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Predictors of multidisciplinary rehabilitation outcomes in patients with chronic musculoskeletal pain: protocol for a systematic review and meta-analysis
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Department of Clinical Sciences, Department of Rehabilitation Medicine, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
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2017 (English)In: Systematic Reviews, E-ISSN 2046-4053, Vol. 6, no 1, article id 199Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Chronic musculoskeletal pain is a major public health problem. Early prediction for optimal treatment results has received growing attention, but there is presently a lack of evidence regarding what information such proactive management should be based on. This study protocol, therefore, presents our planned systematic review and meta-analysis on important predictive factors for health and work-related outcomes following multidisciplinary rehabilitation (MDR) in patients with chronic musculoskeletal pain.

METHODS: We aim to perform a synthesis of the available evidence together with a meta-analysis of published peer-reviewed original research that includes predictive factors preceding MDR. Included are prospective studies of adults with benign, chronic (> 3 months) musculoskeletal pain diagnoses who have taken part in MDR. In the studies, associations between personal and rehabilitation-based factors and the outcomes of interest are reported. Outcome domains are pain, physical functioning including health-related quality of life, and work ability with follow-ups of 6 months or more. We will use a broad, explorative approach to any presented predictive factors (demographic, symptoms-related, physical, psychosocial, work-related, and MDR-related) and these will be analyzed through (a) narrative synthesis for each outcome domain and (b) if sufficient studies are available, a quantitative synthesis in which variance-weighted pooled proportions will be computed using a random effects model for each outcome domain. The strength of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation.

DISCUSSION: The strength of this systematic review is that it aims for a meta-analysis of prospective cohort or randomized controlled studies by performing an extensive search of multiple databases, using an explorative study approach to predictive factors, rather than building on single predictor impact on the outcome or on predefined hypotheses. In this way, an overview of factors central to MDR outcome can be made and will help strengthen the evidence base and inform a wide readership including health care practitioners and policymakers.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016025339.

Place, publisher, year, edition, pages
BioMed Central, 2017. Vol. 6, no 1, article id 199
Keywords [en]
Chronic musculoskeletal pain, Literature review, Meta-analysis, Multidisciplinary rehabilitation, Prognostic factors, Treatment outcome
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Other Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-146906DOI: 10.1186/s13643-017-0598-0PubMedID: 29020989OAI: oai:DiVA.org:umu-146906DiVA, id: diva2:1199997
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-06-09Bibliographically approved

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Stålnacke, Britt-Marie

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