TY  - JOUR
AU  - de Melo Santana, Bruna
AU  - Raffin Moura, Julia
AU  - Martins de Toledo, Aline
AU  - Burke, Thomaz Nogueira
AU  - Fernandes Probst, Livia
AU  - Pasinato, Fernanda
AU  - Luiz Carregaro, Rodrigo
PY  - 2023
DA  - 2023/11/2
TI  - Efficacy of mHealth Interventions for Improving the Pain and Disability of Individuals With Chronic Low Back Pain: Systematic Review and Meta-Analysis
JO  - JMIR Mhealth Uhealth
SP  - e48204
VL  - 11
KW  - physiotherapy
KW  - back pain
KW  - mobile technology
KW  - efficacy
KW  - disability
KW  - chronic condition
KW  - chronic
KW  - effectiveness
KW  - self-management
KW  - systematic review
KW  - pain
KW  - meta-analysis
KW  - treatment
KW  - mHealth
KW  - mobile health
AB  - Background: Low back pain is one of the main causes of disability worldwide. Individuals with chronic conditions have been widely affected by the COVID-19 pandemic. In this context, mobile health (mHealth) has become popular, mostly due to the widespread use of smartphones. Despite the considerable number of apps for low back pain available in app stores, the effectiveness of these technologies is not established, and there is a lack of evidence regarding the effectiveness of the isolated use of mobile apps in the self-management of low back pain. Objective: We summarized the evidence on the effectiveness of mHealth interventions on pain and disability for individuals with chronic low back pain. Methods: We conducted a systematic review and meta-analysis comparing mHealth to usual care or no intervention. The search terms used were related to low back pain and mHealth. Only randomized controlled trials were included. The primary outcomes were pain intensity and disability, and the secondary outcome was quality of life. Searches were carried out in the following databases, without date or language restriction: PubMed, Scopus, Embase, Physiotherapy Evidence Database (PEDro), the Cochrane Library, and OpenGrey, in addition to article references. The risk of bias was analyzed using the PEDro scale. Data were summarized descriptively and through meta-analysis (pain intensity and disability). In the meta-analysis, eligible studies were combined while considering clinical and methodological homogeneity. The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) criteria. Results: A total of 5 randomized controlled trials were included, totaling 894 participants (447 allocated to the mHealth group and 445 to the usual care group), and they had similar methodological structure and interventions. Follow-up ranged from 6 weeks to 12 months. The studies did not demonstrate significant differences for pain intensity (mean difference −0.86, 95% CI −2.29 to 0.58; P=.15) and disability (standardized mean difference −0.24, 95% CI −0.69 to 0.20; P=.14) when comparing mHealth and usual care. All studies showed biases, with emphasis on nonconcealed allocation and nonblinding of the outcome evaluator. The certainty of evidence was rated as low for the analyzed outcomes. Conclusions: mHealth alone was no more effective than usual care or no treatment in improving pain intensity and disability in individuals with low back pain. Due to the biases found and the low certainty of evidence, the evidence remains inconclusive, and future quality clinical trials are needed. Trial Registration: PROSPERO CRD42022338759; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=338759 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2023/1/e48204
UR  - https://doi.org/10.2196/48204
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37962085
DO  - 10.2196/48204
ID  - info:doi/10.2196/48204
ER  -