Barbara I. Nicholl|Louise Fleng Sandal|Mette Jensen Stochkendahl|Marianne McCallum|N Suresh|Ottar Vasseljen|Jan Hartvigsen|Paul Jarle Mork|Per Kjær|Karen Søgaard|Frances S Mair
Digital Support Interventions for the Self-Management of Low Back Pain: A Systematic Review
University of Glasgow|University of Southern Denmark|University of Southern Denmark|Nordisk Institut for Kiropraktik og Klinisk Biomekanik|University of Glasgow|University of Glasgow|Norwegian University of Science and Technology|University of Southern Denmark|Nordisk Institut for Kiropraktik og Klinisk Biomekanik|Norwegian University of Science and Technology|University of Southern Denmark|University of Southern Denmark|University of Glasgow
low back pain lbp common cause disability ranked burdensome health condition globally selfmanagement including components increased knowledge monitoring symptoms physical activity consistently recommended clinical guidelines costeffective strategies lbp management increasing interest potential role digital healththe study aimed synthesize critically appraise published evidence concerning use interactive digital interventions support selfmanagement lbp following specific questions examined 1 key components digital selfmanagement interventions lbp including theoretical underpinnings 2 outcome measures used randomized trials digital selfmanagement interventions lbp effect intervention 3 specific characteristics components interventions appear associated beneficial outcomesbibliographic databases searched 2000 march 2016 included medline embase cinahl psycinfo cochrane library dopher trophi social science citation index science citation index reference citation searching also undertaken search strategy combined following concepts 1 back pain 2 digital intervention 3 selfmanagement randomized controlled trial rct protocols completed rcts involving adults lbp published peerreviewed journals included two reviewers independently screened titles abstracts fulltext articles extracted data assessed risk bias using cochrane risk bias tool independent third reviewer adjudicated disagreements data synthesized narrativelyof total 7014 references identified 11 included describing 9 studies 6 completed rcts 3 protocols future rcts completed rcts included total 2706 participants range 1141343 participants per study varied considerably nature delivery interventions durationdefinition lbp outcomes measured effectiveness interventions participants generally white middle aged 5 6 rct reports majority female reported educational level time college higher one study reported betweengroup differences favor digital intervention considerable variation extent reporting characteristics components theories underpinning intervention none studies showed evidence harmthe literature extremely heterogeneous making difficult understand might work best circumstances participants predominantly female white well educated middle aged thus wider applicability digital selfmanagement interventions remains uncertain information costeffectiveness reported evidence base interactive digital interventions support patient selfmanagement lbp remains weak