Vibration therapy to improve pain and function in patients with chronic low back pain: a systematic review and meta-analysis.

Abstract

BACKGROUND: Vibration therapy (VT), a treatment of musculoskeletal disorders, has been developed for clinical applications in the past decade. However, its effect on relieving chronic low back pain (CLBP) and improving lumbar function is still illusive, lacking sufficient evidence-based medical data. OBJECTIVE: This systematic review aimed to evaluate the efficacy of vibration therapy on pain and function in people with CLBP. METHODS: PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang Date, VIP, and CBM were applied to search for clinical randomized controlled trials (RCTs) on vibration therapy for people with CLBP. The electronic databases were searched from the establishment of the database until July 1, 2023. Two researchers assessed the quality of the included studies and extracted data. The outcome indicators included the pain intensity index, Oswestry dysfunction index (ODI) score, and Roland-Morris dysfunction questionnaire (RMDQ) score. GRADE was used to evaluate the certainty of evidence of each outcome indicator. The meta-analysis was conducted using RevMan 5.3 software. RESULTS: Fourteen papers met the inclusion criteria with 860 subjects (VT group n = 432 and control group n = 428). VT for patients with CLBP reduced the pain intensity index [SMD = – 0.71, 95% CI (- 1.02, – 0.39), I(2) = 76%, P < 0.0001], the ODI score value [MD = - 4.24, 95% CI (- 8.10, - 0.38), I(2) = 88%, P = 0.03], and the RMDQ score value [MD = - 2.21, 95% CI (- 3.41, - 1.01), I(2) = 0%, P = 0.0003]. Subgroup analysis displayed that the pain intensity index was lower in the whole-body vibration (WBV) group than in the control group [SMD = - 0.49, 95% CI (- 0.79, - 0.19), I(2) = 58%, P = 0.001] and the local vibration (LV) group [SMD = - 1.07, 95% CI (- 1.60, - 0.53), I(2) = 76%, P < 0.0001]. The ODI scores in the WBV group were lower than those in the control group [MD = - 3.30, 95% CI (- 5.76, - 0.83), I(2) = 36%, P = 0.009]. There was no statistically significant difference in ODI scores between the LV group and the control group [MD = - 5.78, 95% CI (- 16.23, 4.66), I(2) = 97%, P = 0.28]. CONCLUSION: The data from this study suggest that VT can reduce pain and improve lumbar function in patients with CLBP. However, we still need to carefully interpret the results of this study, as the certainty of evidence was low, and the clinical relevance of the results is questionable. Further RCTs are needed in the future to ascertain this.