The effectiveness of interventions aimed at increasing physical activity in adults with persistent musculoskeletal pain: a systematic review and meta-analysis

BMC Musculoskeletal Disorders

Research Article

John O’Hanlon¹  Lou Atkins²  Brendan Bunting³  Sarah Howes³  Alison Porter-Armstrong³  Joanne Marley⁴  Suzanne M. McDonough⁵  Mark A. Tully⁶ 

[1] Belfast Health and Social Care Trust, Chronic Pain Service, Belfast City Hospital, 51 Lisburn Road, BT9 7AB, Belfast, UK;Centre for Behaviour Change, University College London, 1-9 Torrington Place, London, UK;Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Shore Road, BT37 0QB, Newtownabbey, Co Antrim, UK;Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Shore Road, BT37 0QB, Newtownabbey, Co Antrim, UK;Belfast Health and Social Care Trust, Chronic Pain Service, Belfast City Hospital, 51 Lisburn Road, BT9 7AB, Belfast, UK;Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Shore Road, BT37 0QB, Newtownabbey, Co Antrim, UK;UKCRC Centre of Excellence for Public Health (Northern Ireland), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast Room 02020, Institute of Clinical Science B, Royal Victoria Hospital, Grosvenor Road, 12 6BJ, Belfast, BT, UK;Honorary Research Professor, School of Physiotherapy, University of Otago, Dunedin, New Zealand;Centre for Public Health, Queens University Belfast, Royal Victoria Hospital, Grosvenor Road, BT12 6BA, Belfast, UK;UKCRC Centre of Excellence for Public Health (Northern Ireland), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast Room 02020, Institute of Clinical Science B, Royal Victoria Hospital, Grosvenor Road, 12 6BJ, Belfast, BT, UK;

关键词: Physical activity;    Low back pain;    Osteoarthritis;    Musculoskeletal pain;    Chronic pain;    Persistent pain;    Behaviour change techniques;    Systematic review;   

DOI  :  10.1186/s12891-017-1836-2

 received in 2017-06-01, accepted in 2017-11-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIndividuals with persistent musculoskeletal pain (PMP) have an increased risk of developing co-morbid health conditions and for early-mortality compared to those without pain. Despite irrefutable evidence supporting the role of physical activity in reducing these risks; there has been limited synthesis of the evidence, potentially impacting the optimisation of these forms of interventions. This review examines the effectiveness of interventions in improving levels of physical activity and the components of these interventions.MethodsRandomised and quasi-randomised controlled trials were included in this review. The following databases were searched from inception to March 2016: CENTRAL in the Cochrane Library, Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Embase, CINAHL, PsycINFO and AMED. Two reviewers independently screened citations, assessed eligibility, extracted data, assessed risk of bias and coded intervention content using the behaviour change taxonomy (BCTTv1) of 93 hierarchically clustered techniques. GRADE was used to rate the quality of the evidence.ResultsThe full text of 276 articles were assessed for eligibility, twenty studies involving 3441 participants were included in the review. Across the studies the mean number of BCTs coded was eight (range 0–16); with ‘goal setting’ and ‘instruction on how to perform the behaviour’ most frequently coded. For measures of subjective physical activity: interventions were ineffective in the short term, based on very low quality evidence; had a small effect in the medium term based on low quality evidence (SMD 0.25, 95% CI 0.01 to 0.48) and had a small effect in the longer term (SMD 0.21 95% CI 0.08 to 0.33) based on moderate quality evidence. For measures of objective physical activity: interventions were ineffective - based on very low to low quality evidence.ConclusionsThere is some evidence supporting the effectiveness of interventions in improving subjectively measured physical activity however, the evidence is mostly based on low quality studies and the effects are small. Given the quality of the evidence, further research is likely/very likely to have an important impact on our confidence in effect estimates and is likely to change the estimates. Future studies should provide details on intervention components and incorporate objective measures of physical activity.

【 授权许可】

CC BY   
© The Author(s). 2017