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160 APPENDICES Physiotherapy KCE reports vol.40
Table 9 Acute low back pain: treatment modalities applied by Belgian ambulatory physiotherapists and evidence-based literature
Treatment modality
Frequency
(proportion
± accuracy)
Spinal tractions 18 ± 5%
Type of
evidence
Evidence
against
(moderate to
strong)
Evidence available in the literature on physiotherapy of acute low back pain (LBP)
There is moderate to strong evidence that intermittent and continuous traction is
ineffective to treat low back pain in general, with or without sciatica.
Muscle chains 18 ± 5% ? No information available in the literature review.
Proprioceptive rehabilitation 16 ± 4% ? No information available in the literature review.
Reflexotherapy 09 ± 4%
?
(only chronic
LBP)
Relaxation 08 ± 3% ?
Behavioural therapy 05 ± 3%
Biofeedback (EMG) 00 ± 0%
No evidence
for nor
against
(only chronic
LBP)
Evidence
against
(moderate to
strong)
(only chronic
LBP)
Reflexotherapy seems efficient at short- (5 minutes) and intermediate- (30 to 45 days)
terms. Other studies are however required as the available literature is based on the scientific
work of only one team.
Effectiveness of reflexotherapy is less clear for patients with subacute low back pain.
There is moderate evidence that massage has a superior positive effect on low back pain as
compared to passive therapeutic modalities such as relaxation, acupuncture and self-care
education.
There is strong evidence that most behavioural interventions are more effective that no
treatment in reducing pain and improving function in patients with chronic low back pain.
There is weak evidence that behavioural interventions are equivalent in terms of
effectiveness as compared with exercise therapy.
There is moderate evidence that adding a behavioural intervention to more traditional
treatments is not effective in improving function as compared to the traditional treatment
alone.
There is a moderate to strong evidence that EMG biofeedback is not effective in patients
with chronic low back pain.