Web-Based Interventions for Chronic Back Pain: A Systematic Review
BACKGROUND: Chronic low back pain is one of the most common presenting complaints to a physician’s office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources. OBJECTIVE: The aim of this review is to determine which...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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JMIR Publications
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978860/ https://www.ncbi.nlm.nih.gov/pubmed/27460413 http://dx.doi.org/10.2196/jmir.4932 |
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author | Garg, Shashank Garg, Divya Turin, Tanvir C Chowdhury, M Faruq U |
author_facet | Garg, Shashank Garg, Divya Turin, Tanvir C Chowdhury, M Faruq U |
author_sort | Garg, Shashank |
collection | PubMed |
description | BACKGROUND: Chronic low back pain is one of the most common presenting complaints to a physician’s office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources. OBJECTIVE: The aim of this review is to determine which Web-based interventions aimed at chronic low back pain are of benefit to patients. METHODS: Randomized controlled trials (RCTs) studying Web-based interventions directed at adults with chronic low back pain were included. Retrospective studies, narrative reviews, nonrandomized trials, and observational studies were excluded. Electronic databases and bibliographies were searched. RESULTS: In total, nine unique RCTs were identified (total participants=1796). The number of patients randomized in each trial ranged from 51 to 580. Four trials studied online cognitive behavioral therapy (CBT) and five trials studied other Web-based interventions with interactive features. Empowerment/control was improved in six studies. Use of CBT was associated with reduced catastrophization among patients. Mixed results were reported with regards to reduction in pain levels and disability, although some studies showed promise in reducing disability in the short term. One study that measured health care utilization reported reduced utilization with the use of moderated email discussion. CONCLUSIONS: Limited data are available regarding effective Web-based interventions to improve outcomes for patients with chronic low back pain. Nine RCTs with small sample sizes were identified in this review. Online CBT appears to show some promise in terms of reducing catastrophization and improving patient attitudes. Further research in this area with larger-scale studies focusing on appropriate outcomes appears to be a priority. |
format | Online Article Text |
id | pubmed-4978860 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-49788602016-08-29 Web-Based Interventions for Chronic Back Pain: A Systematic Review Garg, Shashank Garg, Divya Turin, Tanvir C Chowdhury, M Faruq U J Med Internet Res Review BACKGROUND: Chronic low back pain is one of the most common presenting complaints to a physician’s office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources. OBJECTIVE: The aim of this review is to determine which Web-based interventions aimed at chronic low back pain are of benefit to patients. METHODS: Randomized controlled trials (RCTs) studying Web-based interventions directed at adults with chronic low back pain were included. Retrospective studies, narrative reviews, nonrandomized trials, and observational studies were excluded. Electronic databases and bibliographies were searched. RESULTS: In total, nine unique RCTs were identified (total participants=1796). The number of patients randomized in each trial ranged from 51 to 580. Four trials studied online cognitive behavioral therapy (CBT) and five trials studied other Web-based interventions with interactive features. Empowerment/control was improved in six studies. Use of CBT was associated with reduced catastrophization among patients. Mixed results were reported with regards to reduction in pain levels and disability, although some studies showed promise in reducing disability in the short term. One study that measured health care utilization reported reduced utilization with the use of moderated email discussion. CONCLUSIONS: Limited data are available regarding effective Web-based interventions to improve outcomes for patients with chronic low back pain. Nine RCTs with small sample sizes were identified in this review. Online CBT appears to show some promise in terms of reducing catastrophization and improving patient attitudes. Further research in this area with larger-scale studies focusing on appropriate outcomes appears to be a priority. JMIR Publications 2016-07-26 /pmc/articles/PMC4978860/ /pubmed/27460413 http://dx.doi.org/10.2196/jmir.4932 Text en ©Shashank Garg, Divya Garg, Tanvir C Turin, M Faruq U Chowdhury. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.07.2016. https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/ (https://creativecommons.org/licenses/by/2.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Review Garg, Shashank Garg, Divya Turin, Tanvir C Chowdhury, M Faruq U Web-Based Interventions for Chronic Back Pain: A Systematic Review |
title | Web-Based Interventions for Chronic Back Pain: A Systematic Review |
title_full | Web-Based Interventions for Chronic Back Pain: A Systematic Review |
title_fullStr | Web-Based Interventions for Chronic Back Pain: A Systematic Review |
title_full_unstemmed | Web-Based Interventions for Chronic Back Pain: A Systematic Review |
title_short | Web-Based Interventions for Chronic Back Pain: A Systematic Review |
title_sort | web-based interventions for chronic back pain: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978860/ https://www.ncbi.nlm.nih.gov/pubmed/27460413 http://dx.doi.org/10.2196/jmir.4932 |
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