TY  - JOUR
AU  - Zhu, Beiyao
AU  - Zhu, Dian
AU  - Xue, Xiao'ao
AU  - Yang, Hongyi
AU  - Zhang, Shurong
PY  - 2025
DA  - 2025/3/19
TI  - Behavioral Therapy–Based Digital Interventions for Treating Osteoarthritis: Systematic Review and Meta-Analysis
JO  - J Med Internet Res
SP  - e56227
VL  - 27
KW  - osteoarthritis
KW  - digital intervention
KW  - behavioral therapy
KW  - treatment
KW  - systematic review
KW  - meta-analysis
KW  - pain
KW  - impairment
KW  - quality of life
KW  - socioeconomic burden
KW  - psychotherapy-based digital intervention
KW  - patient
KW  - pain reduction
AB  - Background: Osteoarthritis (OA) is characterized by pain, functional impairments, muscle weakness, and joint stiffness. Since OA heightens reliance on heath care resources and exacerbates socioeconomic burden, remote OA rehabilitation using digital technologies is rapidly evolving. Objective: The aim of this study was to analyze the efficacy of behavioral therapy–based digital interventions for patients with OA. Methods: This study is a systematic review of randomized controlled trials (RCTs) that assessed the effects of behavioral therapy–based digital intervention tools for OA. These RCTs were searched from inception to June 2023 in the Web of Science, Embase, Cochrane Library, Ovid, and PubMed databases. Results: Ten eligible RCTs comprising 1895 patients with OA were included. Digital tools based on either cognitive behavioral therapy (CBT) or behavior change technique (BCT) were investigated. All studies demonstrated low-to-moderate effects on pain reduction in the short term (standardized mean difference [SMD] –0.20, 95% CI –0.35 to –0.05). Six studies reported improvement in physical function (SMD –0.20, 95% CI –0.41 to 0.00), and 5 confirmed increased pain self-efficacy (SMD 0.22, 95% CI 0.02-0.42). In subgroup analysis, compared with CBT, BCT-based digital interventions demonstrated their effects on pain reduction (SMD –0.25, 95% CI –0.49 to 0.00) and physical function (SMD –0.26, 95% CI –0.54 to –0.01) in the short term. In addition, physiotherapist involvement in treatment had a positive effect on pain control (SMD –0.14, 95% CI –0.27 to –0.02). Furthermore, web-based digital tools improved physical function in the short term (SMD –0.28, 95% CI –0.54 to –0.01). Conclusions: Moderate- and low-quality evidence supported that behavioral therapy–based digital tools improved pain intensity, physical function, and self-efficacy in the short term. However, affective interactions between patients and professionals may affect the clinical outcomes. Trial Registration: PROSPERO CRD42023430716; https://tinyurl.com/yc49vzyy 
SN  - 1438-8871
UR  - https://www.jmir.org/2025/1/e56227
UR  - https://doi.org/10.2196/56227
DO  - 10.2196/56227
ID  - info:doi/10.2196/56227
ER  -