数字健康干预措施治疗肌肉骨骼疼痛疾病：随机对照试验的系统评价和荟萃分析。
Digital Health Interventions for Musculoskeletal Pain Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials.
机构信息
Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, Netherlands.
Department of Health Services Research, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
出版信息
J Med Internet Res. 2022 Sep 6;24(9):e37869. doi: 10.2196/37869.
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.
背景
数字健康解决方案可以为患有肌肉骨骼疼痛的人群提供高覆盖率、低成本、易于获取且可扩展的患者教育和自我管理干预措施，这些措施符合时间和资源限制。
目的
本研究的主要目的是确定数字健康干预措施对肌肉骨骼疼痛患者（如腰痛、颈痛、肩痛、膝痛、肘痛、踝痛和挥鞭伤）的有效性。
方法
进行了系统评价和荟萃分析。我们检索了 PubMed 和 Cochrane 对照试验中心注册库（从 1974 年至 2021 年 8 月），并选择了针对患有肌肉骨骼疼痛的患者目标人群的数字健康干预措施的随机对照试验，随访时间至少为 1 个月。两名研究人员独立筛选和提取数据。
结果
共有 56 项符合条件的研究纳入了 9359 名参与者，平均随访时间为 25（SD 15.48）周。在中等质量证据中，数字健康干预措施对疼痛（标准化均数差 [SMD] 0.19，95%置信区间 [CI] 0.06-0.32）、残疾（SMD 0.14，95%CI 0.03-0.25）、生活质量（SMD 0.22，95%CI 0.07-0.36）、情绪功能（SMD 0.24，95%CI 0.12-0.35）和自我管理（SMD 0.14，95%CI 0.05-0.24）有较小的影响。
结论
中等质量证据支持数字健康干预措施可有效减轻肌肉骨骼疼痛，并改善其功能和自我管理的结论。低质量证据表明，数字健康干预措施可以提高生活质量和整体治疗效果。关于数字健康对费用、知识、整体改善、活动范围、肌肉力量和实施保真度的影响的研究较少。
试验注册
PROSPERO CRD42022307504；https://tinyurl.com/2cd25hus。
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