It Hurts to Move! Intervention Effects and Assessment Methods for Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review with Meta-analysis

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

OBJECTIVES: To estimate the effects of musculoskeletal rehabilitation interventions on movementevoked pain and to explore the assessment methods/protocols used to evaluate movement-evoked pain in adults with musculoskeletal pain.

DESIGN: Systematic review with meta-analysis.

LITERATURE SEARCH: Three electronic databases (PubMed, Web of Science, and Scopus) were searched.

STUDY SELECTION CRITERIA: Randomized controlled trials investigating musculoskeletal rehabilitation interventions for movement-evoked pain in adults with musculoskeletal pain were included.

DATA SYNTHESIS: Meta-analysis was conducted for outcomes with homogeneous data from at least 2 trials. The mean change in movementevoked pain was the primary outcome measure. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework.

RESULTS: Thirty-eight trials were included, and 60 different interventions were assessed. There was moderate-certainty evidence of a beneficial effect of exercise therapy compared to no treatment (standardized mean difference [SMD], -0.65; 95% confidence interval [CI]: -0.83, -0.47; P<.001) on movement-evoked pain in adults with musculoskeletal pain. There was low-certainty evidence of a beneficial effect of transcutaneous electrical nerve stimulation compared to no treatment (SMD, -0.46; 95% CI: -0.71, -0.21; P = .0004). There was no benefit of transcutaneous electrical nerve stimulation when compared to sham transcutaneous electrical nerve stimulation (SMD, -0.28; 95% CI: -0.60, 0.05; P = .09; moderate-certainty evidence).

CONCLUSION: There was moderate-certainty evidence that exercise therapy is effective for reducing movement-evoked pain in patients with musculoskeletal pain compared to no treatment. Consider exercise therapy as the first-choice treatment for movement-evoked pain in clinical practice. J Orthop Sports Phys Ther 2022;52(6):345-374. Epub: 05 Feb 2022. doi:10.2519/jospt.2022.10527.

Original languageEnglish
Article number52
Pages (from-to)345-374
Number of pages30
JournalJournal of Orthopaedic & Sports Physical Therapy
Volume52
Issue number6
DOIs
Publication statusPublished - Jun 2022

Bibliographical note

Funding Information:
1Rehabilitation Research Group, Vrije Universiteit Brussel, Brussels, Belgium. 2Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. 3Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium. 4School of Physical & Occupational Therapy, McGill University, Montréal, Canada. 5Department of Physiotherapy, University of Applied Sciences Rotterdam, Rotterdam, the Netherlands. 6Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium. 7MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. 8Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. This review was registered with PROSPERO (registration number CRD42020114576). Funding for this study was obtained from a Wetenschappelijk Fonds Willy Gepts (WFWG) grant of UZ Brussel. The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Dr Lynn Leemans, Rehabilitation Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium. E-mail: Lynn.Leemans@vub.be U Copyright ©2022 JOSPT ®, Inc

Publisher Copyright:
© 2022 JOSPT®, Inc.

Copyright:
Copyright 2022 Elsevier B.V., All rights reserved.

Keywords

  • Adult
  • Exercise Therapy
  • Humans
  • Musculoskeletal Pain/therapy
  • Transcutaneous Electric Nerve Stimulation

Fingerprint

Dive into the research topics of 'It Hurts to Move! Intervention Effects and Assessment Methods for Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review with Meta-analysis'. Together they form a unique fingerprint.

Cite this