JMIR Publications

ABSTRACT

Background:

Musculoskeletal (MSK) conditions are the second greatest contributor to disability worldwide and have significant individual, societal and economic implications. Due to the growing burden of MSK disability, an integrated and strategic response is urgently required. Digital health technologies provide high-reach, low cost, readily accessible and scalable interventions for large patient populations that address time and resource constraints.

Objective:

To investigate whether digital interventions are clinically effective in the management of MSK conditions.

Methods:

A systematic review was undertaken to address the research objective. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The review protocol was registered with PROSPERO (reference number: CRD42018093343) prior to commencement of the study. The following database were searched: Medline, Embase, Cinahl, and The Cochrane Library from January 2000 – February 2019 using search terms and database specific MeSH terms in various combinations appropriate to the research objective. Primary outcomes were pain intensity, and pain-related disability/physical functioning.

Results:

Twenty-nine articles were eligible for inclusion. Three articles were published from one study therefore providing 27 sets of data. Of the 24 studies that assessed pain intensity as an outcome, 14 reported statistically significant reductions following digital intervention. Of the 17 studies that investigated pain-related disability/physical functioning, 12 studies showed a statistically significant reduction following the digital intervention. Significant improvements were also found in a range of additional outcomes including patient knowledge, health-related quality of life, catastrophising, anxiety, self-efficacy, surgery interest, work, and happiness/depression.

Conclusions:

This review demonstrated that digital interventions were effective in the management of MSK conditions, with the majority of studies showing a reduction in pain intensity and improvements in pain-related disability/physical functioning. Evidence suggests digital interventions should not be used to replace direct contact with clinicians, but rather provide a scalable, cost-efficient, effective, evidence-based management option, that can work both in a supplementary capacity to direct clinician input, and also as a validated treatment approach to specific MSK conditions. However, further high quality research into digital interventions for MSK conditions is needed.