Digital interventions for promoting exercise adherence in chronic musculoskeletal pain: a systematic review and meta-analysis

Background Chronic musculoskeletal disorders are the second largest contributor to disability globally. Exercise is typically recommended by physiotherapists to manage symptoms. However, adherence to the prescribed exercise programme is often poor. Adjunctive digital interventions offer potential to enhance exercise adherence. Objectives To review evidence on the effectiveness of digital interventions for improving exercise adherence in people with chronic musculoskeletal conditions. The study is reported in line with PRISMA guidance and was registered with PROSPERO (CRD42019124502). Data Sources MEDLINE, Embase and PsycInfo were searched using a comprehensive search strategy. The reference lists of all included papers and relevant systematic reviews identified during the search were scanned for relevant articles. Study appraisal and synthesis methods Two researchers independently checked articles for inclusion and extracted data. Results The search returned a total of 4257 results of which five trials were included in the review and two studies were included in a random effects meta-analysis. There was no statistically significant difference in exercise adherence (SMD: 0.23; 95% CI: -0.10, 0.57). Studies that were not suitable for inclusion in the meta-analysis reported similar results. Heterogeneity of effects was high and study quality ranged from low to moderate. All of the meta-analysed data related to osteoarthritis of the hip and/or knee. Conclusion We found no evidence that digital interventions enhance adherence to therapeutic exercise in patients with chronic musculoskeletal disorders. However, further, high quality research is required to draw definitive conclusions on their effectiveness and to identify key components that are associated with effectiveness. (C) 2021 Chartered Society of Physiotherapy. Published by YElsevier Ltd. All rights reserved.

Automated summary

Digital interventions did not enhance adherence to therapeutic exercise in patients with chronic musculoskeletal disorders. Further high quality research is needed to draw definitive conclusions on their effectiveness and to identify key components associated with effectiveness.