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Effectiveness of proprioceptive neuromuscular facilitation on pain intensity and functional disability in patients with low back pain: A systematic review and meta-analysis
Authors
R. Bagheri
M. Pourahmadi
M. Sahebalam
Publication date
1 January 2020
Publisher
Mashhad University of Medical Sciences
Abstract
Background: This systematic review aimed to investigate the effectiveness of proprioceptive neuromuscular facilitation (PNF) training on back pain intensity and functional disability in people with low back pain (LBP). Methods: Totally, five electronic databases, including PubMed/Medline (NLM), Scopus, Google Scholar, PEDro, and Cochrane Central Register of Controlled Clinical Trials were searched up to October 31, 2018. Clinical trials with a concurrent comparison group (s) that compared the effectiveness of PNF training with any other physical therapy intervention were selected. Publication language was restricted to English language articles. Methodologic quality was assessed using the PEDro scale. The measures of continuous variables were summarized as Hedges fs g. Results: In total, 20 eligible trials were identified with 965 LBP patients. A large effect size (standardized mean difference SMD=-2.14, 95% confidence interval CI=3.23 to -1.05) and significant effect were observed favoring the use of PNF training to alleviate back pain intensity in patients with LBP. Moreover, large effect size and the significant result were also determined for the effect of PNF training on functional disability improvement (SMD=-2.68, 95% CI=-3.36 to -2.00) in population with LBP. A qualitative synthesis of results indicated that PNF training can significantly improve sagittal spine ROM. Statistical heterogeneity analysis showed that there was considerable statistical heterogeneity among the selected trials for the primary outcomes (I2� 86.6%). Conclusion: There is a low quality of evidence and weak strength of recommendation that PNF training has positive effects on back pain and disability in LBP people. Further high-quality randomized clinical trials regarding long-term effects of PNF training versus validated control intervention in a clinical setting is recommendable. Level of evidence: I. © 2020 Mashhad University of Medical Sciences. All rights reserved
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Last time updated on 01/12/2020