Effects of Exercise Training on Fear-Avoidance in Pain and Pain-Free Populations: Systematic Review and Meta-analysis.
Sports Med
; 50(12): 2193-2207, 2020 Dec.
Article
em En
| MEDLINE
| ID: mdl-32946074
ABSTRACT
BACKGROUND:
Fear of pain and movement is an important factor in the development of hypervigilance and avoidance behaviours.OBJECTIVE:
We examined the effectiveness of exercise training on improving fear-avoidance beliefs.METHODS:
A systematic review (data sources MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL) and metaanalysis of randomised controlled/clinical trials of exercise training in adults versus relevant nonexercise comparators that quantified fear-avoidance was conducted.RESULTS:
After screening 4603 identified records, 17 (2014 participants) and 13 (1152 participants) studies were eligible for qualitative and quantitative synthesis, respectively. Pairwise meta-analysis showed exercise training was more effective than all non-exercise comparators (standardised mean difference (SMD) [95% CI] - 0.378 [- 0.623, - 0.133], P = 0.002, Grading of Recommendations Assessment, Development and Evaluation [GRADE] very low) for reducing fear-avoidance. Exercise training was more effective than true control for reducing fear avoidance (- 0.407 [- 0.750, - 0.065], P = 0.020, GRADE very low), however it was not more effective than other interventions (- 0.243 [- 0.614, 0.128], P = 0.199, GRADE very low). In people with low back pain, exercise training was more effective than non-exercise comparator groups for reducing fear-avoidance (- 0.530 [- 0.755, - 0.304], P < 0.001, GRADE very low). For individuals with neck pain, exercise training was not more effective than non-exercise comparator groups for reducing fear-avoidance (0.061 [- 0.360, 0.482], P = 0.777, GRADE very low).CONCLUSION:
There is very low to low-quality evidence that exercise training is effective for reducing fear-avoidance, including in people with low back pain. Exercise training may be more effective than no intervention for reducing fear avoidance, but there is very low-quality evidence that non-exercise interventions are as effective as exercise for fear avoidance. Few studies with low risk of bias is a limitation. TRAIL REGISTRATION PROSPERO Registration Number CRD42019139678.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor Lombar
/
Terapia por Exercício
/
Medo
Tipo de estudo:
Clinical_trials
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Guideline
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Prognostic_studies
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Qualitative_research
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Systematic_reviews
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Sports Med
Ano de publicação:
2020
Tipo de documento:
Article