Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Disabil Rehabil. 2022 Dec;44(25):7781-7790. doi: 10.1080/09638288.2021.2005161. Epub 2021 Dec 2.
To explore the effectiveness of smartphone apps for the self-management of low back pain in adults.
Prospectively registered systematic review of randomised controlled trials (2008-) published in English. Studies investigating smartphone apps for the self-management of low back pain (adults ≥18 years), including ≥1 NICE low back pain and sciatica clinical guideline-recommended component and functioning without health professional input were included. Outcomes were pain, function, quality of life and adherence.
Six studies were included ( = 2100 participants). All comparator groups incorporated some form of management ( = 3 physiotherapy, = 2 GPs, = 1 not specified). Three studies reported a significant decrease in pain intensity in the intervention group compared with the control. One study reported no significant difference between groups in pain self-efficacy. One study reported a significant reduction in disability (function) in the intervention group compared with the control. Two studies reported no between-group differences in quality of life. One study reported no correlation between adherence (app use) and change in pain intensity and one study reported that app use mediated the effect of teleconsultations on pain improvements.
Inconclusive evidence exists for the use of smartphone applications for the self-management of low back pain. Further research is needed.Implications for RehabilitationSmartphone apps have the potential to improve outcomes for people with LBP aligned with current self-management guidelines.There is a paucity of literature exploring smartphone apps for LBP self-management and current evidence is inconclusive for smartphone app use without supported care.Commercially available smartphone apps are not well regulated for content or alignment with evidence-based guidelines and recommendations.Further evaluation of commercially available apps is required to guide and instil confidence in consumers and health professionals that consumer-accessible apps may lead to improved outcomes.
探索智能手机应用程序在成年人腰痛自我管理中的有效性。
对 2008 年后发表的英文随机对照试验进行前瞻性注册系统评价。研究调查了智能手机应用程序在腰痛（18 岁及以上成年人）自我管理中的应用，包括至少包含 1 项 NICE 腰痛和坐骨神经痛临床指南推荐的组成部分和无需健康专业人员输入即可运行的应用程序。主要结局指标为疼痛、功能、生活质量和依从性。
纳入了 6 项研究（共 2100 名参与者）。所有对照组都采用了某种形式的管理（包括 3 项物理治疗、2 项全科医生治疗、1 项未明确）。有 3 项研究报告称干预组的疼痛强度较对照组显著降低。有 1 项研究报告称两组间的疼痛自我效能无显著差异。有 1 项研究报告称干预组的残疾（功能）较对照组显著降低。有 2 项研究报告称两组间的生活质量无差异。有 1 项研究报告称，依从性（应用程序使用）与疼痛强度变化之间无相关性，有 1 项研究报告称，应用程序使用介导了远程咨询对疼痛改善的效果。
目前尚缺乏智能手机应用程序用于腰痛自我管理的证据。需要进一步研究。
智能手机应用程序有可能改善符合当前自我管理指南的腰痛患者的结局。目前，针对没有支持性护理的腰痛自我管理的智能手机应用程序的文献很少，且现有证据尚不确定。商业上可用的智能手机应用程序在内容或与基于证据的指南和建议的一致性方面没有得到很好的监管。需要进一步评估商业上可用的应用程序，以指导和增强消费者和卫生专业人员对消费者可访问的应用程序可能带来更好的结果的信心。
