Barnet-Hepples Talia, Dario Amabile, Oliveira Juliana, Maher Christopher, Tiedemann Anne, Amorim Anita
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
J Physiother. 2024 Apr;70(2):115-123. doi: 10.1016/j.jphys.2024.01.001. Epub 2024 Mar 16.
What is the effect of health coaching on physical activity, disability, pain and quality of life compared with a non-active control in adults with chronic non-cancer pain?
Systematic review and meta-analysis of randomised controlled trials. Evidence was synthesised as standardised mean differences with 95% confidence intervals using random-effects models. Risk of bias was assessed using the revised Cochrane risk of bias tool. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to determine evidence certainty.
MEDLINE, Embase, CENTRAL, CINAHL, Scopus and PEDro were searched from inception to November 2023.
Adults with chronic non-cancer pain.
Health coaching to increase physical activity.
Measures of physical activity, disability, pain and quality of life.
Twenty-six randomised trials (n = 4,403) were included. Trials had moderate to high risk of bias. Health coaching had a trivial to small effect on improving physical activity compared with control (15 trials; SMD 0.21, 95% CI 0.07 to 0.35; low certainty evidence). Health coaching had a small effect on improving disability (19 trials; SMD 0.25, 95% CI 0.17 to 0.32; moderate certainty evidence) and pain (19 trials; SMD 0.31, 95% CI 0.18 to 0.43; very low certainty evidence) compared with control. The effect of health coaching on quality of life was unclear due to significant imprecision in the effect estimate (five trials; SMD 0.19, 95% CI -0.14 to 0.53; moderate certainty evidence).
Health coaching promotes a trivial to small improvement in physical activity and small improvements in disability and pain in adults with chronic non-cancer pain. The effect of health coaching on quality of life remains unclear.
PROSPERO CRD42020182740.
与非积极对照组相比，健康指导对患有慢性非癌性疼痛的成年人的身体活动、残疾、疼痛和生活质量有何影响？
随机对照试验的系统评价和荟萃分析。使用随机效应模型将证据综合为具有95%置信区间的标准化均值差。使用修订后的Cochrane偏倚风险工具评估偏倚风险。采用推荐分级评估、制定和评价（GRADE）来确定证据的确定性。
检索了从数据库建立至2023年11月的MEDLINE、Embase、CENTRAL、CINAHL、Scopus和PEDro数据库。
患有慢性非癌性疼痛的成年人。
旨在增加身体活动的健康指导。
身体活动、残疾、疼痛和生活质量的测量指标。
纳入了26项随机试验（n = 4403）。试验存在中度至高度偏倚风险。与对照组相比，健康指导对改善身体活动有微小至较小的效果（15项试验；标准化均值差0.21，95%置信区间0.07至0.35；低确定性证据）。与对照组相比，健康指导对改善残疾（19项试验；标准化均值差0.25，95%置信区间0.17至0.32；中度确定性证据）和疼痛（19项试验；标准化均值差0.31，95%置信区间0.18至0.43；极低确定性证据）有较小效果。由于效应估计存在显著不精确性，健康指导对生活质量的影响尚不清楚（5项试验；标准化均值差0.19，95%置信区间-0.14至0.53；中度确定性证据）。
健康指导对患有慢性非癌性疼痛的成年人的身体活动有微小至较小的改善，对残疾和疼痛有较小改善。健康指导对生活质量的影响仍不明确。
PROSPERO CRD42020182740
