ABSTRACT
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, adherence, 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 participants. 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.