Effectiveness of physical and cognitive-behavioural intervention programmes for chronic musculoskeletal pain in adults: A systematic review and meta-analysis of randomised controlled trials

被引:28
|
作者
Cheng, Joyce Oi Suet [1 ]
Cheng, Sheung-Tak [2 ,3 ]
机构
[1] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Norwich, Norfolk, England
[2] Educ Univ Hong Kong, Dept Hlth & Phys Educ, Hong Kong, Peoples R China
[3] Univ East Anglia, Norwich Med Sch, Dept Clin Psychol, Norwich, Norfolk, England
来源
PLOS ONE | 2019年 / 14卷 / 10期
关键词
LOW-BACK-PAIN; CHRONIC NECK PAIN; DISABILITY; EXERCISE; THERAPY; MANAGEMENT; RELIABILITY; DEPRESSION; REHABILITATION; PHYSIOTHERAPY;
D O I
10.1371/journal.pone.0223367
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
This systematic review and meta-analysis aimed to examine the effects of physical exercise cum cognitive-behavioural therapy (CBT) on alleviating pain intensity, functional disabilities, and mood/mental symptoms in those suffering with chronic musculoskeletal pain. MEDLINE, EMBASE, PubMEd, PsycINFO and CINAHL were searched to identify relevant randomised controlled trials from inception to 31 December 2018. The inclusion criteria were: (a) adults >= 18 years old with chronic musculoskeletal pain >= 3 months, (b) randomised controlled design, (c) a treatment arm consisting of physical intervention and CBT combined, (d) the comparison arm being waitlist, usual care or other non-pharmacological interventions such as physical exercise or CBT alone, and (e) outcomes including pain intensity, pain-related functional disabilities (primary outcomes), or mood/mental symptoms (secondary outcome). The exclusion criteria were: (a) the presence of comorbid mental illnesses other than depression and anxiety and (b) non-English publication. The search resulted in 1696 records and 18 articles were selected for review. Results varied greatly across studies, with most studies reporting null or small effects but a few studies reporting very large effects up to 2-year follow-up. Pooled effect sizes (Hedges' g) were similar to 1.00 for pain intensity and functional disability, but no effect was found for mood/mental symptoms. The effects were mainly driven by several studies reporting unusually large differences between the exercise cum CBT intervention and exercise alone. When these outliers were removed, the effect on pain intensity disappeared at post-intervention while a weak effect (g = 0.21) favouring the combined intervention remained at follow-up assessment. More consistent effects were observed for functional disability, though the effects were small (g = 0.26 and 0.37 at post-intervention and follow-up respectively). More importantly, the value of adding CBT to exercise interventions is questionable, as consistent benefits were not seen. The clinical implications and directions for future research are discussed.
引用
收藏
页数:30
相关论文
共 50 条
  • [1] The Effectiveness of Auricular Acupressure on Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Lee, Tony Kwok Wong
    Chang, Jeremy R.
    Dong, Fang Hao
    Fu, Siu-Ngor
    Wong, Arnold Yu Lok
    JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE, 2025, 31 (01): : 25 - 35
  • [2] Effectiveness of interventions in older adults with cognitive frailty: a systematic review and meta-analysis of randomised controlled trials
    Zheng, Lufang
    Wang, Cong
    Qiu, Yiming
    Li, Xin
    Zhang, Xueyan
    Zhang, Meishuang
    Ma, Tianjiao
    Li, Guichen
    Chen, Li
    AGE AND AGEING, 2022, 51 (12)
  • [3] Effects of cognitive behavioural therapy on insomnia in adults with tinnitus: Systematic review and meta-analysis of randomised controlled trials
    Curtis, Ffion
    Laparidou, Despina
    Bridle, Chris
    Law, Graham R.
    Durrant, Simon
    Rodriguez, Alina
    Pierzycki, Robert H.
    Siriwardena, Aloysius N.
    SLEEP MEDICINE REVIEWS, 2021, 56
  • [4] The effectiveness of peer support interventions for community-dwelling adults with chronic musculoskeletal pain: a systematic review and meta-analysis of randomised trials
    Wilson, Monique V.
    Braithwaite, Felicity A.
    Arnold, John B.
    Crouch, Sophie M.
    Moore, Emily
    Heil, Alrun
    Cooper, Kay
    Stanton, Tasha R.
    PAIN, 2024, 165 (12) : 2698 - 2720
  • [5] Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials
    Uchendu, C.
    Blake, H.
    DIABETIC MEDICINE, 2017, 34 (03) : 328 - 339
  • [6] The effectiveness of cognitive behavioural therapy in chronic neck pain: A systematic review with meta-analysis
    Ploutarchou, George
    Savva, Christos
    Karagiannis, Christos
    Pavlou, Kyriakos
    O'Sullivan, Kieran
    Korakakis, Vasilleios
    COGNITIVE BEHAVIOUR THERAPY, 2023, 52 (05) : 523 - 563
  • [7] Internet-delivered cognitive and behavioural based interventions for adults with chronic pain: a systematic review and meta-analysis of randomized controlled trials
    Gandy, Milena
    Pang, Sharon T. Y.
    Scott, Amelia J.
    Heriseanu, Andreea, I
    Bisby, Madelyne A.
    Dudeney, Joanne
    Karin, Eyal
    Titov, Nickolai
    Dear, Blake F.
    PAIN, 2022, 163 (10) : E1041 - E1053
  • [8] Effectiveness of social prescribing for chronic disease prevention in adults: a systematic review and meta-analysis of randomised controlled trials
    Htun, Htet Lin
    Teshale, Achamyeleh Birhanu
    Cumpston, Miranda S.
    Demos, Lisa
    Ryan, Joanne
    Owen, Alice
    Freak-Poli, Rosanne
    JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2023, 77 (04) : 265 - 276
  • [9] Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials
    Beltman, Matthijs W.
    Voshaar, Richard C. Oude
    Speckens, Anne E.
    BRITISH JOURNAL OF PSYCHIATRY, 2010, 197 (01) : 11 - 19
  • [10] Impact of support on the effectiveness of written cognitive behavioural self-help: A systematic review and meta-analysis of randomised controlled trials
    Farrand, Paul
    Woodford, Joanne
    CLINICAL PSYCHOLOGY REVIEW, 2013, 33 (01) : 182 - 195