Peruth Nabirye, Lukiza B Paul, Erisa S Mwaka
Attitudes and usage of visual-aids in graduate student learning of gross anatomy at Makerere University
African health sciences
objective ascertain whether manipulating contextual effects eg interaction patients beliefs treatments boosted outcomes nonpharmacological nonsurgicaltreatments chronic primary musculoskeletal pain design systematic review randomized controlled trials data sources searched trials six databases citation tracking clinical trials registers included trials compared treatments enhanced contextual effects treatments without enhancement adults chronic primary musculoskeletal pain data synthesis outcomes interest pain intensity physical functioning global ratings improvement quality life depression anxiety sleep evaluated risk bias certainty evidence using cochrane risk bias tool 20 grade approach respectively results 17637 records included 10 trials 990 participants identified 5 ongoing trials treatments acupuncture education exercise training physical therapy contextual effects improved enhanced treatments patientpractitioner relationship patient beliefs characteristics therapeutic settingenvironment treatment characteristics analysis showed improving contextual effects nonpharmacological nonsurgical treatments may make much difference pain intensity mean difference md 177 95ci 871 516 k 7 trials n 719 participants scale 0100 grade low physical functioning md 027 95ci 102 049 95pi 204 151 k 6 n 567 scale 010 grade low shortterm later followups sensitivity analyses revealed similar findings conclusion whilst evidence gaps exist per current evidence may possible achieve meaningful benefit patients chronic musculoskeletal pain manipulating context nonpharmacological nonsurgical treatments trial registration systematic review prospectively registered prospero registration number crd42023391601