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Louise Prior J, Vesentini G, De Gregorio JAM, et al. Health coaching for low back pain, hip and knee osteoarthritis: A Systematic Review with Meta-Analysis. Pain Med. 2022 Jul 1. pii: 6625662. doi: 10.1093/pm/pnac099. (Systematic review)
Abstract

BACKGROUND AND OBJECTIVE: Health coaching aims to empower people to reach their goals and is increasingly used in healthcare settings. Whether health coaching improves pain and disability for people with hip and/or knee osteoarthritis (OA), or low back pain (LBP) is yet unknown.

DATABASES AND DATA TREATMENT: Six databases were searched for randomised controlled trials assessing health coaching or motivational programs in adults with hip, knee OA or LBP investigating each condition independently. Meta-analyses were performed using random-effects models in the Cochrane Collaboration Review Manager 5.3 program.

RESULTS: 17 eligible studies were found. No studies found analysing hip OA alone. Pooled analyses found statistically significant decreases in mid-term pain (Mean Difference MD: -7.57, 95% CI: -10.08 to -5.07, p < 0.001, I2 = 0%), short-term disability (Standard Mean Difference SMD -0.22; 95% CI [-0.41, -0.03]; p = 0.02, z = 2.32, I2 = 0%) and mid-term disability (SMD -0.42; 95% CI [-0.75, -0.09]; p = 0.01, z = 2.49, I2 = 60%) favouring the intervention for chronic LBP. There were significant improvements in knee OA long-term functional disability (MD -3.04, 95% CI [-5.70, -0.38]; P = 0.03; Z = 2.24; I2 0%).

CONCLUSION: Meta-analyses provide evidence that health coaching, reduces both disability and pain, in people with chronic LBP and disability in knee OA, although the clinical significance is unknown. There is currently no evidence supporting or refuting it's use for hip osteoarthritis.

Ratings
Discipline Area Score
Rehab Clinician (OT/PT) 6 / 7
Psychologist 5 / 7
Physician 5 / 7
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Comments from MORE raters

Physician rater

Heterogenous review and does not add anything compared with previous reviews and recommendations about exercise for knee osteoarthritis and chronic low-back pain.

Physician rater

Very important analysis. Primary care doctors can understand the importance of procedures that improve QoL in progressing conditions like OA. This meta-analysis cautiously supports using those intervention. An honest and interesting discussion is worth additional attention.

Psychologist rater

It's good that the review was done but there need to be higher quality studies to provide more definitive findings. This is more useful to researchers than clinicians.

Rehab Clinician (OT/PT) rater

It is potentially useful information but based on this article, there is not enough evidence for or against health coaching for LBP or knee OA. It is a window into the future as I am sure more studies will be done and a pattern established.

Rehab Clinician (OT/PT) rater

This is a very interesting study that is a good reminder of the importance and value of health coaching.
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