Effects of matched vs. unmatched physical therapy interventions on pain or disability in patients with neck pain - a systematic review and meta-analysis.

MASTROMARCHI, Paolo, MCLEAN, Sionnadh, ALI, Nancy and MAY, Stephen (2023). Effects of matched vs. unmatched physical therapy interventions on pain or disability in patients with neck pain - a systematic review and meta-analysis. Physiotherapy theory and practice.

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Abstract

Background

The interventions performed in most randomized controlled trials (RCTs) on neck pain patients are standardized, irrespective of the high heterogeneity of patients. However, clinicians tend to choose an intervention based on the patients' clinical characteristics, and thus match the treatment to the patient.

Objectives

To investigate the effectiveness of interventions matched to the clinical characteristics of patients with neck pain versus the same, but unmatched treatment for improving pain or disability.

Design

A systematic review and meta-analysis conducted following Cochrane guidelines.

Methods

Databases searches were performed from inception to September 2023. RCTs were included if the patients in the experimental group received a treatment matched to clinical presentation or to clinicians' assessment, if the patients in the control group received a similar but unmatched treatment, and if pain or disability were reported as outcome measures.

Results

The literature search produced 9516 records of which 27 met the inclusion criteria. Matched exercise therapy was superior to unmatched exercise for pain (SMD -0.57; 95% CI -0.95, -0.18) and for disability (SMD -0.69; 95% CI -1.14, -0.23) at short term, but not at intermediate-term follow-up. Matched manual treatment was not superior to unmatched manual therapy for pain or for disability at short or intermediate-term follow-up.

Conclusions

Results suggest that matching exercise to movement limitation, trapezius myalgia, or forward head position may lead to better outcomes in the short term, but not in the intermediate-term. Matched manual therapy was not superior to unmatched treatment either short or intermediate-term. Further research is warranted to verify if those criteria are potentially useful matching criteria.

Item Type:	Article
Uncontrolled Keywords:	Neck pain; assessment; clinical decision making; clinical reasoning; matched treatment; 1103 Clinical Sciences; 1106 Human Movement and Sports Sciences; Rehabilitation; 4201 Allied health and rehabilitation science
Identification Number:	https://doi.org/10.1080/09593985.2023.2285892
SWORD Depositor:	Symplectic Elements
Depositing User:	Symplectic Elements
Date Deposited:	10 Jan 2024 16:03
Last Modified:	10 Jan 2024 16:15
URI:	https://shura.shu.ac.uk/id/eprint/32973

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