 1993, the Clinical Efficacy Assessment Subcommittee began evaluation of new topics and reevaluation of previous guidelines on common screening tests, which were published in Annals of Internal Medicine between 1988 and 1990 and republished as a collection in 1991 (Eddy DM, ed. Common Screening Tests. Philadelphia: ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:1995-06-15 00:00:00
abstract::Antibiotic-associated diarrhea and colitis were well established soon after antibiotics became available. Early work implicated Staphylococcus aureus, but in 1978 Clostridium difficile became the established pathogen in the vast majority of cases. In the first 5 years (1978 through 1983), the most common cause was cli...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2006-11-21 00:00:00
abstract::Streptococcus pneumoniae causes substantial morbidity and mortality. Incidence and severity are increased among populations with some chronic diseases. The currently available polyvalent polysaccharide vaccine induces antibody production among immunologically competent recipients against the 14 serotypes responsible f...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
doi:10.7326/0003-4819-96-2-208
更新日期:1982-02-01 00:00:00
abstract::We prospectively studied the evaluation of dementia in 107 unselected outpatients; 83 had so-called "irreversible" dementias, including 74 who had an Alzheimer-type dementia. Fifteen patients had potentially reversible dementias, of which hypothyroidism and drug toxicity were the commonest causes. Distinguishing featu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1984-03-01 00:00:00
abstract::Three patients with advanced Graves' ophthalmopathy were treated with cyclophosphamide. All had proptosis and diplopia. One patient had disabling iatrogenic Cushing's syndrome from steroid treatment of the ophthalmopathy and had undergone bilateral orbital decompression before cyclophosphamide therapy; steroids could ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-6-921
更新日期:1979-06-01 00:00:00
abstract:OBJECTIVE:To assess safety, pharmacokinetics, and in-vivo virologic activity of five different combination regimens of zidovudine and didanosine compared with zidovudine alone in patients with human immunodeficiency virus type 1 (HIV-1) infection. DESIGN:Open-label, partially randomized, dose-ranging study. SETTING:U...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-119-8-199310150-00003
更新日期:1993-10-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-2-199401150-00004
更新日期:1994-01-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2015-09-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:2003-11-04 00:00:00
abstract::Conventional interpretation of clinical trials relies heavily on the classic p value. The p value, however, represents only a false-positive rate, and does not tell the probability that the investigator's hypothesis is correct, given his observations. This more relevant posterior probability can be quantified by an ex...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-3-385
更新日期:1983-03-01 00:00:00
abstract:PURPOSE:To review the clinical use of noninvasive positive pressure ventilation, including its efficacy with acute and chronic forms of respiratory failure, its mechanism of action, and its implementation. DATA SOURCES:Studies were identified through a MEDLINE search using the key words respiratory failure and mechani...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-120-9-199405010-00008
更新日期:1994-05-01 00:00:00
abstract::9-(1,3-dihydroxy-2-propoxymethyl) guanine (ganciclovir) was used to treat 41 patients (median age, 37 years) with the acquired immunodeficiency syndrome and cytomegalovirus gastrointestinal infection. Sites of infection were the colon in 31, the esophagus in 5, the rectum in 4, and the small bowel in 1. Patients recei...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1987-08-01 00:00:00
abstract::The growing population of older persons in our society will require increased attention. It is contended that the current pattern of third-party reimbursement for hospitalization and technical procedures focuses upon acute care and cure. The philosophy underlying medical education and practice is a barrier to the prov...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Recent guidelines for adult prevention do not recommend a comprehensive annual physical examination, but current public expectations in light of this change are unknown. OBJECTIVE:To determine public belief in the need for and content of an annual physical examination and to examine the effect of financial ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2002-05-07 00:00:00
abstract::We tested the relative efficacy of bronchodilators delivered in aerosol and in oral form in 17 patients with asthma in a double-blind randomized sequence. Treatment consisted of a 20-mg tablet of metaproterenol sulfate, five puffs of metaproterenol aerosol (0.65 mg in each puff for a total of 3.25 mg) administered 20 ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1980-09-01 00:00:00