Browsing by Author "Riley, R.D."

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Exercise treatment effect modifiers in persistent low back pain: an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials.
Hayden, J.A. ; Wilson, M.N. ; Stewart, S. ; Cartwright, J.L. ; Smith, A.O. ; Riley, R.D. ; Tulder, M. van ; Bendix, T. ; Cecchi, F. ; Costa, L.O.P. ; Dufour, N. ; Ferreira, M.L. ; Foster, N.E. ; Gudavalli, M.R. ; Hartvigsen, J. ; Helmhout, P. ; Kool, J. ; Koumantakis, G.A. ; Kovacs, F.M. ; Kuukkanen, T. ; Long, A. ; Macedo, L.G. ; Machado, L.A.C. ; Maher, C.G. ; Mehling, W. ; Morone, G. ; Peterson, T. ; Rasmussen-Barr, E. ; Ryan, C.G. ; Sjögren, T. ; Smeets, R. ; Staal, J.B. ; Unsgaard-Tøndel, M. ; Wajswelner, H. ; Yeung, E.W. et al. sine al.
2020, Article / Letter to editor (British Journal of Sports Medicine, vol. 54, iss. 21, (2020), pp. 1277-1278)BACKGROUND: Low back pain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific low back pain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise. METHODS: In parallel with a Cochrane review update, we requested individual participant data (IPD) from high-quality randomised clinical trials of adults with our two primary outcomes of interest, pain and functional limitations, and calculated global recovery. We compiled a master data set including baseline participant characteristics, exercise and comparison characteristics, and outcomes at short-term, moderate-term and long-term follow-up. We conducted descriptive analyses and one-stage IPD meta-analysis using multilevel mixed-effects regression of the overall treatment effect and prespecified potential treatment effect modifiers. RESULTS: We received IPD for 27 trials (3514 participants). For studies included in this analysis, compared with no treatment/usual care, exercise therapy on average reduced pain (mean effect/100 (95% CI) -10.7 (-14.1 to -7.4)), a result compatible with a clinically important 20% smallest worthwhile effect. Exercise therapy reduced functional limitations with a clinically important 23% improvement (mean effect/100 (95% CI) -10.2 (-13.2 to -7.3)) at short-term follow-up. Not having heavy physical demands at work and medication use for low back pain were potential treatment effect modifiers-these were associated with superior exercise outcomes relative to non-exercise comparisons. Lower body mass index was also associated with better outcomes in exercise compared with no treatment/usual care. This study was limited by inconsistent availability and measurement of participant characteristics. CONCLUSIONS: This study provides potentially useful information to help treat patients and design future studies of exercise interventions that are better matched to specific subgroups. PROTOCOL PUBLICATION: https://doi.org/10.1186/2046-4053-1-64.
Subgrouping and TargetEd Exercise pRogrammes for knee and hip OsteoArthritis (STEER OA): a systematic review update and individual participant data meta-analysis protocol.
Holden, M.A. ; Burke, D.L. ; Runhaar, J. ; Windt, D. van Der ; Riley, R.D. ; Dziedzic, K. ; Legha, A. ; Evans, A.L. ; Abbott, J.H. ; Baker, K. ; Brown, J. ; Bennell, K.L. ; Bossen, D. ; Brosseau, L. ; Chaipinyo, K. ; Christensen, R. ; Cochrane, T. ; Rooij, M. de ; Doherty, M. ; French, H.P. ; Hickson, S. ; Hinman, R.S. ; Hopman-Rock, M. ; Hurley, M.V. ; Ingram, C. ; Knoop, J. ; Krauss, I. ; McCarthy, C. ; Messier, S.P. ; Patrick, D.L. ; Sahin, N. ; Talbot, L.A. ; Taylor, R. ; Teirlinck, C.H. ; Middelkoop, M. van ; Walker, C. ; Foster, N.E. et al. sine al.
2017, Article / Letter to editor (BMJ Open, vol. 7, iss. 12, (2017), pp. e018971)INTRODUCTION: Knee and hip osteoarthritis (OA) is a leading cause of disability worldwide. Therapeutic exercise is a recommended core treatment for people with knee and hip OA, however, the observed effect sizes for reducing pain and improving physical function are small to moderate. This may be due to insufficient targeting of exercise to subgroups of people who are most likely to respond and/or suboptimal content of exercise programmes. This study aims to identify: (1) subgroups of people with knee and hip OA that do/donnot respond to therapeutic exercise and to different types of exercise and (2) mediators of the effect of therapeutic exercise for reducing pain and improving physical function. This will enable optimal targeting and refining the content of future exercise interventions. METHODS AND ANALYSIS: Systematic review and individual participant data meta-analyses. A previous comprehensive systematic review will be updated to identify randomised controlled trials that compare the effects of therapeutic exercise for people with knee and hip OA on pain and physical function to a non-exercise control. Lead authors of eligible trials will be invited to share individual participant data. Trial-level and participant-level characteristics (for baseline variables and outcomes) of included studies will be summarised. Meta-analyses will use a two-stage approach, where effect estimates are obtained for each trial and then synthesised using a random effects model (to account for heterogeneity). All analyses will be on an intention-to-treat principle and all summary meta-analysis estimates will be reported as standardised mean differences with 95% CI. ETHICS AND DISSEMINATION: Research ethical or governance approval is exempt as no new data are being collected and no identifiable participant information will be shared. Findings will be disseminated via national and international conferences, publication in peer-reviewed journals and summaries posted on websites accessed by the public and clinicians. PROSPERO REGISTRATION NUMBER: CRD42017054049.

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