Attempting to separate placebo effects from exercise in chronic pain: a systematic review and meta-analysis

Review written by Robin Kerr info

Key Points

  1. In the management of chronic pain with exercise interventions, the relative contribution of effects between the physical training, placebo, and non-specific effects is unexplored.
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BACKGROUND & OBJECTIVE

It is important for a clinician to know the relative contributions that exercise training, placebo, and non-specific effects may have in a patient’s treatment outcome. Placebo and non-specific effects are gaining support as legitimate and powerful effects in therapy (1,2) and hence exploring how powerful the exercise component also is in a program is important.

This systematic review (SR) and meta-analysis aimed to explore the relative effect size of the placebo effect, non-specific effects (i.e. natural history, regression to the mean, spontaneous improvement, hawthorne effect), and exercise training for pain reduction in adults with chronic musculoskeletal pain.

Placebo and non-specific effects are gaining support as legitimate and powerful effects in therapy.
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It is important that clinicians interact with their chronic pain patients and develop bespoke management programs based on patient preference.

METHODS

  • This paper was a systematic review and meta-analysis (registered with PROSPERO and completed in accordance with PRISMA guidelines).
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