Lara-Palomo Inmaculada Carmen, Gil-Martínez Esther, Ramírez-García Juan Diego, Capel-Alcaraz Ana María, García-López Héctor, Castro-Sánchez Adelaida María, Antequera-Soler Eduardo
Department of Nursing, Physiotherapy and Medicine, Almería University, Almería, Spain.
Telemed J E Health. 2022 Dec;28(12):1734-1752. doi: 10.1089/tmj.2021.0599. Epub 2022 May 9.
Low-back pain (LBP) is the leading cause of disability worldwide. Around 75-84% of the world's population will experience LBP at some point, establishing it as a major global health problem. e-Health is the remote delivery of therapeutic services, clinical information, and medical care, and may prove a very useful approach to tackle this pathology. To evaluate the efficacy of e-health-based interventions in improving the symptoms of chronic LBP. A systematic review with meta-analysis was performed in PubMed, Web of Science, and PEDro until January 2022 through the assessment of methodological quality of systematic reviews (AMSTAR). Studies were included in which e-health interventions were used as experimental treatment compared to physical therapy to determine changes in back-specific functional status and pain in patients with chronic LBP. Two reviewers examined the sources individually, calculated the risk of bias, and extracted the data (PROSPERO number CRD42022306130). The effect size was calculated using the standardized mean difference (SMD) and its confidence interval (95% CI). A total of 9 randomized controlled trials with 3,180 participants were included. The results of the findings showed an effect of e-health compared to other physical therapy on short-term (SMD = -0.59, 95% CI: -1.77 to 0.59) and intermediate short-term (SMD = -0.40, 95% CI: -0.91 to 0.11) pain intensity and back-specific functional status in the short term (SMD = -0.20, 95% CI: -0.81 to 0.41) and intermediate short term (SMD = -0.30, 95% CI: -0.74 to 0.14). The effect of e-health compared to minimal intervention on short-term intermediate pain intensity (SMD = -0.64, 95% CI: -1.72 to 0.45) and short-term intermediate back-specific functional status (SMD = -0.39, 95% CI: -0.87 to 0.09). e-Health interventions based on self-maintenance and education are as effective on pain and back-specific functional status as other face-to-face or home-based interventions in patients with chronic LBP, with moderate scientific evidence.
腰痛（LBP）是全球致残的主要原因。全球约75-84%的人口在某个阶段会经历腰痛，这使其成为一个重大的全球健康问题。电子健康是指远程提供治疗服务、临床信息和医疗护理，可能是解决这一病症的非常有用的方法。为了评估基于电子健康的干预措施在改善慢性腰痛症状方面的疗效。通过对系统评价的方法学质量（AMSTAR）进行评估，于2022年1月前在PubMed、科学网和PEDro数据库中进行了一项荟萃分析的系统评价。纳入的研究中，将电子健康干预措施作为实验性治疗与物理治疗进行比较，以确定慢性腰痛患者背部特定功能状态和疼痛的变化。两名评审员分别检查资料来源，计算偏倚风险，并提取数据（国际前瞻性系统评价注册库编号CRD42022306130）。使用标准化平均差（SMD）及其置信区间（95%CI）计算效应量。总共纳入了9项随机对照试验，涉及3180名参与者。研究结果显示，与其他物理治疗相比，电子健康在短期（SMD = -0.59，95%CI：-1.77至0.59）和中短期（SMD = -0.40，95%CI：-0.91至0.11）对疼痛强度以及在短期（SMD = -0.20，95%CI：-0.81至0.41）和中短期（SMD = -0.30，95%CI：-0.74至0.14）对背部特定功能状态有影响。与最小干预相比，电子健康在短期和中短期对疼痛强度（SMD = -0.64，95%CI：-1.72至0.45）和短期和中短期背部特定功能状态（SMD = -0.39，95%CI：-0.87至0.09）有影响。基于自我维持和教育的电子健康干预措施在慢性腰痛患者的疼痛和背部特定功能状态方面与其他面对面或居家干预措施同样有效，有中等科学证据支持。
