title: Climbing for preventing and treating health problems: a systematic review of randomized controlled trials.
abstract: OBJECTIVE
  To summarize the best available evidence on effectiveness of therapeutic or sport climbing in preventing or treating health problems.
  
  
  METHODS
  We searched Medline, Embase, CENTRAL, PsycINFO, PEDro, OTseeker and SportDiscus for randomized controlled trials published up to December 26, 2010. We included all trials assessing patient-relevant outcomes. Two reviewers independently selected relevant studies, assessed their methodological quality and extracted data. Quality of evidence was rated using the GRADE system. Data were entered into RevMan 5 to calculate effect sizes and 95% confidence intervals where appropriate.
  
  
  RESULTS
  Eligible for inclusion were four RCTs studying the effectiveness of climbing in (a) geriatric patients, (b) adults with multiple sclerosis, (c) adults with chronic low-back pain and (d) children with disabilities and poor motor function. The sample sizes ranged between 20 and 95. All trials had major methodological limitations. We found very low quality evidence that therapeutic climbing may improve activities of daily living in geriatric patients compared to physiotherapy as measured by the Barthel index (difference in mean change score: 2.32 [95%-CI: 0.45 to 4.19]). We found very low quality evidence that therapeutic climbing compared to standard exercise therapy may improve physical functioning (difference in mean change score: 16.15 [95%-CI: 4.45 to 27.85]) and general physical health (13.14 [95%-CI: 3.61 to 22.67]) as measured by the SF-36 in adults with chronic low back-pain.
  
  
  CONCLUSIONS
  Evidence for the effectiveness of therapeutic climbing is limited to small trials at high risk of bias. The effects of therapeutic climbing are therefore unclear.
authors.affiliation: Institute for Quality and Efficiency in Health Care (IQWiG), Köln, Germany. roland.buechter@iqwig.de
authors.forename: Roland Brian
authors.initials: RB
authors.lastname: Buechter
authors.forename: Dennis
authors.initials: D
authors.lastname: Fechtelpeter
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D019988:Children with Disabilities / Q000534:rehabilitation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D009051:Mountaineering; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic