RT Journal Article
SR Electronic
T1 Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 172
OP 181
DO 10.1136/bjsports-2017-098765
VO 53
IS 3
A1 Gisela Cristiane Miyamoto
A1 Chung-Wei Christine Lin
A1 Cristina Maria Nunes Cabral
A1 Johanna M van Dongen
A1 Maurits W van Tulder
YR 2019
UL http://bjsm.bmj.com/content/53/3/172.abstract
AB Objective To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain.Design Systematic review of economic evaluations.Data sources The search was performed in 5 clinical and 3 economic electronic databases.Eligibility criteria for selecting studies We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed.Results Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain.Conclusions Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed.Registration PROSPERO, CRD42017059025.