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基于行为疗法的数字干预治疗骨关节炎：系统评价与荟萃分析

Behavioral Therapy-Based Digital Interventions for Treating Osteoarthritis: Systematic Review and Meta-Analysis.

作者信息

Zhu Beiyao, Zhu Dian, Xue Xiao'ao, Yang Hongyi, Zhang Shurong

机构信息

Shanghai Jiao Tong University, The Ninth People's Hospital, Shanghai, China.

School of Design, Shanghai Jiao Tong University, Shanghai, China.

出版信息

J Med Internet Res. 2025 Mar 19;27:e56227. doi: 10.2196/56227.

DOI:10.2196/56227
PMID:40106814
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11966084/
Abstract

BACKGROUND: Osteoarthritis (OA) is characterized by pain, functional impairments, muscle weakness, and joint stiffness. Since OA heightens reliance on heath care resources and exacerbates socioeconomic burden, remote OA rehabilitation using digital technologies is rapidly evolving. OBJECTIVE: The aim of this study was to analyze the efficacy of behavioral therapy-based digital interventions for patients with OA. METHODS: This study is a systematic review of randomized controlled trials (RCTs) that assessed the effects of behavioral therapy-based digital intervention tools for OA. These RCTs were searched from inception to June 2023 in the Web of Science, Embase, Cochrane Library, Ovid, and PubMed databases. RESULTS: Ten eligible RCTs comprising 1895 patients with OA were included. Digital tools based on either cognitive behavioral therapy (CBT) or behavior change technique (BCT) were investigated. All studies demonstrated low-to-moderate effects on pain reduction in the short term (standardized mean difference [SMD] -0.20, 95% CI -0.35 to -0.05). Six studies reported improvement in physical function (SMD -0.20, 95% CI -0.41 to 0.00), and 5 confirmed increased pain self-efficacy (SMD 0.22, 95% CI 0.02-0.42). In subgroup analysis, compared with CBT, BCT-based digital interventions demonstrated their effects on pain reduction (SMD -0.25, 95% CI -0.49 to 0.00) and physical function (SMD -0.26, 95% CI -0.54 to -0.01) in the short term. In addition, physiotherapist involvement in treatment had a positive effect on pain control (SMD -0.14, 95% CI -0.27 to -0.02). Furthermore, web-based digital tools improved physical function in the short term (SMD -0.28, 95% CI -0.54 to -0.01). CONCLUSIONS: Moderate- and low-quality evidence supported that behavioral therapy-based digital tools improved pain intensity, physical function, and self-efficacy in the short term. However, affective interactions between patients and professionals may affect the clinical outcomes. TRIAL REGISTRATION: PROSPERO CRD42023430716; https://tinyurl.com/yc49vzyy.

摘要

背景：骨关节炎（OA）的特征是疼痛、功能障碍、肌肉无力和关节僵硬。由于OA增加了对医疗保健资源的依赖并加重了社会经济负担，利用数字技术的远程OA康复正在迅速发展。 目的：本研究旨在分析基于行为疗法的数字干预对OA患者的疗效。 方法：本研究是一项对随机对照试验（RCT）的系统评价，这些试验评估了基于行为疗法的数字干预工具对OA的影响。从创刊到2023年6月，在Web of Science、Embase、Cochrane Library、Ovid和PubMed数据库中检索了这些RCT。 结果：纳入了10项符合条件的RCT，共1895例OA患者。研究了基于认知行为疗法（CBT）或行为改变技术（BCT）的数字工具。所有研究均表明，短期内对减轻疼痛有低至中等程度的效果（标准化均数差[SMD] -0.20，95%CI -0.35至-0.05）。6项研究报告了身体功能的改善（SMD -0.20，95%CI -0.41至0.00），5项研究证实疼痛自我效能感增加（SMD 0.22，95%CI 0.02 - 0.42）。在亚组分析中，与CBT相比，基于BCT的数字干预在短期内显示出对减轻疼痛（SMD -0.25，95%CI -0.49至0.00）和身体功能（SMD -0.26，95%CI -0.54至-0.01）的效果。此外，物理治疗师参与治疗对疼痛控制有积极影响（SMD -0.14，95%CI -0.27至-0.02）。此外，基于网络的数字工具在短期内改善了身体功能（SMD -0.28，95%CI -0.54至-0.01）。 结论：中低质量证据支持基于行为疗法的数字工具在短期内改善了疼痛强度、身体功能和自我效能感。然而，患者与专业人员之间的情感互动可能会影响临床结果。 试验注册：PROSPERO CRD42023430716；https://tinyurl.com/yc49vzyy。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/506c84a531b5/jmir_v27i1e56227_fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/38b1550c0ff8/jmir_v27i1e56227_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/2a6d844b2ca7/jmir_v27i1e56227_fig2.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/bf323b36d849/jmir_v27i1e56227_fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/110b658d1879/jmir_v27i1e56227_fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/506c84a531b5/jmir_v27i1e56227_fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/38b1550c0ff8/jmir_v27i1e56227_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/2a6d844b2ca7/jmir_v27i1e56227_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/c4352c3262f5/jmir_v27i1e56227_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/77c3155bbfd4/jmir_v27i1e56227_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/e8f27ee60a70/jmir_v27i1e56227_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/2b6b393ba1ef/jmir_v27i1e56227_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/bf323b36d849/jmir_v27i1e56227_fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/110b658d1879/jmir_v27i1e56227_fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bf/11966084/506c84a531b5/jmir_v27i1e56227_fig9.jpg

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引用本文的文献

[1]
Digital Behavior Change Interventions to Promote Physical Activity and Reduce Sedentary Behavior Among Survivors of Breast Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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本文引用的文献

[1]
Let's Move with Leon. A randomised controlled trial of a UK digital intervention to improve physical activity in people with a musculoskeletal condition.

Public Health. 2023-4

[2]
A digital application and augmented physician rounds reduce postoperative pain and opioid consumption after primary total knee replacement (TKR): a randomized clinical trial.

BMC Med. 2022-12-5

[3]
Effectiveness of home-based exercise delivered by digital health in older adults: a systematic review and meta-analysis.

Age Ageing. 2022-11-2

[4]
Comparison of Face-to-Face vs Digital Delivery of an Osteoarthritis Treatment Program for Hip or Knee Osteoarthritis.

JAMA Netw Open. 2022-11-1

[5]
Digital Health Interventions for Musculoskeletal Pain Conditions: Systematic Review and Meta-analysis of Randomized Controlled Trials.

J Med Internet Res. 2022-9-6

[6]
Experiences of activity monitoring and perceptions of digital support among working individuals with hip and knee osteoarthritis - a focus group study.

BMC Public Health. 2022-8-30

[7]
Applications of Digital Health Technologies in Knee Osteoarthritis: Narrative Review.

JMIR Rehabil Assist Technol. 2022-6-8

[8]
Comparative Efficacy of 5 Exercise Types on Cardiometabolic Health in Overweight and Obese Adults: A Systematic Review and Network Meta-Analysis of 81 Randomized Controlled Trials.

Circ Cardiovasc Qual Outcomes. 2022-6

[9]
Efficacy of Mobile Health Applications to Improve Physical Activity and Sedentary Behavior: A Systematic Review and Meta-Analysis for Physically Inactive Individuals.

Int J Environ Res Public Health. 2022-4-18

[10]
Efficacy of Exercise-Based Rehabilitation Programs for Improving Muscle Function and Size in People with Hip Osteoarthritis: A Systematic Review with Meta-Analysis.

Biology (Basel). 2021-11-30

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