Effectiveness of mHealth Interventions to Improve Pain Intensity and Functional Disability in Individuals With Hip or Knee Osteoarthritis: A Systematic Review and Meta-analysis

Abstract

Objective This review aimed to investigate the effectiveness of mHealth-supported active exercise interventions to reduce pain intensity and disability level in persons with hip or knee osteoarthritis (OA).

Data Sources Three databases (PubMed, Cochrane Library, and Web of Science) were systematically searched for randomized controlled trials (RCTs) published between January 1, 2012 and July 31, 2023. PROSPERO registration number of this review was CRD42023394119.

Study Selection We included only RCTs that were identified and screened by 2 independent reviewers (J.M. and G.N.). In addition, the reference lists of the identified studies were manually checked for further inclusion. Included studies had to provide mHealth-supported active exercises for persons with hip or knee OA, and evaluate pain intensity and disability using both questionnaires and performance tests.

Data Extraction From the included studies, the 2 independent authors extracted data using a predetermined Excel form. Characteristics of the interventions were described and a meta-analysis was performed.

Data Synthesis Twelve RCTs were included, representing 1541 patients with a mean age of 58.7±5 years, and a body mass index of 28.8±3.1 kg/m2; women being more predominant than men with a total female to male ratio of 2.2. The methodological quality of the included studies was moderate in 75% of the studies. There was no statistically significant difference between mHealth-supported active exercises compared with the interventions without mHealth in terms of pain reduction (standard mean differences [SMD]=−0.42; 95% CI, −0.91 to 0.07; P=.08) and disability mitigation (SMD=−0.36; 95% CI, −0.81 to 0.09; P=.10). However, a statistically significant difference was found between patient education combined with mHealth-supported active exercises compared with patient education alone in terms of pain (SMD= −0.42; 95% CI, −0.61 to −0.22; P<.01) and disability (SMD=−0.27; 95% CI, −0.46 to −0.08; P<.01) reduction.

Conclusions mHealth-supported exercises were found to be effective, especially when combined with patient education, in reducing pain and mitigating disability in patients with hip or knee OA.