Health Coaching for Low Back Pain and Hip and Knee Osteoarthritis: A Systematic Review with Meta-Analysis

Abstract

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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