Título :	Efficacy of mHealth interventions for improving the pain and disability of individuals with chronic low back pain : systematic review and meta-analysis
Autor :	Santana, Bruna de Melo Moura, Julia Raffin Toledo, Aline Martins de Burke, Thomaz Nogueira Probst, Livia Fernandes Pasinato, Fernanda Carregaro, Rodrigo Luiz
metadata.dc.identifier.orcid:	https://orcid.org/0000-0002-7004-0433 https://orcid.org/0000-0002-1592-6004 https://orcid.org/0000-0002-0041-0750 https://orcid.org/0000-0002-4872-2139 https://orcid.org/0000-0002-4696-0862 https://orcid.org/0000-0002-1546-9579 https://orcid.org/0000-0002-2382-0787
metadata.dc.contributor.affiliation:	Universidade de Brasília, Faculdade de Ceilândia Universidade de Brasília, Faculdade de Ceilândia Universidade de Brasília, Faculdade de Ceilândia Universidade Federal do Mato Grosso do Sul Hospital Alemão Oswaldo Cruz Universidade de Brasília, Faculdade de Ceilândia Universidade de Brasília, Faculdade de Ceilândia
Assunto::	Fisioterapia Dor nas costas Dor crônica Tecnologia em saúde Telemedicina
Fecha de publicación :	11-feb-2023
Editorial :	JMIR Publications
Citación :	SANTANA, Bruna de Melo et al. Efficacy of mHealth interventions for improving the pain and disability of individuals with chronic low back pain: systematic review and meta-analysis. JMIR Mhealth Uhealth, [S.l.], v. 11, 2023. DOI: https://doi.org/10.2196/48204. Disponível em: https://mhealth.jmir.org/2023/1/e48204. Acesso em: 13 nov. 2024.
Abstract:	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.
metadata.dc.description.unidade:	Faculdade UnB Ceilândia (FCE)
metadata.dc.description.ppg:	Programa de Pós-Graduação em Ciências da Reabilitação
Licença::	This is an open-access article distributed under the terms of the Creative Commons Attribution License (https:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited.
DOI:	https://doi.org/10.2196/48204
metadata.dc.relation.publisherversion:	https://mhealth.jmir.org/2023/1/e48204
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