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                <title xml:lang="en">Assessing the impact of manual therapy in the management of nonspecific low back pain: a scoping review of the outcomes used in clinical trials</title>
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                <term xml:lang="en">Scoping review</term>
                <term xml:lang="en">Musculoskeletal manipulations</term>
                <term xml:lang="en">Manual therapy</term>
                <term xml:lang="en">Low back pain</term>
                <term xml:lang="en">Core outcome set</term>
                <term xml:lang="fr">Revue de la portée</term>
                <term xml:lang="fr">Manipulations musculosquelettiques</term>
                <term xml:lang="fr">Thérapie manuelle</term>
                <term xml:lang="fr">Lombalgie</term>
                <term xml:lang="fr">Core outcome set</term>
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              <p>Background: Low Back Pain (LBP) is the leading cause of disability worldwide, 90% of which is nonspecific. Manual therapy is one of the recommended treatment modalities. However, reported outcomes may be variable. This review aims to identify their scope in the context of the development of a Core Outcome Set (COS), which is defined as « an agreed standardised set of outcomes that should be measured and reported, as a minimum, in all clinical trials in specific areas of health or health care ».Methods: A scoping review with risk of bias assessment of randomised controlled trials (RCTs) of manual therapy for nonspecific LBP was conducted using MEDLINE, CENTRAL, PEDro, WebOfScience and ClinicalTrials.gov, from 2010 up to August 2024. Manual therapy was considered the use, alone or in combination, of manipulations (high velocity, low amplitude), mobilisations (low-grade velocity, small-to-large amplitude) or soft tissue relaxation (especially massage, trigger points, muscle contractions).Results: Out of 3929 articles, 147 RCTs and 74 protocols were included. Two main outcomes emerged: pain intensity (assessed by numerical rating scale or visual analogue scale) and disability (mostly assessed by Rolland-Morris Disability Questionnaire or Oswestry Disability Index). Range of motion is the most frequent clinical outcome assessed. Psychological factors such as fear-avoidance beliefs, kinesiophobia and catastrophising, and healthcare consumption, particularly medication, are also frequent. Most of the outcomes were patient-reported outcomes.Conclusion: Consistent with a previous COS on nonspecific low back pain, manual therapy appears to address the same outcomes. Clinical trials in manual therapy should focus on using the existing COS by measuring pain intensity using a numerical rating scale, disability using the ODI 2.1a or the 24-item RMDQ, health-related quality of life using the SF-12 or the 10-item PROMIS. Additionally, due to the gap between clinical research and pain experience, trials should consider conducting subgroup analyses to identify effects on outcomes related to gender or age, paying particular attention to health inequalities by carrying out analyses based on socioeconomic status, as these factors are well known to significantly impact pain experience and access to care.Review protocol: PROSPERO registration CRD42024576475, COMET Database registration 3229.</p>
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              <p>Introduction : La lombalgie est la principale cause d’incapacité dans le monde, jusqu’à 95% étant non spécifiques. La thérapie manuelle est l’une des modalités de traitement recommandées. Cependant, les critères de jugement utilisés peuvent être variables. Cette revue vise à développer un Core Outcome Set (COS), défini comme “un ensemble standardisé de critères devant être mesurés et rapportés, au minimum, dans tous les essais cliniques dans des domaines spécifiques de la santé ou des soins de santé”, pour la prise en charge des lombalgies non spécifiques en thérapie manuelle.Méthodes : Une revue de la portée avec analyse du risque de biais d’essais contrôlés randomisés (ECR) sur la prise en charge en thérapie manuelle des lombalgies non spécifiques a été menée sur MEDLINE, CENTRAL, PEDro, WebOfScience et ClinicalTrials.gov, de 2010 à août 2024. La thérapie manuelle incluait manipulations (haute vélocité, faible amplitude), mobilisations (faible vélocité, faible à grande amplitude) et relaxation des tissus mous (massages, points gâchettes, contractions musculaires).Résultats : Sur 3 929 articles, 147 ECR et 74 protocoles ont été inclus. Deux critères principaux ont émergé : l’intensité de la douleur (échelle numérique ou visuelle analogique) et l’incapacité (Rolland Morris Disability Questionnaire (RMDQ) ou Oswestry Disability Index (ODI). L’amplitude des mouvements était le résultat clinique le plus fréquent. Les facteurs psychologiques (croyances de peur-évitement, kinésiophobie, catastrophisme) et la consommation de soins de santé (médicaments) étaient aussi régulièrement rapportés. La plupart des résultats étaient des résultats rapportés par les patients.Conclusion : Les critères identifiés concordent avec le COS préexistant pour les lombalgies non spécifiques. Les essais cliniques doivent mesurer la douleur via une échelle numérique, l’incapacité par l’ODI 2.1a ou le RMDQ-24, et la qualité de vie par le SF-12 ou le PROMIS-10. La réalisation d’analyses de sous-groupes basées sur le genre, l’âge et le statut socio-économique est préconisée pour intégrer les inégalités de santé et la variabilité de l’expérience de la douleur.Enregistrement du protocole : PROSPERO CRD42024576475, Base de données COMET 3229.</p>
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