Der Orthopäde
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Review Meta Analysis Comparative Study
[Subgroup-specific therapy of low back pain: description and validity of two classification systems].
In spite of profound advances in the diagnosis and therapy, low back pain (LBP) remains one of the main challenges for health systems in western industrialized countries. Clinical trials and meta-analyses typically show heterogeneous evidence and small effect sizes. One explanation for this phenomenon is the heterogeneous nature of the population of patients with LBP, not adequately considered in clinical practice and research. Recent studies and one meta-analysis show that therapy which is specifically directed at well defined subgroups leads to improved effectiveness of interventions, especially for non-surgical interventions such as manual therapy or physiotherapy. ⋯ The reliability of the described classification systems is moderate to good, aspects of validity have been shown. Their implementation in clinical practice seems recommendable.