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

BACKGROUND: Health coaching aims to empower people to reach their goals and is increasingly used in health care settings. Whether health coaching improves pain and disability for people with hip or knee osteoarthritis (OA) or low back pain (LBP) is unknown. METHODS: Six databases were searched for randomized controlled trials assessing health coaching or motivational programs in adults with hip or knee OA or LBP, with each condition investigated independently. Meta-analyses were performed with random-effects models in the Cochrane Collaboration Review Manager 5.3 program. RESULTS: Seventeen eligible studies were found. No studies analyzing hip OA alone were found. Pooled analyses found statistically significant decreases in mid-term pain (mean difference [MD]: –7.57; 95% confidence interval [CI]: –10.08 to –5.07; P < 0.001, I(2) = 0%), short-term disability (standard mean difference [SMD]: –0.22; 95% CI: –0.41 to –0.03; P = 0.02, z = 2.32, I(2) = 0%), and mid-term disability (SMD: –0.42; 95% CI: –0.75 to –0.09; P = 0.01, z = 2.49, I(2) = 60%), favoring the intervention for chronic LBP. There were significant improvements in knee OA long-term functional disability (MD: –3.04; 95% CI: –5.70 to –0.38; P = 0.03; z = 2.24; I(2) = 0%). CONCLUSION: Meta-analyses provide evidence that health coaching reduces both disability and pain in people with chronic LBP and reduces disability in people with knee OA, though the clinical significance is unknown. There is currently no evidence supporting or refuting the use of health coaching for hip OA.