Musculoskeletal pain is the greatest cause of disability worldwide. Owing to its increasing prevalence and burden, the importance of affordable treatments has been highlighted. Text message interventions are accessible, low cost, and effective in promoting healthy behaviour and managing chronic diseases. However, little is known about their role in musculoskeletal pain. This systematic review was conducted to appraise the literature on the effects of text messages (as an intervention or a component of an intervention) compared with any control on pain and function in people with musculoskeletal pain (PROSPERO: CRD42018117371). MEDLINE, EMBASE, CINAHL, Cochrane, and PEDro databases were searched from inception to April 2020. Keywords relating to musculoskeletal pain, text messages, and randomised controlled trials were combined. Methodological quality was assessed using the PEDro score. Of the 12,022 studies identified, 11 were included, with a mean PEDro score of 5.4/10 points (SD 1.3). Pooled analyses were not performed because of heterogeneity of interventions and clinical characteristics. When text messages were added to and compared with usual care, some positive effects were found only on treatment adherence. Although small and inconsistent, some positive effects were reported for pain intensity, function, care-seeking behaviour, adherence, and quality of life when text messages were added to multicomponent interventions. Moreover, text message and telephone counselling interventions had similar effects on function. Overall included studies were of limited methodological quality and heterogeneous. However, our results indicate potential benefits of text messages in the treatment of musculoskeletal pain, which need to be confirmed in future trials.
Objective To describe the protocol of a randomized controlled trial that will investigate the effects of the TEXT4myBACK self-management text message intervention compared with control, in people with low back pain. Methods A single-blind (assessor and statistician) randomized controlled trial with economic analysis and process evaluation will be conducted. 304 people with non-specific low back pain of less than 12 weeks will be enrolled and randomly allocated either to TEXT4myBACK intervention or control groups. The TEXT4myBACK intervention group will receive four semi-personalized text messages per week providing advice, motivation and information about low back pain, physical activity, sleep, mood, use of care, medication during 12 weeks. The control group will receive one text message with a link to a low back pain and diet online information package. Outcomes will be assessed at baseline, 3, 6 and 12 months. The primary outcome will be function assessed with the Patient-Specific Functional Scale. Secondary outcomes will include pain intensity, physical activity participation, sedentary behavior, global impression of change, health-related quality of life and eHealth literacy. Data on demographic characteristics, smallest worthwhile change (ie, smallest function scored needed to be achieved at the end of the intervention to consider it to be worthwhile), health care utilization and adverse events (ie, any new health issue that occurs during participation in the study) will be collected. An economic and process evaluation will also be conducted. Impact This study will assess if a self-management text message intervention is effective and cost-effective in improving function of people with low back pain. This study can inform clinical practice of a simple, scalable and affordable intervention for managing low back pain.
Background and Objective Health coaching aims to empower people to reach their goals and is increasingly used in healthcare settings. Whether health coaching improves pain and disability for people with hip and/or knee osteoarthritis (OA), or low back pain (LBP) is yet unknown. Databases and Data treatment Six databases were searched for randomised controlled trials assessing health coaching or motivational programs in adults with hip, knee OA or LBP investigating each condition independently. Meta-analyses were performed using random-effects models in the Cochrane Collaboration Review Manager 5.3 program. Results 17 eligible studies were found. No studies found analysing hip OA alone. Pooled analyses found statistically significant decreases in mid-term pain (Mean Difference MD: -7.57, 95% CI: -10.08 to -5.07, p < 0.001, I2 = 0%), short-term disability (Standard Mean Difference SMD -0.22; 95% CI [-0.41, -0.03]; p = 0.02, z = 2.32, I2 = 0%) and mid-term disability (SMD -0.42; 95% CI [-0.75, -0.09]; p = 0.01, z = 2.49, I2 = 60%) favouring the intervention for chronic LBP. There were significant improvements in knee OA long-term functional disability (MD -3.04, 95% CI [-5.70, -0.38]; P = 0.03; Z = 2.24; I2 0%). Conclusion Meta-analyses provide evidence that health coaching, reduces both disability and pain, in people with chronic LBP and disability in knee OA, although the clinical significance is unknown. There is currently no evidence supporting or refuting it’s use for hip osteoarthritis.
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