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

IF 6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Medical Internet Research Pub Date : 2025-03-19 DOI:10.2196/56227

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

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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.

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基于行为疗法的数字干预治疗骨关节炎：系统回顾和荟萃分析。

背景：骨关节炎（OA）以疼痛、功能障碍、肌肉无力和关节僵硬为特征。由于OA增加了对卫生保健资源的依赖并加剧了社会经济负担，因此使用数字技术的远程OA康复正在迅速发展。目的：本研究的目的是分析基于行为治疗的数字干预对OA患者的疗效。方法：本研究是一项随机对照试验（rct）的系统综述，评估了基于行为治疗的数字干预工具对OA的影响。这些随机对照试验从开始到2023年6月在Web of Science、Embase、Cochrane Library、Ovid和PubMed数据库中进行检索。结果：纳入10项符合条件的随机对照试验，包括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。所有研究均显示，短期内对疼痛减轻的影响为低至中度（标准化平均差[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项研究证实了疼痛自我效能的增加（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其对疼痛减轻（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）的影响。此外，物理治疗师参与治疗对疼痛控制有积极作用（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：中等和低质量的证据支持基于行为治疗的数字工具在短期内改善疼痛强度、身体功能和自我效能。然而，患者和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。

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来源期刊

Journal of Medical Internet Research 医学-卫生保健

CiteScore

14.40

自引率

5.40%

发文量

654

审稿时长

1 months

期刊介绍： The Journal of Medical Internet Research (JMIR) is a highly respected publication in the field of health informatics and health services. With a founding date in 1999, JMIR has been a pioneer in the field for over two decades. As a leader in the industry, the journal focuses on digital health, data science, health informatics, and emerging technologies for health, medicine, and biomedical research. It is recognized as a top publication in these disciplines, ranking in the first quartile (Q1) by Impact Factor. Notably, JMIR holds the prestigious position of being ranked #1 on Google Scholar within the "Medical Informatics" discipline.