Evaluating the Effectiveness and Technique Composition of Combined Motor Learning and Behavior Change Strategies for Movement Behavior in Chronic Musculoskeletal Pain: A Systematic Review.
Ingrid van Duijvenbode, Matthijs Tuijt, Cindy Veenhof and 3 others
PMID 42769590WHAT IT FOUND
Combining motor learning, behavior change, self-management support, and exercise therapy may improve how people with chronic musculoskeletal pain moved, but not how much they moved.
Effects on daily activities were inconsistent.
Key findings
01The review found moderate evidence that combined motor learning, behavior change, self-management support, and exercise therapy improved quality of movement behavior, but insufficient evidence for movement quantity.
02For activities of daily life, 15 studies used 23 outcome measures, and half favored the combined strategies while half did not.
03The interventions mostly used explicit motor learning techniques and a limited set of behavior change techniques, so the review could not show which components drove the effects.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 16 trials were included, and they had different diagnoses, controls, session numbers, and techniques. Most outcome measures were rated high risk of bias, and 5 had some concern. The review did not pool results statistically, so it cannot give a single effect size. Few studies measured movement behavior directly, and the tools used were not standardized. Many interventions did not describe the motor learning or behavior change techniques clearly enough to identify active components. Patients and therapists usually knew the treatment, and many outcomes were self-report. Control groups varied widely, from no treatment to active exercise or usual care. The search stopped in January 2023 and did not search registries for ongoing studies.
Declared interests
Three authors report serving on the scientific council of the Dutch Society for Exercise Therapists. The other authors declared nothing.
The easy way to misread this
Do not read the positive movement-quality result as proof that daily activities improve or that any single component caused the effect. The interventions combined motor learning, behavior change, self-management support, and exercise therapy, and the review found inconsistent evidence for activities of daily life.