Abstract:
BACKGROUND:Acute low-back pain (LBP) is a common reason to consult a general practitioner. Debate continues on the comparative effectiveness of advice on bed rest and staying active as part of the primary care management. OBJECTIVES:To determine the effects of advice to rest in bed or stay active for patients with acute low-back pain or sciatica. SEARCH STRATEGY:We searched the Cochrane Back Review Group Trials Register, CENTRAL, MEDLINE, EMBASE, Sport, and SCISEARCH to May 2009, reference lists of relevant articles, and contacted authors of relevant articles. SELECTION CRITERIA:Randomised trials of the effectiveness of advice to stay active or rest in bed for patients with acute LBP or sciatica. The main outcomes were pain, functional status, recovery and return to work. DATA COLLECTION AND ANALYSIS:Two authors independently selected trials, assessed the risk of bias and extracted data. The trials were combined qualitatively or statistically, depending on data availability and presentation. MAIN RESULTS:We included ten RCTs with varying risk of bias. For patients with acute LBP, results from two trials (N = 401) suggest small improvements in pain relief (SMD 0.22 (95% CI: 0.02 to 0.41) and functional status (SMD 0.29 (95% CI: 0.09 to 0.49) in favour of advice to stay active. For patients with sciatica, there is moderate quality evidence of little or no difference in pain relief (SMD -0.03 (95% CI: -0.24 to 0.18)) or functional status (SMD 0.19 (95% CI: -0.02 to 0.41)), between advice to rest in bed or stay active.Low quality evidence (3 RCTs, N = 931) suggests little or no difference between exercises, advice to rest in bed or stay active for patients with acute LBP. Low quality evidence (1 RCT, N = 250) suggests little or no difference between physiotherapy, advice to rest in bed or stay active for patients with sciatica. No trials that compared different ways of delivering advice. AUTHORS' CONCLUSIONS:Moderate quality evidence shows that patients with acute LBP may experience small benefits in pain relief and functional improvement from advice to stay active compared to advice to rest in bed; patients with sciatica experience little or no difference between the two approaches. Low quality evidence suggests little or no difference between those who received advice to stay active, exercises or physiotherapy. Further research is very likely to have an important impact on the estimate of effect and is likely to change our confidence in it.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Dahm KT,Brurberg KG,Jamtvedt G,Hagen KBdoi
10.1002/14651858.CD007612.pub2subject
Has Abstractpub_date
2010-06-16 00:00:00pages
CD007612issue
6issn
1469-493Xpub_type
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doi:10.1002/14651858.CD011907.pub2
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doi:10.1002/14651858.CD007892.pub6
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001993.pub2
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doi:10.1002/14651858.CD011588.pub3
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abstract:BACKGROUND:Immediate delivery of the preterm fetus with suspected compromise may decrease the risk of damage due to intrauterine hypoxia. However, it may also increase the risks of prematurity. OBJECTIVES:To assess the effects of immediate versus deferred delivery of preterm babies with suspected fetal compromise on n...
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doi:10.1002/14651858.CD001518
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abstract:BACKGROUND:Anaemia in pregnancy is a major health problem in many developing countries where nutritional deficiency, malaria and other parasitic infections contribute to increased maternal and perinatal mortality and morbidity. OBJECTIVES:The objective of this review was to assess the effects of iron supplementation o...
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doi:10.1002/14651858.CD006580.pub3
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doi:10.1002/14651858.CD004739.pub3
更新日期:2007-01-24 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005257.pub2
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doi:10.1002/14651858.CD009233.pub2
更新日期:2013-06-05 00:00:00
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doi:10.1002/14651858.CD004563.pub2
更新日期:2006-07-19 00:00:00
abstract:BACKGROUND:Aphasia describes language impairment associated with a brain lesion. OBJECTIVES:The objective of this review was to assess the effects of formal speech and language therapy and non-professional types of support from untrained providers for people with aphasia after stroke. SEARCH STRATEGY:We searched the ...
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doi:10.1002/14651858.CD000425
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doi:10.1002/14651858.CD002850
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doi:10.1002/14651858.CD002883
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更新日期:2015-10-19 00:00:00
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更新日期:2019-09-30 00:00:00
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