Software-based interventions for low back pain management: A systematic review and meta-analysis

IF 2.4 3区医学 Q1 NURSING Journal of Nursing Scholarship Pub Date : 2023-10-10 DOI:10.1111/jnu.12937

Se Jin Hong PhD, RN, Jinkyung Park PhD, MPH, RN, Soyeon Park BSN student, Bright Eze PhDc, RN, Susan G. Dorsey PhD, RN, FAAN, Angela Starkweather PhD, ACNP-BC, FAANP, FAAN, Kyounghae Kim PhD, RN

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Abstract

Introduction

Using software for self-management interventions can improve health outcomes for individuals with low back pain, but there is a dearth of research to confirm its effectiveness. Additionally, no known research has evaluated the effective elements of software-based interventions for low back pain self-management components. This study aimed to synthesize the effectiveness of software-based interventions to promote self-management health outcomes among individuals with low back pain.

Design

A systematic review and meta-analysis was conducted.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, relevant studies up to July 2022 were searched via four electronic databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Web of Science.

Results

4908 adults with low back pain who participated in 23 studies were included. Software-based interventions were effective in reducing fear avoidance (mean difference [MD] = −0.95, 95% CI: −1.45 to −0.44), pain catastrophizing (MD = −1.31, 95% CI: −1.84 to −0.78), disability (MD = −8.21, 95% CI: −13.02 to −3.39), and pain intensity (MD = −0.86, 95% CI: −1.17 to −0.55). Specifically, interventions that included an exercise component were more effective in reducing pain and disability. Additionally, cognitive behavioral therapy (CBT) intervention significantly reduced fear avoidance and pain catastrophizing but had no noticeable impact on disability and pain compared to standard treatment. The certainty of the evidence in this review varied from very low to high across outcomes. The heterogeneity of the study results was significant, suggesting that future studies in this area could optimize the design, time points, measures, and outcomes to strengthen the evidence.

Conclusions

Low back pain self-management interventions delivered through software-based programs effectively reduce pain intensity, disability, fear avoidance, and pain catastrophizing.

Clinical Relevance

Low back pain is among the most common reasons for seeking healthcare visits. Combining exercise and counseling through soft-based programs may effectively address this issue and its associated suffering and disability.

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基于软件的腰痛管理干预措施：系统综述和荟萃分析。

引言：使用软件进行自我管理干预可以改善腰痛患者的健康状况，但缺乏研究来证实其有效性。此外，没有已知的研究评估基于软件的干预措施对腰痛自我管理组件的有效成分。本研究旨在综合基于软件的干预措施的有效性，以促进腰痛患者的自我管理健康结果。设计：进行系统回顾和荟萃分析。方法：根据系统评价和荟萃分析声明的首选报告项目，通过四个电子数据库搜索截至2022年7月的相关研究：PubMed、Embase、护理和相关健康文献累积索引和Web of Science。结果：4908名患有腰痛的成年人参与了23项研究。基于软件的干预措施在减少恐惧回避方面是有效的（平均差异[MD] = -0.95，95%置信区间：-1.45至-0.44），疼痛恶化（MD = -1.31，95%置信区间：-1.84至-0.78），残疾（MD = -8.21，95%置信区间：-13.02至-3.39）和疼痛强度（MD = -0.86，95%可信区间：-1.17至-0.55）。具体而言，包括运动成分在内的干预措施在减少疼痛和残疾方面更有效。此外，认知行为疗法（CBT）干预显著减少了恐惧回避和疼痛灾难，但与标准治疗相比，对残疾和疼痛没有明显影响。这篇综述中证据的确定性从很低到很高不等。研究结果的异质性是显著的，这表明该领域未来的研究可以优化设计、时间点、措施和结果，以加强证据。结论：通过基于软件的程序提供的腰痛自我管理干预有效地降低了疼痛强度、残疾、恐惧回避和疼痛灾难。临床相关性：腰痛是寻求医疗保健就诊的最常见原因之一。通过软性项目将锻炼和咨询相结合，可以有效地解决这个问题及其相关的痛苦和残疾。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nursing Scholarship 医学-护理

CiteScore

6.30

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers. Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.