Effectiveness of smartphone-based applications in low-back pain rehabilitation: a systematic review and meta-analysis

Abstract

Abstract Background Telerehabilitation is an innovative approach used to deliver care to patients with low-back pain (LBP) and overcome barriers to access. This review aimed to summarise the effectiveness of smartphone-based applications on pain, disability, and quality of life (QoL) of patients with LBP. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines and the Physiotherapy Evidence Database (PEDro) were used. Four electronic databases were searched (MEDLINE, Web of Science, Scopus, CINAHL) for eligible randomised control trials employing physiotherapy interventions via smartphone application in patients with LBP published in English from 2015 to January 2025. Data on pain, disability, and QoL were extracted and analysed. Results The search yielded 1540 studies. After screening for duplicates, titles, and abstracts, 90 met the eligibility criteria for a full review; however, only 15 studies met the criteria for analysis. The data of 4195 adult patients with LBP was extracted from the included studies. Eight studies compared smartphone-based interventions to in-person physiotherapy. Four studies compared to usual medical care. Two studies compared the education control group, and one employed home exercises with an information sheet. There are three studies of poor quality with a high risk of bias, 10 studies of fair quality with a moderate risk of bias, and only two studies of outstanding quality with a low risk of bias. The pooled results of four studies (1606 patients) comparing smartphone-based apps and usual care in reducing pain showed no significant difference between the two groups (standardized mean difference [SMD] = − 0.597; 95% CI − 1.342 to 0.148; p = 0.116). Similarly, no significant differences were observed between the two groups in reducing disability, when three studies involving 925 patients were pooled (SMD = − 0.846; 95% CI − 2.071 to 0.379; p = 0.176), and improving QoL (SMD = 1.359; 95% CI − 0.798 to 3.516; p = 0.217) when two studies (878 patients) were pooled. Conclusion This review indicates that smartphone-based application interventions may offer comparable benefits to usual care in reducing pain and disability and improving QoL and serve as a viable alternative to other interventions for patients with LBP.