Background

Efficacy of conservative therapy for low back pain in pregnancy (PLBP) is unclear.

Objective

To investigate the efficacy of conservative therapy on pain, disability, and quality of life in PLBP.

Methods

The protocol of this systematic review was prospectively registered at PROSPERO (CRD42020164640). Search strategy was conducted on six databases up to August 24 2020 without date or language restrictions. Minimal intervention (i.e., placebo, sham, waiting list or no intervention) was the comparator of interest. Selection of randomized controlled trials, data extraction and methodological quality assessment of included trials were conducted independently by two reviewers. The PEDro scale (0–10) was used to assess methodological quality. Effect sizes for specific therapies were pooled when possible, using random-effects models. The quality of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.

Results

Ten included trials provide uncertain evidence (low to very low quality) about the effects of auriculotherapy, education, exercise, exercise plus education, oil treatment, and osteopathy in pain, disability, and quality of life at short- and long-term. At short-term, mean differences (MDs) and 95% confidence intervals (CI) on a 0–10 points pain intensity scale were: for oil treatment, 2.8 points (2.6, 3.1) (n = one trial, 114 participants); for auriculotherapy, 1.6 points (1.2, 2.0) (n = one trial, 112 participants); for exercise, 2.2 points (-1.8, 6.2) (n = three trials, 297 participants).

Conclusion

There is an urgent need for larger high-quality trials investigating effects of conservative therapy in pain, disability, and quality of life in this population.

中文翻译：

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保守治疗对妊娠期腰痛疼痛、残疾和生活质量的有效性：随机对照试验的系统评价

背景

保守治疗对妊娠期腰痛 (PLBP) 的疗效尚不清楚。

客观的

探讨保守治疗对 PLBP 患者疼痛、残疾和生活质量的疗效。

方法

本系统评价的方案已在 PROSPERO 前瞻性注册（CRD42020164640）。截至 2020 年 8 月 24 日，对六个数据库进行了检索策略，没有日期或语言限制。最小干预（即安慰剂、假手术、等待名单或无干预）是感兴趣的比较器。随机对照试验的选择、纳入试验的数据提取和方法学质量评估由两名评价员独立进行。PEDro 量表（0-10）用于评估方法学质量。在可能的情况下，使用随机效应模型汇集特定疗法的效应大小。使用建议评估分级（GRADE）方法评估证据的质量。

结果

十项纳入的试验提供了关于耳疗法、教育、运动、运动加教育、精油治疗和整骨疗法对短期和长期疼痛、残疾和生活质量的影响的不确定证据（低到极低质量）。短期来看，0-10 分疼痛强度量表的平均差异 (MD) 和 95% 置信区间 (CI) 为：精油治疗为 2.8 分 (2.6, 3.1)（n  = 一项试验，114 名受试者）；耳穴疗法，1.6 分 (1.2, 2.0)（n  = 一项试验，112 名受试者）；对于运动，2.2 分 (-1.8, 6.2)（n  = 三项试验，297 名参与者）。

结论

迫切需要进行更大规模的高质量试验来调查保守治疗对该人群疼痛、残疾和生活质量的影响。