{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:57:22Z","timestamp":1776272242873,"version":"3.50.1"},"reference-count":69,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Occup Rehabil"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Evaluate benefits and harms of needling therapies (NT) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Electronic databases were searched for randomized controlled trials (RCTs) assessing NT compared with placebo\/sham, usual care, or no intervention (comparing interventions where the attributable effect could be isolated). We conducted meta-analyses where indicated and graded the certainty of evidence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We screened 1831 citations and 109 full text RCTs, yeilding 37 RCTs. The certainty of evidence was low or very low across all included outcomes. There was little or no difference between NT and comparisons across most outcomes; there may be some benefits for certain outcomes. Compared with sham, NT improved health-related quality of life (HRQoL) (physical) (2 RCTs; SMD\u2009=\u20090.20, 95%CI 0.07; 0.32) at 6\u00a0months. Compared with no intervention, NT reduced pain at 2\u00a0weeks (21 RCTs; MD\u2009=\u2009\u2212 1.21, 95%CI \u2212 1.50; \u2212 0.92) and 3\u00a0months (9 RCTs; MD\u2009=\u2009\u2212 1.56, 95%CI \u2212 2.80; \u2212 0.95); and reduced functional limitations at 2\u00a0weeks (19 RCTs; SMD\u2009=\u2009\u2212 1.39, 95%CI \u2212 2.00; \u2212 0.77) and 3\u00a0months (8 RCTs; SMD\u2009=\u2009\u2212 0.57, 95%CI \u2212 0.92; \u2212 0.22). In older adults, NT reduced functional limitations at 2\u00a0weeks (SMD\u2009=\u2009\u2212 1.10, 95%CI \u2212 1.71; \u2212 0.48) and 3\u00a0months (SMD\u2009=\u2009\u2212 1.04, 95%CI \u2212 1.66; \u2212 0.43). Compared with usual care, NT reduced pain (MD\u2009=\u2009\u2212 1.35, 95%CI \u2212 1.86; \u2212 0.84) and functional limitations (MD\u2009=\u2009\u2212 2.55, 95%CI \u2212 3.70; \u2212 1.40) at 3\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Based on low to very low certainty evidence, adults with CPLBP experienced some benefits in pain, functioning, or HRQoL with NT; however, evidence showed little to no differences for other outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10926-023-10125-3","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T14:05:47Z","timestamp":1700661947000},"page":"661-672","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Needling Therapies for Chronic Primary Low Back Pain in Adults"],"prefix":"10.1007","volume":"33","author":[{"given":"Hainan","family":"Yu","sequence":"first","affiliation":[]},{"given":"Dan","family":"Wang","sequence":"additional","affiliation":[]},{"given":"Leslie","family":"Verville","sequence":"additional","affiliation":[]},{"given":"Danielle","family":"Southerst","sequence":"additional","affiliation":[]},{"given":"Andr\u00e9","family":"Bussi\u00e8res","sequence":"additional","affiliation":[]},{"given":"Douglas P.","family":"Gross","sequence":"additional","affiliation":[]},{"given":"Paulo","family":"Pereira","sequence":"additional","affiliation":[]},{"given":"Silvano","family":"Mior","sequence":"additional","affiliation":[]},{"given":"Andrea C.","family":"Tricco","sequence":"additional","affiliation":[]},{"given":"Christine","family":"Cedraschi","sequence":"additional","affiliation":[]},{"given":"Ginny","family":"Brunton","sequence":"additional","affiliation":[]},{"given":"Margareta","family":"Nordin","sequence":"additional","affiliation":[]},{"given":"Heather M.","family":"Shearer","sequence":"additional","affiliation":[]},{"given":"Jessica J.","family":"Wong","sequence":"additional","affiliation":[]},{"given":"Gaelan","family":"Connell","sequence":"additional","affiliation":[]},{"given":"Danny","family":"Myrtos","sequence":"additional","affiliation":[]},{"given":"Sophia","family":"da Silva-Oolup","sequence":"additional","affiliation":[]},{"given":"James J.","family":"Young","sequence":"additional","affiliation":[]},{"given":"Martha","family":"Funabashi","sequence":"additional","affiliation":[]},{"given":"Andrew","family":"Romanelli","sequence":"additional","affiliation":[]},{"given":"Joyce G. 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CC\u00a0(Carol Cancelliere), LV, DS, HY, GC, JJW, HMS report funding from the Canadian Chiropractic Guideline Initiative. ACT is funded by a Tier 2 Canada Research Chair in Knowledge Synthesis. JJW is funded by a Banting Postdoctoral Fellowship from the Canadian Institutes of Health Research (CIHR). CAH reports grants to the University of Zurich from the Foundation for the Education of Chiropractors in Switzerland, the Swiss National Science Foundation (SNSF), and the European Centre for Chiropractic Research Excellence (ECCRE) outside the submitted work. SM reports grants from the\u00a0Canadian Chiropractic Association, Canadian Chiropractic Research Foundation, and CIHR outside of submitted work. JJW reports grants from the CIHR and Canadian Chiropractic Research Foundation (paid to university), and travel reimbursement for research meetings from the Chiropractic Academy of Research Leadership outside the submitted work. JML reports a grant from the European Cooperation in Science and Technology (COST) outside the submitted work. AB reports grants from the Canadian Chiropractic Association, Canadian Chiropractic Research Foundation, and Health Canada outside the submitted work. JJY is funded by an Arthritis Society Canada Postdoctoral Training Fellowship, CIHR Fellowship, and grant from the Danish Foundation for Chiropractic Research and Post-graduate Education, all outside the submitted work.<b>Ethical Approval<\/b>Ethical approval was not required for this systematic review of previously published studies.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}