Physical activity with person-centred guidance supported by a digital platform for persons with chronic widespread pain: A randomized controlled trial.

Abstract

Objective To determine the effectiveness of a person-centred intervention, including advice on physical activity, for improving pain intensity, physical activity, and other health-related outcomes in persons with chronic widespread pain, when delivered with digital eHealth support compared with standard telephone follow-up. Design Randomized controlled trial. Subjects Individuals with chronic widespread pain ( n = 139), aged 20–65 years, who had previously participated in a pain educational programme at primary healthcare units, were contacted during the period 2018–19 and randomized to an intervention group ( n = 69) or an active control group ( n = 70). Methods Together with a physiotherapist, participants in both groups developed person-centred health plans for physical activity. The intervention group was supported via a digital platform for 6 months. The active control group received support via one follow-up phone call. Primary outcome was pain intensity. Secondary outcomes were physical activity and other health-related outcomes. Results No significant differences were found between the groups after 6 months, except for a significant decrease in global fatigue in the active control group compared with the intervention group. Conclusion Future development of interventions supporting persons with chronic pain to maintain regular exercise is warranted. LAY ABSTRACT Despite documented positive effects of physical activity in treating persons with chronic widespread pain, it is challenging for many individuals with chronic widespread pain to independently continue to be physically active over time. This study measured the effects of a person-centred health plan to promote physical activity, delivered using eHealth support compared with standard follow-up by telephone, in persons with chronic widespread pain. Participants with chronic widespread pain ( n = 139) were randomized into 2 groups: an intervention group, in which participants created an individual health plan together with a physiotherapist and were provided with digital eHealth support for 6 months; and an active control group, who also created an individual health plan together with a physiotherapist, and received one follow-up support phone call. The results showed no significant difference between the groups regarding change in the primary outcome, pain intensity. The active control group showed a significant decrease in global fatigue compared with the intervention group. Future development of interventions supporting persons with chronic pain to maintain regular exercise is warranted.

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

“…From the 749 studies initially detected, a total of 41 RCTs were included [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ]. The PRISMA 2020 flow chart is detailed in Appendix A.2 .…”

“…We included 5018 participants with a mean age ranging from 33.7 to 65.8 years. The patients were mostly women (N = 3631, 72.4%) diagnosed with chronic back pain [ 47 , 52 , 72 , 79 , 80 ], chronic low back pain [ 41 , 55 ], unspecific chronic pain [ 43 , 51 , 53 , 56 , 59 , 67 , 68 , 69 , 70 , 71 , 73 , 74 , 75 , 76 , 81 ], fibromyalgia [ 42 , 46 , 48 , 49 , 58 , 63 , 66 ], headache [ 44 , 60 , 61 , 78 ], rheumatic disorders [ 45 , 57 , 62 , 64 ], or others [ 50 , 54 , 65 ]. Details of the participant’s characteristics and studies are shown in Appendix A.3 .…”

“…The studies compared online cognitive-behavioral therapy [ 42 , 43 , 45 , 46 , 47 , 54 , 55 , 59 , 63 , 70 , 72 , 79 , 80 , 81 ], acceptance and commitment therapy [ 56 , 58 , 70 , 71 , 73 , 76 ], self-management [ 52 , 59 , 62 , 66 , 67 , 68 , 69 , 77 ], mindfulness therapy [ 61 , 65 , 70 , 72 , 76 ], or other e-BMT [ 41 , 44 , 48 , 49 , 50 , 53 , 57 , 60 , 64 , 74 , 75 , 78 ], against most frequently waiting list [ 43 , 44 , 46 , 48 , 51 , 54 , 56 , 57 , 60 , <...>…”

“…According to the PEDro scale, 30 were evaluated as having good [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 55 , 56 , 58 , 59 , 62 , 63 , 64 , 65 , 66 , 68 , 70 , 71 , 72 , 73 , 75 , 76 , 77 , 78 , 80 ] and 11 as having fair methodological quality [ 52 , 53 , 54 , 57 , 60 , 61 , 67 , 69 , 74 , 79 , 81 ] ( Appendix A.5 ). The inter-rater reliability of the methodological quality assessment between assessors was high (κ = 0.823).…”

“…Four studies compared e-BMT with in-person BMT. They applied CBT [ 47 , 63 ], ACT [ 76 ] or person-centered intervention [ 50 ]. Two found non-statistically significant differences between groups for depressive symptoms (n = 253; MD = 0.24, 95% CI −2.32 to 2.80 [ 47 ] and MD = −0.51, 95% CI −2.42 to 1.40 [ 76 ]); however, Vallejo et al found statistically significant between-group differences post-treatment in favor of e-BMT (n = 40; MD = −5.06, 95% CI −7.39 to −2.73) [ 63 ].…”