Clinical Efficacy and Safety of Acupressure on Low Back Pain: A Systematic Review and Meta-Analysis

Table 3

GRADE summary of finding.

Interventions	Outcomes	Illustrative comparative risks (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)
		Assumed risk (control group)	Corresponding risk (test group)
Acupressure versus tuina massage	Response rate	743 per 1000	928 per 1000 (862 to 1000)	RR 1.25 (1.16 to 1.35)	491 (5 studies)	⊕⊕⊝ low^a,b
	VAS	The mean visual analog scale in the control groups was 4.3275 points	The mean VAS in the intervention groups was 1.94 standard deviations lower (0.78 to 3.11 lower)		663 (4 studies)	⊕⊝⊝⊝ very low^a,b,c
Acupressure versus physical therapy	VAS	The mean visual analog scale in the control groups was 5.176 points	The mean VAS in the intervention groups was 0.88 standard deviations lower (1.10 to 0.65 lower)		335 (3 studies)	⊕⊕⊕⊝ moderate^d
Acupressure versus usual care	VAS	The mean visual analog scale in the control groups was 4.97 points	The mean VAS in the intervention groups was 0.32 standard deviations lower (0.02 to 0.61 lower)		180 (2 studies)	⊕⊕⊝⊝ low^c,d
	ODI	The mean ODI in the control groups was 15.705 points	The mean ODI in the intervention groups was 0.55 standard deviations lower (0.25 to 0.84 lower)		180 (2 studies)	⊕⊕⊝⊝ low^c,d
Acupressure + acupuncture versus acupuncture	Response rate	772 per 1000	919 per 1000 (873 to 973)	RR 1.19 (1.13 to 1.26)	720 (9 studies)	⊕⊕⊝⊝ low^a,b
Acupressure + acupuncture versus acupuncture	VAS	The mean VAS in the control groups was 1.39 points	The mean VAS in the intervention groups was 1.13 standard deviations lower (0.94 to 1.31 lower)		530 (6 studies)	⊕⊝⊝⊝ very low^a,b,c
	JOA	The mean JOA in the control groups was 19.095 points	The mean JOA in the intervention groups was 1.14 standard deviations higher (0.94 to 1.34 higher)		470 (6 studies)	⊕⊝⊝⊝ very low^a,b,c

Note: (1) The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). (2) GRADE Working Group grades of evidence: high quality: further research is very unlikely to change our confidence in the estimate of effect; moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; very low quality: we are very uncertain about the estimate. (3) a: randomization and blinding are not adequate or appropriate; b: high heterogeneity; c: confidence intervals are too wide; d: insufficient sample size.