Physical activity-based interventions using electronic feedback may be ineffective for reducing pain and disability in patients with chronic musculoskeletal pain: a systematic review with meta-analysis

Publication date: Available online 6 November 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Crystian B. Oliveira, Márcia R. Franco, Chris G. Maher, Paulo H. Ferreira, Priscila K. Morelhão, Tatiana M. Damato, Cynthia Gobbi, Rafael Z. Pinto
ObjectiveTo investigate the effectiveness of physical activity-based interventions using electronic feedback to reduce pain and disability compared to minimal or no interventions in patients with chronic musculoskeletal pain.DesignSystematic review with meta-analysisData SourcesThe following electronic databases were searched: EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Web of Science, Physiotherapy Evidence Database (PEDro), and main clinical trial registers.Study SelectionRandomized controlled trials (RCTs) investigating the effect of physical activity interventions using electronic feedback (eg. physical activity monitors) on pain and disability compared to minimal or no intervention in adults with chronic musculoskeletal pain were considered eligible.Data ExtractionPooled effects were calculated using the standardized mean difference (SMD) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the overall quality of evidence.Data SynthesisFour published RCTs and four registered unpublished RCTs were included. For short-term follow-up, pooled estimations showed no significant differences between physical activity-based interventions compared to minimal intervention on pain intensity (two trials; n= 116; SMD=-0.50; 95% CI -1.91 to 0.91) and disability (two trials, n= 116; SMD=-0.81 95% CI -2.34 to 0.73). Similarly, non-significant results were found for the intermediate-term. According to GRADE, the overall quality of evidence was considered to be of low quality.ConclusionOur findings suggest that physical activity-based interventions using with electronic feedback may be ineffective for reducing pain and disability compared to minimal intervention for patients with chronic musculoskeletal pain. Clinicians should be cautious when implementing this intervention in patients with chronic musculoskeletal pain.



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