Secondary Logo

Institutional members access full text with Ovid®

The Effectiveness of Group-Based Physiotherapy-Led Behavioral Psychological Interventions on Adults With Chronic Low Back Pain

A Systematic Review and Meta-Analysis

Zhang, Qi, PhD student; Jiang, Shujun, PhD; Young, Lufei, PhD; Li, Feng, PhD

American Journal of Physical Medicine & Rehabilitation: March 2019 - Volume 98 - Issue 3 - p 215–225
doi: 10.1097/PHM.0000000000001053
Original Research Articles

Group-based physiotherapy-led behavioral psychological interventions (GPBPIs) are an emerging treatment for chronic low back pain, but the efficacy of these interventions is uncertain. A review of relevant randomized controlled trials and a meta-analysis was conducted to evaluate the effectiveness of GPBPIs on pain relief in adults with chronic low back pain. Literature databases, Google Scholar, bibliographies, and other relevant sources were searched. Thirteen intervention studies (13) published from 1998 to 2013 were included. The meta-analysis was conducted using RevMan software in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. In reviewing the short- (<6 mos), intermediate- (≥6 and <12 mos), and longer-term (≥12 mos) effects of GPBPIs, long-term follow-up evaluations showed large and significant effect sizes (standardized mean difference = −0.25, 95% confidence interval = −0.39 to −0.11, I 2 = 38%, P < 0.01). Subgroup analysis indicated that patients from GPBPIs group had the greater short-, intermediate-, and long-term pain reduction than patients on waiting listing or usual care group. Compared with other active treatments, GPBPIs showed a small but significant long-term pain reduction in patients with chronic low back pain (standardized mean difference = −0.18, 95% confidence interval = −0.35 to −0.01, I 2 = 32%, P = 0.04). In general, GPBPIs may be an acceptable intervention to relieve pain intensity.

From the College of Nursing, Jilin University, Changchun, China (QZ, FL); Binzhou Medical University, Yantai, China (SJ); and College of Nursing, Augusta University, Augusta, Georgia (LY).

All correspondence should be addressed to: Feng Li, PhD, College of Nursing, Jilin University, Changchun 130021, Jilin Province, China.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.