The effectiveness of exercise-based telemedicine on pain, physical activity and quality of life in the treatment of chronic pain: A systematic review
The effectiveness of exercise-based telemedicine on pain, physical activity and quality of life in the treatment of chronic pain: A systematic review
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DOI：
10.1177/1357633x17716576
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发表时间：
2018-09-01
影响因子：
4.7
通讯作者：
Stuiver, Martijn M.
中科院分区：
文献类型：
--
作者：
Adamse, Corine;Dekker-Van Weering, Marit G. H.;Stuiver, Martijn M.
简介：本研究的目的是系统地回顾证据的有效性运动为基础的远程医疗在慢性pain.Methods：我们搜索了科克伦，PubMed，MEDLINE，EMBASE，CINAHL和PEDRO数据库从2000年至2015年的随机对照试验，比较运动为基础的远程医疗干预，没有干预或常规护理的成年人慢性疼痛。使用随机效应荟萃分析汇总主要结局数据。主要结局为疼痛、体力活动（PA）、日常生活活动（ADL）受限和生活质量（QoL）。次要结果是障碍，促进者和可用性的远程medicine.Results：16项研究。在具有可比对照条件的三个研究亚组中进行荟萃分析。远程医疗与无干预相比，疼痛评分显著降低（MD-0.57，95% CI -0.81; -0.34），但远程医疗与常规护理相比（MD-0.08，95% CI -0.41; 0.26）或在常规护理基础上（MD-0.25，95% CI -1.50; 1.00）的疼痛评分均无显著降低。与无干预相比，远程医疗对PA无显著影响（MD 19.93分钟/周，95% CI -5.20; 45.06），ADL限制显著减少（SMD-0.20，95% CI -0.29; -0.12）。除了PA或ADL的常规护理外，远程医疗没有发现任何差异（SMD 0.16，95%CI-0.66：0.34）。远程医疗与常规护理的ADL无差异（SMD 0.08，95% CI -0.37; 0.53）。远程医疗与三个对照组的生活质量相比没有差异。有限的信息被发现的次要outcome.Conclusions：基于远程医疗干预的诊断似乎并没有增加价值，通常的护理。作为常规护理的替代，远程医疗可能是适用的，但由于证据质量有限，需要进一步探索快速发展的远程医疗领域。
Introduction: The aim of this study was to systematically review the evidence on the effectiveness of exercise-based telemedicine in chronic pain.Methods: We searched the Cochrane, PubMed, MEDLINE, EMBASE, CINAHL and PEDRO databases from 2000 to 2015 for randomised controlled trials, comparing exercise-based telemedicine intervention to no intervention or usual care in adults with chronic pain. Primary outcome data were pooled using random effect meta-analysis. Primary outcomes were pain, physical activity (PA), limitations in activities of daily living (ADL) and quality of life (QoL). Secondary outcomes were barriers, facilitators and usability of telemedicine.Results: Sixteen studies were included. Meta-analyses were performed in three subgroups of studies with comparable control conditions. Telemedicine versus no intervention showed significantly lower pain scores (MD -0.57, 95% CI -0.81; -0.34), but not for telemedicine versus usual care (MD -0.08, 95% CI -0.41; 0.26) or in addition to usual care (MD -0.25, 95% CI -1.50; 1.00). Telemedicine compared to no intervention showed non-significant effects for PA (MD 19.93 min/week, 95% CI -5.20; 45.06) and significantly diminished ADL limitations (SMD -0.20, 95% CI -0.29; -0.12). No differences were found for telemedicine in addition to usual care for PA or for ADL (SMD 0.16, 95% CI -0.66; 0.34). Telemedicine versus usual care showed no differences for ADL (SMD 0.08, 95% CI -0.37; 0.53). No differences were found for telemedicine compared to the three control groups for QoL. Limited information was found on the secondary outcomes.Conclusions: Exercise-based telemedicine interventions do not seem to have added value to usual care. As substitution of usual care, telemedicine might be applicable but due to limited quality of the evidence, further exploration is needed for the rapidly developing field of telemedicine.