OBJECTIVE: To summarize the effectiveness of eHealth interventions for improving pain, physical disability, psychological factors, and the quality of life for people with spine pain. DESIGN: Overview of systematic reviews. LITERATURE SEARCH: CINAHL, Embase, PubMed, and SPORTDiscus e-databases were searched. STUDY SELECTION CRITERIA: Systematic reviews with meta-analysis of randomized clinical trials evaluating any type of eHealth were included. DATA SYNTHESIS: AMSTAR 2 was used to assess the methodological quality of included reviews. The degree of overlap between reviews was calculated. RESULTS: Sixteen systematic reviews were included. Of them, 13 reviews were exclusively focused on back pain or low back pain. Exercise and psychological interventions were the primary contents of eHealth interventions. In general, eHealth interventions based on physical exercise may improve the quality of life of people with low back pain. eHealth interventions based on cognitive behavioral therapy may reduce pain catastrophizing and fear-avoidance beliefs for physical activity for people with low back pain. eHealth interventions based on multidisciplinary approaches including physical exercise may reduce low back pain. Few systematic reviews used the GRADE system to evaluate the certainty of evidence, and few specified the content of eHealth interventions. CONCLUSION: eHealth interventions may improve the quality of life, pain catastrophizing, and fear-avoidance beliefs for people with low back pain. It is unclear, based on available systematic reviews, how clinicians should deliver eHealth interventions for people with spine pain (eg, neck pain or low back pain). J Orthop Sports Phys Ther 2024;54(12):1-18. Epub 4 November 2024. doi:10.2519/jospt.2024.12844.
| Discipline Area | Score |
|---|---|
| Physician |  |
Physician rater
The most effective eHealth interventions based on exercise, cognitive behavioral therapy, or multidisciplinary approaches using apps, websites, and telemedicine can improve quality-of-life, pain catastrophizing, and fear-avoidance beliefs in patients with low back pain. However, there remains a significant gap in methodological rigor and clarity on how clinicians should effectively deliver eHealth interventions tailored to individual patient needs. The details of comparative effectiveness between low back pain and neck pain are not clearly delineated.
Physician rater
These results reinforce previous evidence that eHealth interventions, mainly cognitive behavioral therapy, have promising outcomes for spinal pain in improving quality-of-life, pain catastrophizing, and fear-avoidance in people with low back pain. However, the optimal method for clinicians to deliver these interventions remains uncertain. Additional high-quality RCTs are needed to improve the certainty of the evidence. The methodological quality of the available systematic reviews was a concern.
, McMaster University