Exploring Factors Associated with Changes in Pain and Function Following mHealth-Based Exercise Therapy for Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis and Meta-Regression

Author:

Rodríguez-Sánchez-Laulhé Pablo12ORCID,Heredia-Rizo Alberto Marcos23ORCID,Salas-González Jesús12,Piña-Pozo Fernando1ORCID,Fernández-Seguín Lourdes María23ORCID,García-Muñoz Cristina24ORCID

Affiliation:

1. Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Seville, Spain

2. CTS 1110: Understanding Movement and Self in Health from Science (UMSS) Research Group, 41009 Andalusia, Spain

3. Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, 41013 Seville, Spain

4. Departamento de Salud, Universidad Loyola Andalucía, 41704 Seville, Spain

Abstract

Exercise therapy is the first-line intervention recommended for those with chronic musculoskeletal pain (CMP). Smartphone technologies (mHealth) represent a feasible means for exercise prescription and individualization. This systematic review with meta-analysis aimed to identify factors associated with changes in pain and function following mHealth-based exercise therapy in patients with CMP. CINAHL (via EBSCOhost), Embase, PubMed, Scopus, and SPORTdiscus were searched from inception to February 2023. Observational and controlled clinical trials with correlation or regression analysis of factors associated with the effect of mHealth exercise interventions on pain and function were included. The risk of bias, completeness of interventions, spin of information, and certainty in the evidence were evaluated. Eight studies with 51,755 participants were included. Reduced pain intensity after intervention was associated with higher physical function: r (95% CI) = −0.55 (−0.67 to −0.41); I2 = 86%, Tau2 = 0.02; p < 0.01. Meta-regression identified the Body Mass Index (BMI), exercise dose, and completion rate as potential moderators between changes in pain and physical function following mHealth exercise therapy. No association was found between pain and anxiety: r (95% CI) = 0.15 (−0.08 to 0.37); I2 = 87%, Tau2 = 0.02; p = 0.19. Very low certainty in the evidence was observed due to serious concerns regarding the risk of bias, inconsistency, and indirectness. The limited available evidence detracts from the clinical interpretation of the findings.

Publisher

MDPI AG

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