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Efficacy of Mobile Health in Patients With Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials
Background: Low back pain is one of the most common health problems and a main cause of disability, which imposes a great burden on patients. Mobile health (mHealth) affects many aspects of people’s lives, and it has progressed rapidly, showing promise as an effective intervention for patients with...
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Published in: | JMIR mHealth and uHealth 2021-06, Vol.9 (6), p.e26095-e26095 |
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description | Background: Low back pain is one of the most common health problems and a main cause of disability, which imposes a great burden on patients. Mobile health (mHealth) affects many aspects of people’s lives, and it has progressed rapidly, showing promise as an effective intervention for patients with low back pain. However, the efficacy of mHealth interventions for patients with low back pain remains unclear; thus, further exploration is necessary. Objective: The purpose of this study was to evaluate the efficacy of mHealth interventions in patients with low back pain compared to usual care. Methods: This was a systematic review and meta-analysis of randomized controlled trials designed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement standard. We searched for studies published in English before October 2020 in the PubMed, EMBASE, Web of Science, and Cochrane Library databases. Two researchers independently scanned the literature, extracted data, and assessed the methodological quality of the included studies. Bias risks were assessed using the Cochrane Collaboration tool. We used RevMan 5.4 software to perform the meta-analysis. Results: A total of 9 studies with 792 participants met the inclusion criteria. The simultaneous use of mHealth and usual care showed a better reduction in pain intensity than usual care alone, as measured by the numeric rating scale (mean difference [MD] –0.85, 95% CI –1.29 to –0.40; P |
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Mobile health (mHealth) affects many aspects of people’s lives, and it has progressed rapidly, showing promise as an effective intervention for patients with low back pain. However, the efficacy of mHealth interventions for patients with low back pain remains unclear; thus, further exploration is necessary. Objective: The purpose of this study was to evaluate the efficacy of mHealth interventions in patients with low back pain compared to usual care. Methods: This was a systematic review and meta-analysis of randomized controlled trials designed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement standard. We searched for studies published in English before October 2020 in the PubMed, EMBASE, Web of Science, and Cochrane Library databases. Two researchers independently scanned the literature, extracted data, and assessed the methodological quality of the included studies. Bias risks were assessed using the Cochrane Collaboration tool. We used RevMan 5.4 software to perform the meta-analysis. Results: A total of 9 studies with 792 participants met the inclusion criteria. The simultaneous use of mHealth and usual care showed a better reduction in pain intensity than usual care alone, as measured by the numeric rating scale (mean difference [MD] –0.85, 95% CI –1.29 to –0.40; P<.001), and larger efficacy in reducing disability, as measured by the Rolland-Morris Disability Questionnaire (MD –1.54, 95% CI –2.35 to –0.73; P<.001). Subgroup analyses showed that compared with usual care, mHealth using telephone calls significantly reduced pain intensity (MD –1.12, 95% CI –1.71 to –0.53; P<.001) and disability score (MD –1.68, 95% CI –2.74 to –0.63; P<.001). However, without the use of telephone calls, mHealth had no obvious advantage over usual care in improving pain intensity (MD –0.48, 95% CI –1.16 to 0.20; P=.16) and the disability score (MD –0.41, 95% CI –1.88 to 1.05; P=.58). The group that received a more sensitive feedback intervention showed a significantly reduced disability score (MD –4.30, 95% CI –6.95 to –1.69; P=.001). Conclusions: The use of simultaneous mHealth and usual care interventions has better efficacy than usual care alone in reducing pain intensity and disability in patients with low back pain. Moreover, the results of subgroup analysis revealed that mHealth using telephone calls might play a positive role in improving pain intensity and disability in patients with low back pain.</description><identifier>ISSN: 2291-5222</identifier><identifier>EISSN: 2291-5222</identifier><identifier>DOI: 10.2196/26095</identifier><identifier>PMID: 34114965</identifier><language>eng</language><publisher>Toronto: JMIR Publications</publisher><subject>Bias ; Cellular telephones ; Meta-analysis ; Review ; Software ; Text messaging</subject><ispartof>JMIR mHealth and uHealth, 2021-06, Vol.9 (6), p.e26095-e26095</ispartof><rights>2021. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Mingrong Chen, Tingting Wu, Meina Lv, Chunmei Chen, Zongwei Fang, Zhiwei Zeng, Jiafen Qian, Shaojun Jiang, Wenjun Chen, Jinhua Zhang. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 11.06.2021. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-89ca24f7712ff8230f6c54081bcd762705a1ba0863b96aca613ad459567cb62b3</citedby><cites>FETCH-LOGICAL-c434t-89ca24f7712ff8230f6c54081bcd762705a1ba0863b96aca613ad459567cb62b3</cites><orcidid>0000-0003-0456-3452 ; 0000-0002-0812-2059 ; 0000-0002-5629-0348 ; 0000-0002-4483-7465 ; 0000-0002-6722-0978 ; 0000-0002-3900-7723 ; 0000-0001-5407-5110 ; 0000-0003-3544-7104 ; 0000-0002-1016-838X ; 0000-0002-5464-8414</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2546774049/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2546774049?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids></links><search><creatorcontrib>Chen, Mingrong</creatorcontrib><creatorcontrib>Wu, Tingting</creatorcontrib><creatorcontrib>Lv, Meina</creatorcontrib><creatorcontrib>Chen, Chunmei</creatorcontrib><creatorcontrib>Fang, Zongwei</creatorcontrib><creatorcontrib>Zeng, Zhiwei</creatorcontrib><creatorcontrib>Qian, Jiafen</creatorcontrib><creatorcontrib>Jiang, Shaojun</creatorcontrib><creatorcontrib>Chen, Wenjun</creatorcontrib><creatorcontrib>Zhang, Jinhua</creatorcontrib><title>Efficacy of Mobile Health in Patients With Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials</title><title>JMIR mHealth and uHealth</title><description>Background: Low back pain is one of the most common health problems and a main cause of disability, which imposes a great burden on patients. Mobile health (mHealth) affects many aspects of people’s lives, and it has progressed rapidly, showing promise as an effective intervention for patients with low back pain. However, the efficacy of mHealth interventions for patients with low back pain remains unclear; thus, further exploration is necessary. Objective: The purpose of this study was to evaluate the efficacy of mHealth interventions in patients with low back pain compared to usual care. Methods: This was a systematic review and meta-analysis of randomized controlled trials designed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement standard. We searched for studies published in English before October 2020 in the PubMed, EMBASE, Web of Science, and Cochrane Library databases. Two researchers independently scanned the literature, extracted data, and assessed the methodological quality of the included studies. Bias risks were assessed using the Cochrane Collaboration tool. We used RevMan 5.4 software to perform the meta-analysis. Results: A total of 9 studies with 792 participants met the inclusion criteria. The simultaneous use of mHealth and usual care showed a better reduction in pain intensity than usual care alone, as measured by the numeric rating scale (mean difference [MD] –0.85, 95% CI –1.29 to –0.40; P<.001), and larger efficacy in reducing disability, as measured by the Rolland-Morris Disability Questionnaire (MD –1.54, 95% CI –2.35 to –0.73; P<.001). Subgroup analyses showed that compared with usual care, mHealth using telephone calls significantly reduced pain intensity (MD –1.12, 95% CI –1.71 to –0.53; P<.001) and disability score (MD –1.68, 95% CI –2.74 to –0.63; P<.001). However, without the use of telephone calls, mHealth had no obvious advantage over usual care in improving pain intensity (MD –0.48, 95% CI –1.16 to 0.20; P=.16) and the disability score (MD –0.41, 95% CI –1.88 to 1.05; P=.58). The group that received a more sensitive feedback intervention showed a significantly reduced disability score (MD –4.30, 95% CI –6.95 to –1.69; P=.001). Conclusions: The use of simultaneous mHealth and usual care interventions has better efficacy than usual care alone in reducing pain intensity and disability in patients with low back pain. Moreover, the results of subgroup analysis revealed that mHealth using telephone calls might play a positive role in improving pain intensity and disability in patients with low back pain.</description><subject>Bias</subject><subject>Cellular telephones</subject><subject>Meta-analysis</subject><subject>Review</subject><subject>Software</subject><subject>Text messaging</subject><issn>2291-5222</issn><issn>2291-5222</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdkl9LHDEUxUNpUbH7HQKl0Jdpk0z-TPpQaBdbhZWKtfgY7mQymm1mosmssoLfvdldKdWnezn38OPew0VoRslHRrX8xCTR4hU6YEzTSjDGXv_X76NZzktCCKVMMC320H7NKeVaigP0eNT33oJd49jj09j64PCxgzBdYz_iM5i8G6eML30RFvEefwP7p8h-_Ix_rfPkhuKw-NzdeXePYezwqZugghHCOvu8gZ4XNQ7-wXV4HscpxRBKe5E8hPwWvelLcbOneoh-fz-6mB9Xi58_TuZfF5XlNZ-qRltgvFeKsr5vWE16aQUnDW1tpyRTRABtgTSybrUEC5LW0HGhhVS2laytD9HJjttFWJqb5AdIaxPBm60Q05WBVA4JzihpVdMyDVq0XEgBNWkIVVZ2VknX0ML6smPdrNrBdbbkkyA8gz6fjP7aXMU7UxbfxF8AH54AKd6uXJ7M4LN1IcDo4iobVk4TVHHOi_XdC-syrlIJd-uSSnHCdXG937lsijkn1_9bhhKz-Q-z_Y_6L8uUqWI</recordid><startdate>20210611</startdate><enddate>20210611</enddate><creator>Chen, Mingrong</creator><creator>Wu, Tingting</creator><creator>Lv, Meina</creator><creator>Chen, Chunmei</creator><creator>Fang, Zongwei</creator><creator>Zeng, Zhiwei</creator><creator>Qian, Jiafen</creator><creator>Jiang, Shaojun</creator><creator>Chen, Wenjun</creator><creator>Zhang, Jinhua</creator><general>JMIR Publications</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0456-3452</orcidid><orcidid>https://orcid.org/0000-0002-0812-2059</orcidid><orcidid>https://orcid.org/0000-0002-5629-0348</orcidid><orcidid>https://orcid.org/0000-0002-4483-7465</orcidid><orcidid>https://orcid.org/0000-0002-6722-0978</orcidid><orcidid>https://orcid.org/0000-0002-3900-7723</orcidid><orcidid>https://orcid.org/0000-0001-5407-5110</orcidid><orcidid>https://orcid.org/0000-0003-3544-7104</orcidid><orcidid>https://orcid.org/0000-0002-1016-838X</orcidid><orcidid>https://orcid.org/0000-0002-5464-8414</orcidid></search><sort><creationdate>20210611</creationdate><title>Efficacy of Mobile Health in Patients With Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials</title><author>Chen, Mingrong ; Wu, Tingting ; Lv, Meina ; Chen, Chunmei ; Fang, Zongwei ; Zeng, Zhiwei ; Qian, Jiafen ; Jiang, Shaojun ; Chen, Wenjun ; Zhang, Jinhua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-89ca24f7712ff8230f6c54081bcd762705a1ba0863b96aca613ad459567cb62b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bias</topic><topic>Cellular telephones</topic><topic>Meta-analysis</topic><topic>Review</topic><topic>Software</topic><topic>Text messaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Mingrong</creatorcontrib><creatorcontrib>Wu, Tingting</creatorcontrib><creatorcontrib>Lv, Meina</creatorcontrib><creatorcontrib>Chen, Chunmei</creatorcontrib><creatorcontrib>Fang, Zongwei</creatorcontrib><creatorcontrib>Zeng, Zhiwei</creatorcontrib><creatorcontrib>Qian, Jiafen</creatorcontrib><creatorcontrib>Jiang, Shaojun</creatorcontrib><creatorcontrib>Chen, Wenjun</creatorcontrib><creatorcontrib>Zhang, Jinhua</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>JMIR mHealth and uHealth</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Mingrong</au><au>Wu, Tingting</au><au>Lv, Meina</au><au>Chen, Chunmei</au><au>Fang, Zongwei</au><au>Zeng, Zhiwei</au><au>Qian, Jiafen</au><au>Jiang, Shaojun</au><au>Chen, Wenjun</au><au>Zhang, Jinhua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of Mobile Health in Patients With Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials</atitle><jtitle>JMIR mHealth and uHealth</jtitle><date>2021-06-11</date><risdate>2021</risdate><volume>9</volume><issue>6</issue><spage>e26095</spage><epage>e26095</epage><pages>e26095-e26095</pages><issn>2291-5222</issn><eissn>2291-5222</eissn><abstract>Background: Low back pain is one of the most common health problems and a main cause of disability, which imposes a great burden on patients. Mobile health (mHealth) affects many aspects of people’s lives, and it has progressed rapidly, showing promise as an effective intervention for patients with low back pain. However, the efficacy of mHealth interventions for patients with low back pain remains unclear; thus, further exploration is necessary. Objective: The purpose of this study was to evaluate the efficacy of mHealth interventions in patients with low back pain compared to usual care. Methods: This was a systematic review and meta-analysis of randomized controlled trials designed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement standard. We searched for studies published in English before October 2020 in the PubMed, EMBASE, Web of Science, and Cochrane Library databases. Two researchers independently scanned the literature, extracted data, and assessed the methodological quality of the included studies. Bias risks were assessed using the Cochrane Collaboration tool. We used RevMan 5.4 software to perform the meta-analysis. Results: A total of 9 studies with 792 participants met the inclusion criteria. The simultaneous use of mHealth and usual care showed a better reduction in pain intensity than usual care alone, as measured by the numeric rating scale (mean difference [MD] –0.85, 95% CI –1.29 to –0.40; P<.001), and larger efficacy in reducing disability, as measured by the Rolland-Morris Disability Questionnaire (MD –1.54, 95% CI –2.35 to –0.73; P<.001). Subgroup analyses showed that compared with usual care, mHealth using telephone calls significantly reduced pain intensity (MD –1.12, 95% CI –1.71 to –0.53; P<.001) and disability score (MD –1.68, 95% CI –2.74 to –0.63; P<.001). However, without the use of telephone calls, mHealth had no obvious advantage over usual care in improving pain intensity (MD –0.48, 95% CI –1.16 to 0.20; P=.16) and the disability score (MD –0.41, 95% CI –1.88 to 1.05; P=.58). The group that received a more sensitive feedback intervention showed a significantly reduced disability score (MD –4.30, 95% CI –6.95 to –1.69; P=.001). Conclusions: The use of simultaneous mHealth and usual care interventions has better efficacy than usual care alone in reducing pain intensity and disability in patients with low back pain. Moreover, the results of subgroup analysis revealed that mHealth using telephone calls might play a positive role in improving pain intensity and disability in patients with low back pain.</abstract><cop>Toronto</cop><pub>JMIR Publications</pub><pmid>34114965</pmid><doi>10.2196/26095</doi><orcidid>https://orcid.org/0000-0003-0456-3452</orcidid><orcidid>https://orcid.org/0000-0002-0812-2059</orcidid><orcidid>https://orcid.org/0000-0002-5629-0348</orcidid><orcidid>https://orcid.org/0000-0002-4483-7465</orcidid><orcidid>https://orcid.org/0000-0002-6722-0978</orcidid><orcidid>https://orcid.org/0000-0002-3900-7723</orcidid><orcidid>https://orcid.org/0000-0001-5407-5110</orcidid><orcidid>https://orcid.org/0000-0003-3544-7104</orcidid><orcidid>https://orcid.org/0000-0002-1016-838X</orcidid><orcidid>https://orcid.org/0000-0002-5464-8414</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Bias Cellular telephones Meta-analysis Review Software Text messaging |
title | Efficacy of Mobile Health in Patients With Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials |
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