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      EFFECT OF THE MAITLAND CONCEPT TECHNIQUES ON LOW BACK PAIN: A SYSTEMATIC REVIEW Translated title: EFECTO DE LAS TÉCNICAS DEL CONCEPTO MAITLAND EN LA LUMBALGIA: REVISIÓN SISTEMÁTICA Translated title: EFEITO DAS TÉCNICAS DO CONCEITO MAITLAND NA DOR LOMBAR: REVISÃO SISTEMÁTICA

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          Abstract

          ABSTRACT Low back pain has a prevalence that reaches up to 70% of the population between 35-55 years of age and is the principal cause of occupational disability. The scientific evidence on the effect of manual therapy on low back pain is conflicting and there are no specific reviews on the Maitland concept of manual therapy. Therefore, the objective of this systematic review is to analyze the effect of the techniques of the Maitland concept of manual therapy in patients with low back pain and/or determine the level of scientific evidence.For this, a search was carried out in the Cinahl, Medline, Web of Science, PubMed and Scopus databases during the months of January and February 2021 and it was updated in August 2021. In the search, 894 records were obtained, of which 15 randomized clinical trials that obtained a minimum of 3 points out of 5 on the Jadad scale were included.The main results in the current scientific literature suggest that there is solid evidence that the manipulations and mobilizations described in the Maitland Concept, applied alone or in combination with other interventions, reduce pain and disability in subjects with low back pain.The effects on musculature are contradictory. Exercise and patient education increase the effect of manual therapy. Future research requires analyzing whether the effects are preserved in the long term and more homogeneous treatment protocols are needed to determine a prescriptive guideline for manual therapy. Level of evidence I; Systematic review.

          Translated abstract

          Resumen: La lumbalgia tiene una prevalencia que alcanza hasta el 70% de la población entre los 35-55 años y es la primera causa de discapacidad laboral. La evidencia científica sobre el efecto de la terapia manual en la lumbalgia es contradictoria y no existen revisiones específicas sobre el concepto Maitland de terapia manual. Por tanto, el objetivo de esta revisión sistemática consiste en analizar el efecto de las técnicas del concepto Maitland de terapia manual en pacientes con lumbalgia y o determinar el nivel de evidencia científica.Para ello se llevó a cabo una búsqueda en las bases de datos Cinahl, Medline, Web of Science, PubMed e Scopus durante los meses de enero y febrero de 2021 y se actualizó en agosto de 2021. En la búsqueda se obtuvieron un total de 894 registros de los cuales fueron incluidos 15 ensayos clínicos aleatorizados que obtuvieron un mínimo de 3 puntos sobre 5 en la escala de Jadad. Los principales resultadosen la literatura científica actual sugieren que existe evidencia sólida de que las manipulaciones y movilizaciones descritas en el concepto Maitland, aplicadas de forma aislada o en combinación con otras intervenciones, disminuyen el dolor y la discapacidad en sujetos con lumbalgia. Los efectos sobre la musculatura son contradictorios. El efecto de la terapia manual se ve incrementado cuando se combina con ejercicio y educación del paciente. Futuras investigaciones requieren analizar si los efectos se preservan largo plazo y se necesitan protocolos de tratamiento más homogéneos para determinar una pauta prescriptiva de terapia manual. Nivel de evidencia I; Revisión sistemática.

          Translated abstract

          Resumo: A dor lombar tem uma prevalência que atinge até 70% da população entre 35-55 anos e é a principal causa de incapacidade ocupacional. As evidências científicas sobre o efeito da terapia manual na dor lombar são conflitantes e não há revisões específicas sobre o conceito de terapia manual de Maitland. Portanto, o objetivo desta revisão sistemática é analisar o efeito das técnicas do conceito Maitland de terapia manual em pacientes com lombalgia e/ou determinar o nível de evidência científica.Para isso, foi realizada uma busca nas bases de dados Cinahl, Medline, Web of Science, Pubmed e Scopus durante os meses de janeiro e fevereiro de 2021 e foi atualizada em agosto de 2021. Na busca foram obtidos 894 registros dos quais foram incluídos 15 ensaios clínicos randomizados que obtiveram um mínimo de 3 pontos em 5 na escala de Jadad. Os principais resultados na literatura científica atual sugerem que há evidências sólidas de que as manipulações e mobilizações descritas no conceito de Maitland, aplicadas isoladamente ou em combinação com outras intervenções, reduzem a dor e a incapacidade em indivíduos com dor lombar. Os efeitos nos músculos são contraditórios. O efeito da terapia manual é aumentado quando combinada com exercícios e educação do paciente. Pesquisas futuras requerem analisar se os efeitos são preservados em longo prazo e protocolos de tratamento mais homogêneos são necessários para determinar uma diretriz prescritiva para a terapia manual. Nível de evidência I; Revisão sistemática.

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          Most cited references53

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          PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

          The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.
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            Assessing the quality of reports of randomized clinical trials: is blinding necessary?

            It has been suggested that the quality of clinical trials should be assessed by blinded raters to limit the risk of introducing bias into meta-analyses and systematic reviews, and into the peer-review process. There is very little evidence in the literature to substantiate this. This study describes the development of an instrument to assess the quality of reports of randomized clinical trials (RCTs) in pain research and its use to determine the effect of rater blinding on the assessments of quality. A multidisciplinary panel of six judges produced an initial version of the instrument. Fourteen raters from three different backgrounds assessed the quality of 36 research reports in pain research, selected from three different samples. Seven were allocated randomly to perform the assessments under blind conditions. The final version of the instrument included three items. These items were scored consistently by all the raters regardless of background and could discriminate between reports from the different samples. Blind assessments produced significantly lower and more consistent scores than open assessments. The implications of this finding for systematic reviews, meta-analytic research and the peer-review process are discussed.
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              Updated method guidelines for systematic reviews in the cochrane collaboration back review group.

              Descriptive method guidelines. To help reviewers design, conduct, and report reviews of trials in the field of back and neck pain. In 1997, the Cochrane Collaboration Back Review Group published method guidelines for systematic reviews. Since its publication, new methodologic evidence emerged and more experience was acquired in conducting reviews. All reviews and protocols of the Back Review Group were assessed for compliance with the 1997 method guidelines. Also, the most recent version of the Cochrane Handbook (4.1) was checked for new recommendations. In addition, some important topics that were not addressed in the 1997 method guidelines were included (e.g., methods for qualitative analysis, reporting of conclusions, and discussion of clinical relevance of the results). In May 2002, preliminary results were presented and discussed in a workshop. In two rounds, a list of all possible recommendations and the final draft were circulated for comments among the editors of the Back Review Group. The recommendations are divided in five categories: literature search, inclusion criteria, methodologic quality assessment, data extraction, and data analysis. Each recommendation is classified in minimum criteria and further guidance. Additional recommendations are included regarding assessment of clinical relevance, and reporting of results and conclusions. Systematic reviews need to be conducted as carefully as the trials they report and, to achieve full impact, systematic reviews need to meet high methodologic standards.
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                Author and article information

                Journal
                coluna
                Coluna/Columna
                Coluna/Columna
                Sociedade Brasileira de Coluna (São Paulo, SP, Brazil )
                1808-1851
                2177-014X
                2022
                : 21
                : 2
                : e258429
                Affiliations
                [1] orgnameUniversidad de Vigo orgdiv1Department of Functional Biology and Health Science Spain
                Article
                S1808-18512022000200303 S1808-1851(22)02100200303
                10.1590/s1808-185120222102258429
                1466d5bb-b888-4fb9-a7fc-67c5687b3778

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 09 May 2022
                : 22 November 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 54, Pages: 0
                Product

                SciELO Brazil

                Categories
                Review Article

                Revisión Sistemática,Manipulações Musculoesqueléticas,Revisão Sistemática,Dor Lombar,Terapia por Ejercicio,Manipulaciones Musculoesqueléticas,Dolor de la Región Lumbar,Exercise Therapy,Musculoskeletal Manipulations,Systematic Review,Low Back Pain,Terapia por Exercício

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