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Physical Activity–Based Interventions Using Electronic Feedback May Be Ineffective in Reducing Pain and Disability in Patients With Chronic Musculoskeletal Pain: A Systematic Review With Meta-Analysis

Published:November 06, 2017DOI:https://doi.org/10.1016/j.apmr.2017.10.013

      Abstract

      Objective

      To investigate the effectiveness of physical activity–based interventions using electronic feedback in reducing pain and disability compared to minimal or no interventions in patients with chronic musculoskeletal pain.

      Data Sources

      The following electronic databases were searched: EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Web of Science, Physiotherapy Evidence Database, and main clinical trial registers.

      Study Selection

      Randomized controlled trials investigating the effect of physical activity interventions using electronic feedback (eg, physical activity monitors) on pain and disability compared to minimal or no interventions in adults with chronic musculoskeletal pain were considered eligible.

      Data Extraction

      Pooled effects were calculated using the standardized mean difference (SMD), and the Grading of Recommendations Assessment, Development and Evaluation system was used to assess the overall quality of the evidence.

      Data Synthesis

      Four published randomized controlled trials and 4 registered unpublished randomized controlled trials were included. At short-term follow-up, pooled estimations showed no significant differences in pain (2 trials: n=116; SMD=−.50; 95% confidence interval, −1.91 to 0.91) and disability (2 trials: n=116; SMD=−.81; 95% confidence interval, −2.34 to 0.73) between physical activity–based interventions and minimal interventions. Similarly, nonsignificant results were found at intermediate-term follow-up. According to Grading of Recommendations Assessment, Development and Evaluation, the overall quality of the evidence was considered to be of low quality.

      Conclusions

      Our findings suggest that physical activity–based interventions using electronic feedback may be ineffective in reducing pain and disability compared to minimal interventions in patients with chronic musculoskeletal pain. Clinicians should be cautious when implementing this intervention in patients with chronic musculoskeletal pain.

      Keywords

      List of abbreviations:

      CI (confidence interval), GRADE (Grading of Recommendations Assessment, Development and Evaluation), PEDro (Physiotherapy Evidence Database), SMD (standardized mean difference)
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