Neuroreflexotherapy for non-specific low-back pain

Gerard Urrútia, A. Kim Burton, Antoni Morral Fernández, Xavier Bonfill Cosp, Gustavo Zanoli

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

Background: Among the wide range of therapeutic alternatives proposed for the management of low-back pain (LBP), a less widely used technique from Spain, called neuroreflexotherapy (NRT) has claimed to show very favourable results, mainly in patients with chronic low-back pain. Objectives: To assess the effectiveness of NRT for the treatment of non-specific LBP in adult patients, aged 16 to 65 years. A secondary objective was to compare NRT with other conventional interventions. Search strategy: In July 2009, we updated the searches in CENTRAL (Issue 3, 2009), MEDLINE and EMBASE. No new trials were identified. Selection criteria: Only randomised controlled trials (RCTs) of NRT for the treatment of patients with a clinical diagnosis of non-specific LBP were included. Data collection and analysis: Two authors independently selected trials and extracted data using pre-designed forms. Because the outcome variables were not assessed in a homogenous way, it was not possible to pool the results to obtain an estimate of global effect, as initially planned. Main results: Three RCTs were included, with a total of 125 subjects randomised to the control groups and 148 subjects receiving active NRT. Neuroreflexotherapy was the same in all three trials, while the control groups received sham-NRT in two trials and standard care in one. Two trials studied patients with chronic LBP, the third studied patients with a mix of chronic and sub-acute LBP. Clinical outcomes were measured in the short-term (15 to 60 days) in all three trials; in one trial, resource utilization was measured after one year. Individuals who received active NRT showed statistically significantly better outcomes than the control groups for measures of pain, degree of mobility, disability, medication use, consumption of resources and costs. No significant differences were observed for quality of life measures. Side effects were more frequently reported in the control groups during short-term follow-up, with no major side effects reported by those receiving active NRT. Authors' conclusions: NRT appears to be a safe and effective intervention for the treatment of chronic non-specific LBP. The efficacy is less clear for sub-acute LBP. However, these results are limited to three trials conducted by a small number of specifically trained and experienced clinicians, in a limited geographical location. No data are available on the ease and time-frame needed to achieve that level of expertise. RCTs by other practitioners, in other locations, that replicate the effects reported in this review are needed before recommending a broader practice.

Original languageEnglish
Article numberCD003009
Number of pages22
JournalCochrane Database of Systematic Reviews
Issue number2
DOIs
Publication statusPublished - 19 Apr 2004

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Low Back Pain
Control Groups
Randomized Controlled Trials
MEDLINE
Spain
Patient Selection
Therapeutics
Quality of Life
Costs and Cost Analysis
Pain

Cite this

Urrútia, Gerard ; Burton, A. Kim ; Fernández, Antoni Morral ; Cosp, Xavier Bonfill ; Zanoli, Gustavo. / Neuroreflexotherapy for non-specific low-back pain. In: Cochrane Database of Systematic Reviews. 2004 ; No. 2.
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title = "Neuroreflexotherapy for non-specific low-back pain",
abstract = "Background: Among the wide range of therapeutic alternatives proposed for the management of low-back pain (LBP), a less widely used technique from Spain, called neuroreflexotherapy (NRT) has claimed to show very favourable results, mainly in patients with chronic low-back pain. Objectives: To assess the effectiveness of NRT for the treatment of non-specific LBP in adult patients, aged 16 to 65 years. A secondary objective was to compare NRT with other conventional interventions. Search strategy: In July 2009, we updated the searches in CENTRAL (Issue 3, 2009), MEDLINE and EMBASE. No new trials were identified. Selection criteria: Only randomised controlled trials (RCTs) of NRT for the treatment of patients with a clinical diagnosis of non-specific LBP were included. Data collection and analysis: Two authors independently selected trials and extracted data using pre-designed forms. Because the outcome variables were not assessed in a homogenous way, it was not possible to pool the results to obtain an estimate of global effect, as initially planned. Main results: Three RCTs were included, with a total of 125 subjects randomised to the control groups and 148 subjects receiving active NRT. Neuroreflexotherapy was the same in all three trials, while the control groups received sham-NRT in two trials and standard care in one. Two trials studied patients with chronic LBP, the third studied patients with a mix of chronic and sub-acute LBP. Clinical outcomes were measured in the short-term (15 to 60 days) in all three trials; in one trial, resource utilization was measured after one year. Individuals who received active NRT showed statistically significantly better outcomes than the control groups for measures of pain, degree of mobility, disability, medication use, consumption of resources and costs. No significant differences were observed for quality of life measures. Side effects were more frequently reported in the control groups during short-term follow-up, with no major side effects reported by those receiving active NRT. Authors' conclusions: NRT appears to be a safe and effective intervention for the treatment of chronic non-specific LBP. The efficacy is less clear for sub-acute LBP. However, these results are limited to three trials conducted by a small number of specifically trained and experienced clinicians, in a limited geographical location. No data are available on the ease and time-frame needed to achieve that level of expertise. RCTs by other practitioners, in other locations, that replicate the effects reported in this review are needed before recommending a broader practice.",
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Neuroreflexotherapy for non-specific low-back pain. / Urrútia, Gerard; Burton, A. Kim; Fernández, Antoni Morral; Cosp, Xavier Bonfill; Zanoli, Gustavo.

In: Cochrane Database of Systematic Reviews, No. 2, CD003009, 19.04.2004.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Neuroreflexotherapy for non-specific low-back pain

AU - Urrútia, Gerard

AU - Burton, A. Kim

AU - Fernández, Antoni Morral

AU - Cosp, Xavier Bonfill

AU - Zanoli, Gustavo

PY - 2004/4/19

Y1 - 2004/4/19

N2 - Background: Among the wide range of therapeutic alternatives proposed for the management of low-back pain (LBP), a less widely used technique from Spain, called neuroreflexotherapy (NRT) has claimed to show very favourable results, mainly in patients with chronic low-back pain. Objectives: To assess the effectiveness of NRT for the treatment of non-specific LBP in adult patients, aged 16 to 65 years. A secondary objective was to compare NRT with other conventional interventions. Search strategy: In July 2009, we updated the searches in CENTRAL (Issue 3, 2009), MEDLINE and EMBASE. No new trials were identified. Selection criteria: Only randomised controlled trials (RCTs) of NRT for the treatment of patients with a clinical diagnosis of non-specific LBP were included. Data collection and analysis: Two authors independently selected trials and extracted data using pre-designed forms. Because the outcome variables were not assessed in a homogenous way, it was not possible to pool the results to obtain an estimate of global effect, as initially planned. Main results: Three RCTs were included, with a total of 125 subjects randomised to the control groups and 148 subjects receiving active NRT. Neuroreflexotherapy was the same in all three trials, while the control groups received sham-NRT in two trials and standard care in one. Two trials studied patients with chronic LBP, the third studied patients with a mix of chronic and sub-acute LBP. Clinical outcomes were measured in the short-term (15 to 60 days) in all three trials; in one trial, resource utilization was measured after one year. Individuals who received active NRT showed statistically significantly better outcomes than the control groups for measures of pain, degree of mobility, disability, medication use, consumption of resources and costs. No significant differences were observed for quality of life measures. Side effects were more frequently reported in the control groups during short-term follow-up, with no major side effects reported by those receiving active NRT. Authors' conclusions: NRT appears to be a safe and effective intervention for the treatment of chronic non-specific LBP. The efficacy is less clear for sub-acute LBP. However, these results are limited to three trials conducted by a small number of specifically trained and experienced clinicians, in a limited geographical location. No data are available on the ease and time-frame needed to achieve that level of expertise. RCTs by other practitioners, in other locations, that replicate the effects reported in this review are needed before recommending a broader practice.

AB - Background: Among the wide range of therapeutic alternatives proposed for the management of low-back pain (LBP), a less widely used technique from Spain, called neuroreflexotherapy (NRT) has claimed to show very favourable results, mainly in patients with chronic low-back pain. Objectives: To assess the effectiveness of NRT for the treatment of non-specific LBP in adult patients, aged 16 to 65 years. A secondary objective was to compare NRT with other conventional interventions. Search strategy: In July 2009, we updated the searches in CENTRAL (Issue 3, 2009), MEDLINE and EMBASE. No new trials were identified. Selection criteria: Only randomised controlled trials (RCTs) of NRT for the treatment of patients with a clinical diagnosis of non-specific LBP were included. Data collection and analysis: Two authors independently selected trials and extracted data using pre-designed forms. Because the outcome variables were not assessed in a homogenous way, it was not possible to pool the results to obtain an estimate of global effect, as initially planned. Main results: Three RCTs were included, with a total of 125 subjects randomised to the control groups and 148 subjects receiving active NRT. Neuroreflexotherapy was the same in all three trials, while the control groups received sham-NRT in two trials and standard care in one. Two trials studied patients with chronic LBP, the third studied patients with a mix of chronic and sub-acute LBP. Clinical outcomes were measured in the short-term (15 to 60 days) in all three trials; in one trial, resource utilization was measured after one year. Individuals who received active NRT showed statistically significantly better outcomes than the control groups for measures of pain, degree of mobility, disability, medication use, consumption of resources and costs. No significant differences were observed for quality of life measures. Side effects were more frequently reported in the control groups during short-term follow-up, with no major side effects reported by those receiving active NRT. Authors' conclusions: NRT appears to be a safe and effective intervention for the treatment of chronic non-specific LBP. The efficacy is less clear for sub-acute LBP. However, these results are limited to three trials conducted by a small number of specifically trained and experienced clinicians, in a limited geographical location. No data are available on the ease and time-frame needed to achieve that level of expertise. RCTs by other practitioners, in other locations, that replicate the effects reported in this review are needed before recommending a broader practice.

KW - Acute disease

KW - Chronic disease

KW - Humans

KW - Low back pain [therapy]

KW - Randomized controlled trials as topic

KW - Reflexotherapy [methods]

KW - Transcutaneous electric nerve stimulation [methods]

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U2 - 10.1002/14651858.CD003009.pub2

DO - 10.1002/14651858.CD003009.pub2

M3 - Review article

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1361-6137

IS - 2

M1 - CD003009

ER -