• Crystian B Oliveira, Marcia R Franco, Christopher G Maher, Christine Lin Chung-Wei CW George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia., Priscila K Morelhão, Amanda C Araújo, Ruben F Negrão Filho, and Rafael Z Pinto.
• Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil.
• Arthritis Care Res (Hoboken). 2016 Dec 1; 68 (12): 1832-1842.

ObjectiveTo investigate whether physical activity interventions increase objectively measured physical activity levels of patients with chronic musculoskeletal pain (e.g., osteoarthritis, low back pain) compared to no/minimal intervention.MethodsWe performed a systematic review with meta-analysis searching the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, SportDiscus, and Physiotherapy Evidence Database (PEDro) databases, and the main clinical trials registries. Quasirandomized or randomized controlled trials investigating the effect of physical activity interventions on objectively measured physical activity levels (e.g., using accelerometers or pedometers) of patients with chronic musculoskeletal pain compared with no/minimal intervention were considered eligible. Analyses were conducted separately for short-term (≤3 months), intermediate (>3 months and <12 months), and long-term (≥12 months) followups. Pooled effects were calculated using the standardized mean difference (SMD), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used in summary conclusions.ResultsEight published trials and 6 registered trials were included. For the short-term followup, pooling of 6 trials showed no significant effect (SMD 0.34, 95% confidence interval -0.09, 0.77) between a physical activity intervention and no/minimal intervention. Similarly nonsignificant results were found for the intermediate and long-term followups. The overall evidence according to the GRADE approach was classified as low quality.ConclusionOur findings suggest that physical activity-based interventions may lead to little or no difference in objectively measured physical activity levels of patients with chronic musculoskeletal pain compared with no/minimal interventions. Given the number of registered trials, the pooled effect found in this review is likely to change once the results of these trials become available.© 2016, American College of Rheumatology.

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