Use of mobile devices as a strategy for the selfmanagement of individuals with low back pain: evidence synthesis and technological development proposal
Physiotherapy, Back pain, Mobile technology
Introduction: Low back pain is the main cause of disability in the world, causing serious socioeconomic and health systems impact. Individuals with chronic conditions have been widely affected by the COVID-19 pandemic. In this context, mobile health (m-Health) has become popular, mostly due to the wide use of smartphones. Despite the considerable number of applications for low back pain available in the app store, the effectiveness of these technologies is not established and there is a lack of evidence regarding the effectiveness of the isolated use of mobile applications in the selfmanagement of low back pain. Objetivos: Investigate the effectiveness of interventions through the use of mobile health (mhealth) in improving pain and disability of individuals with chronic low back pain, compared to usual healthcare strategies. Methods: A systematic review with metaanalysis comparing m-health technology to usual care or no intervention was performed. Pain intensity and disability were included as primary outcomes, and quality of life as a secondary outcome. Results: Five RCTs totaling 894 participants were included. The studies showed effects of moderate quality for pain intensity (MD -0.86; 95% CI -2.29;0.58) and disability (SMD -0.24; 95% CI - 0.69;0,20) in favor of m-Health, however there was no significant differences between interventions. Most of the studies presented methodological biases such as non-concealed allocation and non-blinding of subjects, participants, or therapists. Conclusion: Our review suggests positive clinical effects from the use of m-Health in improving pain intensity and disability in individuals with low back pain compared to usual care. However, due to the biases found, the evidence remains inconclusive and future clinical trials are needed