Mobile app use to support therapeutic exercise for musculoskeletal pain conditions may help improve pain intensity and self-reported physical function: a systematic review

Question: What is the effect of therapeutic exercise or tailored physical activity programs supported by a mobile app (compared with exercise or physical activity programs delivered using other modes) for people with musculoskeletal pain conditions? Design: Systematic review of published randomised controlled trials with meta-analysis. Participants: People of all ages with musculoskeletal pain conditions. Intervention: Therapeutic exercise or tailored physical activity programs supported by a mobile app. Outcome measures: Pain intensity, pain interference, self-reported physical function, physical performance, adher-ence, psychosocial outcomes, health-related quality of life, work participation, physical activity, goal attainment and satisfaction. Results: Eleven studies were eligible for inclusion, with a total of 845 partici-pants. There was low certainty evidence that using mobile apps to deliver exercise programs helps to reduce pain intensity to a worthwhile extent (SMD -0.60, 95% CI -0.93 to -0.27). There was low certainty evidence that using mobile apps to deliver exercise programs helps to improve self-reported physical function to a worthwhile extent (SMD -0.92, 95% CI -1.57 to -0.27). Although the effect of using mobile apps to deliver exercise programs on pain interference was also estimated to be a worthwhile benefit (SMD -0.66), this estimate came with marked uncertainty (95% CI -1.52 to 0.19) so the effect remains unclear. The remainder of the outcomes were unclear due to sparse evidence. The most common behaviour change intervention functions in the mobile app interventions were: training, enablement and environmental restructuring. Conclusion: Mobile apps supporting therapeutic exercise or tailored physical activity programs for musculoskeletal pain conditions may help in reducing pain intensity and improving physical function. The mobile apps utilised a limited range of behaviour change intervention functions. Registration: CRD42021248046 [Thompson D, Rattu S, Tower J, Egerton T, Francis J, Merolli M (2023) Mobile app use to support therapeutic exercise for musculoskeletal pain conditions may help improve pain intensity and self-reported physical function: a systematic review. Journal of Physiotherapy 69:23-34](c) 2022 Australian Physiotherapy Association. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).