基于身体活动的干预措施，使用电子反馈可能对减轻慢性肌肉骨骼疼痛患者的疼痛和残疾无效：系统评价和荟萃分析。

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.

机构信息

Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University, Presidente Prudente, Sao Paulo, Brazil.

Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

Arch Phys Med Rehabil. 2018 Sep;99(9):1900-1912. doi: 10.1016/j.apmr.2017.10.013. Epub 2017 Nov 6.

DOI:10.1016/j.apmr.2017.10.013

PMID:29122581

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Four published randomized controlled trials and 4 registered unpublished randomized controlled trials were included.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.

摘要

目的

研究基于电子反馈的身体活动干预措施在减轻慢性肌肉骨骼疼痛患者疼痛和残疾方面的有效性，与最小干预或不干预相比。

资料来源

检索了以下电子数据库：EMBASE、MEDLINE、Cochrane 对照试验中心注册库、PsycINFO、护理学和联合健康文献累积索引、SPORTDiscus、Web of Science、物理治疗证据数据库和主要临床试验登记处。

研究选择

符合条件的研究为随机对照试验，研究了基于电子反馈（例如，身体活动监测器）的身体活动干预措施对慢性肌肉骨骼疼痛成人疼痛和残疾的影响，与最小干预或不干预相比。

数据提取

使用标准化均数差（SMD）计算汇总效应，使用推荐评估、制定和评估系统（Grading of Recommendations Assessment, Development and Evaluation system）评估证据的总体质量。

数据分析

纳入了 4 项已发表的随机对照试验和 4 项已注册的未发表的随机对照试验。在短期随访时，2 项试验（n=116）的汇总估计显示，基于身体活动的干预与最小干预之间的疼痛（SMD=-0.50；95%置信区间，-1.91 至 0.91）和残疾（SMD=-0.81；95%置信区间，-2.34 至 0.73）差异无统计学意义。在中期随访时也得出了类似的无统计学意义的结果。根据推荐评估、制定和评估系统，证据的总体质量被认为是低质量的。