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Meta-Analysis
. 2022 Sep 6;24(9):e37869.
doi: 10.2196/37869.

Digital Health Interventions for Musculoskeletal Pain Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials

Pim Peter Valentijn  1   2 , Liza Tymchenko  1 , Teddy Jacobson  3 , Jakob Kromann  3 , Claus W Biermann  3 , Mohamed Atef AlMoslemany  4 , Rosa Ymkje Arends  1   5
Affiliations
Meta-Analysis

Digital Health Interventions for Musculoskeletal Pain Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials

Pim Peter Valentijn et al. J Med Internet Res. .

Abstract

Background: Digital health solutions can provide populations with musculoskeletal pain with high-reach, low-cost, easily accessible, and scalable patient education and self-management interventions that meet the time and resource restrictions.

Objective: The main objective of this study was to determine the effectiveness of digital health interventions for people with musculoskeletal pain conditions (ie, low back pain, neck pain, shoulder pain, knee pain, elbow pain, ankle pain, and whiplash).

Methods: A systematic review and meta-analysis was conducted. We searched PubMed and Cochrane Central Register of Controlled Trials (from 1974 to August 2021) and selected randomized controlled trials of digital health interventions in the target population of patients with musculoskeletal pain with a minimum follow-up of 1 month. A total of 2 researchers independently screened and extracted the data.

Results: A total of 56 eligible studies were included covering 9359 participants, with a mean follow-up of 25 (SD 15.48) weeks. In moderate-quality evidence, digital health interventions had a small effect on pain (standardized mean difference [SMD] 0.19, 95% CI 0.06-0.32), disability (SMD 0.14, 95% CI 0.03-0.25), quality of life (SMD 0.22, 95% CI 0.07-0.36), emotional functioning (SMD 0.24, 95% CI 0.12-0.35), and self-management (SMD 0.14, 95% CI 0.05-0.24).

Conclusions: Moderate-quality evidence supports the conclusion that digital health interventions are effective in reducing pain and improving functioning and self-management of musculoskeletal pain conditions. Low-quality evidence indicates that digital health interventions can improve the quality of life and global treatment. Little research has been conducted on the influence of digital health on expenses, knowledge, overall improvement, range of motion, muscle strength, and implementation fidelity.

Trial registration: PROSPERO CRD42022307504; https://tinyurl.com/2cd25hus.

Keywords: digital health; disability; eHealth; function; mHealth; mobile health; mobile phone; models of care; pain; quality of life; telehealth; telemedicine.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Rainbow model for digital health interventions [14].
Figure 2
Figure 2
Flowchart of search strategy and study selection process.
Figure 3
Figure 3
Summary of the risks of bias in included studies. For each quality item, low risk means that sufficient data were reported in the study to allow the assessment of quality, and the study fulfilled the criteria for the quality item; high risk means that sufficient data were reported in the study to assess quality, but the study did not fulfill the criteria for the quality item; and unclear risk means that incomplete data for the quality item were reported. N/A: not applicable.
Figure 4
Figure 4
Effect of digital health on pain. SMD: standardized mean difference.
Figure 5
Figure 5
Effect of digital health on disability and function. SMD: standardized mean difference.
Figure 6
Figure 6
Effect of digital health on quality of life. SMD: standardized mean difference.
Figure 7
Figure 7
Effect of digital health on emotional functioning. SMD: standardized mean difference.
Figure 8
Figure 8
Effect of digital health on self-management. SMD: standardized mean difference.
See this image and copyright information in PMC

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