Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Abstract

Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables; however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a systematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). Forty-one randomized controlled trials were included, with a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = −0.35; 95% CI −0.46, −0.24) and anxiety (n = 2578; SMD = −0.32; 95% CI −0.42, −0.21) with low to moderate strength of evidence. However, there was no statistically significant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.

Musculoskeletal Pain in Undergraduate Students Is Significantly Associated with Psychological Distress and Poor Sleep Quality

“…The study found a high prevalence of MSKP, and thus there is a need for intervention from policymakers to undertake corrective measures to improve the quality of life of undergraduate students in Saudi Arabia. The findings of this study also highlight the need for providing guidance and support to undergraduate students suffering from MSKP and psychological distress; behavioral modification techniques have been found to be effective in the management of depression and anxiety in patients with MSKP [ 11 ]. The university information technology departments could collaborate with different departments to create a telemedicine center to provide care for students suffering from MSKP and/or psychological distress.…”

“…The university information technology departments could collaborate with different departments to create a telemedicine center to provide care for students suffering from MSKP and/or psychological distress. It has several advantages, including increased treatment adherence, low cost, and reduced load on university clinics [ 11 ].…”

“…Although the causal relationship between MSKP, sleep deprivation, and psychological distress is not entirely understood, the associative relationship is bidirectional. For example, while some studies have shown that a significant proportion of those with MSKP suffer from psychological distress, others have found psychological distress to be resulting in MSKP [ 11 , 12 ]. Similarly, low back pain, the most commonly reported MSKP, has been found to be significantly associated with the quality of sleep quality [ 13 ], and on the other hand, a night of poor sleep quality has been reported to be followed by worsened MSKP intensity [ 14 ].…”

Effect of Exercise on Inflammation in Hemodialysis Patients: A Systematic Review

“…For the imprecision domain, if there were fewer than 300 participants for key outcomes, it was downgraded one level. Finally, if a strong influence of publication bias was detected, one level was downgraded [ 18 ].…”