Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were included.
Specific interventions included in the review
Studies addressing the use of back schools to treat lower-back pain. These included patient education for proper bending and lifting activities (body mechanics education) and the implementation of a passive or active back exercise programme. Comprehensive rehabilitation programmes were defined as interventions that coupled the minimal essential elements of back school (above) with a worksite visit, operant conditioning, cognitive-behavioural group therapy or an intensive physical training regimen that supplemented traditional back exercise programmes.
Participants included in the review
Patients with lower-back pain: those showing symptoms for 8 weeks or less were defined as being in the acute/subacute stage (n = 630, 27%, whilst those showing symptoms for longer than 8 weeks were defined as in the chronic phase (n = 1,263, 53%). Some studies had mixed chronicity (both categories, n = 480, 20%). Ages of subjects varied from 18 to 61 years (mean age 41.8 years, SD 5.5). Of the 1,913 patients whose sex was stated, 55% were male.
Outcomes assessed in the review
The outcome categories included in the review were pain (e.g. measured with visual analogue scale), disability (e.g. scored tests of activities of daily living), spinal motion (e.g. range of motion of the spine), strength/endurance (e.g. isokinetic assessment), work/vocational (e.g. amount of sick leave) and educational /compliance (e.g. measure of the quality of exercise performance at follow-up).
How were decisions on the relevance of primary studies made?
The author does not state how the papers were selected for review, or how many of the reviewers performed the selection.