{"id":"https://openalex.org/W2912660705","doi":"https://doi.org/10.2519/jospt.2019.8734","title":"Treatment Effect Sizes of Mechanical Diagnosis and Therapy for Pain and Disability in Patients With Low Back Pain: A Systematic Review","display_name":"Treatment Effect Sizes of Mechanical Diagnosis and Therapy for Pain and Disability in Patients With Low Back Pain: A Systematic Review","publication_year":2019,"publication_date":"2019-02-14","ids":{"openalex":"https://openalex.org/W2912660705","doi":"https://doi.org/10.2519/jospt.2019.8734","mag":"2912660705","pmid":"https://pubmed.ncbi.nlm.nih.gov/30759358"},"language":"en","primary_location":{"id":"doi:10.2519/jospt.2019.8734","doi":"https://doi.org/10.2519/jospt.2019.8734","is_oa":false,"landing_page_url":"https://doi.org/10.2519/jospt.2019.8734","pdf_url":null,"source":{"id":"https://openalex.org/S7609525","display_name":"Journal of Orthopaedic and Sports Physical Therapy","issn_l":"0190-6011","issn":["0190-6011","1938-1344"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4323283832","host_organization_name":"American Physical Therapy Association","host_organization_lineage":["https://openalex.org/P4323283832"],"host_organization_lineage_names":["American Physical Therapy Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Orthopaedic & Sports Physical Therapy","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5004404152","display_name":"Mark H. Halliday","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800249840","display_name":"Concord Repatriation General Hospital","ror":"https://ror.org/04b0n4406","country_code":"AU","type":"healthcare","lineage":["https://openalex.org/I2800249840"]}],"countries":["AU"],"is_corresponding":false,"raw_author_name":"Mark H. Halliday","raw_affiliation_strings":["Address correspondence to Mark Halliday, Department of Physiotherapy, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139 Australia. E-mail:"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Address correspondence to Mark Halliday, Department of Physiotherapy, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139 Australia. E-mail:","institution_ids":["https://openalex.org/I2800249840"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038225601","display_name":"Alessandra N. Garcia","orcid":"https://orcid.org/0000-0001-9011-6880","observed_orcids":["https://orcid.org/0000-0001-9011-6880"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Alessandra N. Garcia","raw_affiliation_strings":[""],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084769254","display_name":"Anita B. Amorim","orcid":"https://orcid.org/0000-0001-8932-1561","observed_orcids":["https://orcid.org/0000-0001-8932-1561"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Anita B. Amorim","raw_affiliation_strings":[""],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045276959","display_name":"Gustavo C Machado","orcid":"https://orcid.org/0000-0002-8544-0448","observed_orcids":["https://orcid.org/0000-0002-8544-0448"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Gustavo C. Machado","raw_affiliation_strings":[""],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050902327","display_name":"Jill Alison Hayden","orcid":"https://orcid.org/0000-0001-7026-144X","observed_orcids":["https://orcid.org/0000-0001-7026-144X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jill A. Hayden","raw_affiliation_strings":[""],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5077932317","display_name":"Evangelos Pappas","orcid":"https://orcid.org/0000-0002-8340-0303","observed_orcids":["https://orcid.org/0000-0002-8340-0303"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Evangelos Pappas","raw_affiliation_strings":[""],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058493970","display_name":"Paulo H. Ferreira","orcid":"https://orcid.org/0000-0002-5861-7770","observed_orcids":["https://orcid.org/0000-0002-5861-7770","https://orcid.org/0000-0001-6312-6098","https://orcid.org/0000-0001-8932-1561"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Paulo H. Ferreira","raw_affiliation_strings":[""],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5059349186","display_name":"Mark Jonathan Hancock","orcid":"https://orcid.org/0000-0002-9277-5377","observed_orcids":["https://orcid.org/0000-0002-9277-5377"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mark J. Hancock","raw_affiliation_strings":["","Department of Health Professions"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"","institution_ids":[]},{"raw_affiliation_string":"Department of Health Professions","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.5124,"has_fulltext":false,"cited_by_count":33,"citation_normalized_percentile":{"value":0.45574491,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"49","issue":"4","first_page":"219","last_page":"229"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10084","display_name":"Musculoskeletal pain and rehabilitation","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10084","display_name":"Musculoskeletal pain and rehabilitation","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10238","display_name":"Spine and Intervertebral Disc Pathology","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12715","display_name":"Pregnancy-related medical research","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/mechanical-diagnosis-and-therapy","display_name":"mechanical diagnosis and therapy","score":0.9079999923706055},{"id":"https://openalex.org/keywords/low-back-pain","display_name":"low back pain","score":0.9959999918937683},{"id":"https://openalex.org/keywords/treatment-effect-size","display_name":"treatment effect size","score":0.6990000009536743},{"id":"https://openalex.org/keywords/treatment-adherence","display_name":"medication adherence","score":0.6359999775886536},{"id":"https://openalex.org/keywords/pain","display_name":"pain","score":0.3319999873638153},{"id":"https://openalex.org/keywords/disability","display_name":"disability","score":0.9800000190734863},{"id":"https://openalex.org/keywords/conservative-treatment","display_name":"conservative treatment","score":0.5339999794960022},{"id":"https://openalex.org/keywords/symptom-duration","display_name":"symptom duration","score":0.4650000035762787},{"id":"https://openalex.org/keywords/control-measures","display_name":"control measures","score":0.32199999690055847}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9404128193855286},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.694323718547821},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.6843451857566833},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.5205681920051575},{"id":"https://openalex.org/C2780907711","wikidata":"https://www.wikidata.org/wiki/Q852163","display_name":"Low back pain","level":3,"score":0.5016937255859375},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.497999906539917},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.49484628438949585},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.4257052540779114},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.34156984090805054},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.18772688508033752},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.17892056703567505},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.13814854621887207},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.07991412281990051},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D004185","descriptor_name":"Disability Evaluation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005081","descriptor_name":"Exercise Therapy","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015986","descriptor_name":"Confounding Factors, Epidemiologic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017116","descriptor_name":"Low Back Pain","qualifier_ui":"Q000145","qualifier_name":"classification","is_major_topic":false},{"descriptor_ui":"D017116","descriptor_name":"Low Back Pain","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D017116","descriptor_name":"Low Back Pain","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D018401","descriptor_name":"Sample Size","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.2519/jospt.2019.8734","doi":"https://doi.org/10.2519/jospt.2019.8734","is_oa":false,"landing_page_url":"https://doi.org/10.2519/jospt.2019.8734","pdf_url":null,"source":{"id":"https://openalex.org/S7609525","display_name":"Journal of Orthopaedic and Sports Physical Therapy","issn_l":"0190-6011","issn":["0190-6011","1938-1344"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4323283832","host_organization_name":"American Physical Therapy Association","host_organization_lineage":["https://openalex.org/P4323283832"],"host_organization_lineage_names":["American Physical Therapy Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Orthopaedic & Sports Physical Therapy","raw_type":"journal-article"},{"id":"pmid:30759358","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30759358","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Journal of orthopaedic and sports physical therapy","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":41,"referenced_works":["https://openalex.org/W1512449474","https://openalex.org/W1971095674","https://openalex.org/W1972801949","https://openalex.org/W1986309799","https://openalex.org/W1986821988","https://openalex.org/W1993674249","https://openalex.org/W1999177824","https://openalex.org/W2005434131","https://openalex.org/W2019545133","https://openalex.org/W2028181846","https://openalex.org/W2033123160","https://openalex.org/W2036672123","https://openalex.org/W2043294081","https://openalex.org/W2053849576","https://openalex.org/W2055233379","https://openalex.org/W2064295454","https://openalex.org/W2073350349","https://openalex.org/W2083894056","https://openalex.org/W2087428550","https://openalex.org/W2096420362","https://openalex.org/W2098359077","https://openalex.org/W2102480613","https://openalex.org/W2102968146","https://openalex.org/W2107121485","https://openalex.org/W2118383839","https://openalex.org/W2118516436","https://openalex.org/W2137471458","https://openalex.org/W2157659356","https://openalex.org/W2159084013","https://openalex.org/W2171297145","https://openalex.org/W2320054602","https://openalex.org/W2356342535","https://openalex.org/W2468996569","https://openalex.org/W2581432208","https://openalex.org/W2735766471","https://openalex.org/W2783838740","https://openalex.org/W2795195271","https://openalex.org/W2807054746","https://openalex.org/W4214559180","https://openalex.org/W4318598554","https://openalex.org/W4362504902"],"related_works":["https://openalex.org/W7166679426","https://openalex.org/W2795195271","https://openalex.org/W3022131063","https://openalex.org/W3047507306","https://openalex.org/W2935910784","https://openalex.org/W7166732179","https://openalex.org/W2735766471","https://openalex.org/W4411747778","https://openalex.org/W1972908983","https://openalex.org/W2176174391"],"abstract_inverted_index":{"BACKGROUND:":[0],"Mechanical":[1],"Diagnosis":[2],"and":[3,22,80,120,183,203,212],"Therapy":[4],"(MDT)":[5],"is":[6],"a":[7,222],"treatment-based":[8],"classification":[9,16],"system":[10],"founded":[11],"on":[12,167,221],"3":[13,181],"core":[14,75,134,244],"principles:":[15],"into":[17],"diagnostic":[18],"syndromes,":[19],"classification-based":[20],"intervention,":[21],"appropriate":[23],"application":[24],"of":[25,35,48,77,87,123,136,144,147,164,173,205,238],"force.":[26],"Many":[27],"randomized":[28],"controlled":[29],"trials":[30,51,68,81],"have":[31,43],"investigated":[32],"the":[33,54,74,78,133,145,162,195,243],"efficacy":[34],"MDT":[36,49,71,107,196,239],"for":[37,63,103,171],"low":[38,117],"back":[39,118],"pain;":[40],"however,":[41],"results":[42],"varied.":[44],"The":[45],"inconsistent":[46],"delivery":[47,165],"across":[50],"may":[52],"explain":[53],"different":[55],"findings.":[56],"OBJECTIVES:":[57],"To":[58],"compare":[59],"treatment":[60,236],"effect":[61,163],"sizes":[62],"pain":[64,119,124,202],"or":[65,85,125,138,142,178,187],"disability":[66,204],"between":[67],"that":[69,82,105,235],"delivered":[70,106],"consistent":[72],"with":[73,116],"principles":[76,135,146,245],"approach":[79,197],"met":[83],"some":[84,141],"none":[86,143],"these":[88],"principles.":[89],"METHODS:":[90],"In":[91],"this":[92],"systematic":[93],"review,":[94],"databases":[95],"were":[96,128,150,158],"searched":[97],"from":[98],"inception":[99],"to":[100,109,160,194,226],"June":[101],"2018":[102],"studies":[104],"compared":[108,225],"nonpharmacological,":[110],"conservative":[111],"control":[112,184],"interventions":[113],"in":[114,201],"patients":[115],"reported":[121],"outcomes":[122],"disability.":[126],"Studies":[127,190],"classified":[129,191],"as":[130,192],"\"adherent\"":[131],"(meeting":[132],"MDT)":[137],"\"nonadherent\"":[139],"(using":[140],"MDT).":[148],"Data":[149],"extracted":[151],"by":[152],"2":[153],"independent":[154],"reviewers.":[155],"Meta-regression":[156],"procedures":[157],"used":[159],"analyze":[161],"mode":[166],"clinical":[168],"outcomes,":[169],"adjusting":[170],"covariates":[172],"symptom":[174],"duration":[175],"(less":[176],"than":[177,180],"greater":[179,199,241],"months)":[182],"intervention":[185],"(minimal":[186],"active).":[188],"RESULTS:":[189],"adherent":[193],"showed":[198],"reductions":[200],"15.0":[206],"(95%":[207,214],"confidence":[208,215],"interval:":[209,216],"7.3,":[210],"22.7)":[211],"11.7":[213],"5.4,":[217],"18.0)":[218],"points,":[219],"respectively,":[220],"100-point":[223],"scale":[224],"nonadherent":[227],"trials.":[228],"CONCLUSION:":[229],"This":[230],"review":[231],"provides":[232],"preliminary":[233],"evidence":[234],"effects":[237],"are":[240,246],"when":[242],"followed.":[247],"LEVEL":[248],"OF":[249],"EVIDENCE:":[250],"Therapy,":[251],"level":[252],"1a.":[253],"J":[254],"Orthop":[255],"Sports":[256],"Phys":[257],"Ther":[258],"2019;49(4):219-229.":[259],"Epub":[260],"13":[261],"Feb":[262],"2019.":[263],"doi:10.2519/jospt.2019.8734.":[264]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":2},{"year":2024,"cited_by_count":4},{"year":2023,"cited_by_count":8},{"year":2022,"cited_by_count":4},{"year":2021,"cited_by_count":5},{"year":2020,"cited_by_count":6},{"year":2019,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2019-02-21T00:00:00"}