Rehabilitation and Management Interventions for People with Chronic Musculoskeletal Condition/S And Mental Distress: A Systematic Scoping Review

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Currently, mental and physical healthcare is often segregated despite growing recognition for integrative interventions. This review aimed to map out and provide an overview of non-pharmacological management and rehabilitation interventions for adults with long-term MSK conditions and mental distress, to identify evidence gaps and provide recommendations for future research. Method MEDLINE, CINAHL, PsycInfo, and Cochrane Library were searched for peer-reviewed articles published between 2003 and 2024 for studies involving rehabilitation/ management interventions for adults with long-term MSK conditions and mental distress. Titles and abstracts were divided among three reviewers for screening and full-texts of included articles were screened by two. Data were extracted on year, location, condition, design, key intervention characteristics and outcomes. Results Fifty-seven primary studies involving 62 interventions were included. Most studies (70%) were Randomised Controlled Trials conducted in Europe (65%), with substantial heterogeneity in the design of the remaining studies. 42% included adults with low back pain and five major intervention approaches were identified: In-person multidisciplinary, Internet, digital and telephone, Additional in-person psychological, Education-based, and Predominantly self-management. Eight studies did not fit a distinct category. Most interventions were conducted in primary or tertiary care, all included a physical activity/exercise component and 65% integrated psychologically-orientated strategies, of which Cognitive Behavioural Therapy was the most common, while 35% were undefined. 54% were delivered by multidisciplinary teams involving physiotherapists. There was substantial heterogeneity in outcome measures, with 202 outcome measures identified spanning 13 domains and 22 subdomains. Only 19% of studies included economic evaluations. Conclusions This review highlights global interest on the topic, with a growing number of studies evaluating internet, digital and telephone interventions, however insufficient intervention reporting and limited representation from community-based and low-income settings reduces global relevance. The findings are broadly discussed in relation to physiotherapists’ role in psychologically-orientated care when access to psychologists is limited, promoting access to care with a focus on underserved and low-income communities, and reporting for an international audience. Systematic Review Registration: Open Science Framework registration (OSF) on the 13th July 2023 https://osf.io/489fj/ Musculoskeletal chronic conditions Mental distress Non-pharmacological interventions Physiotherapist Rehabilitation Scoping review Figures Figure 1 Figure 2 Figure 3 Background Musculoskeletal (MSK) conditions pose significant global challenges for healthcare, affecting 1.71 billion people worldwide [ 1 ] and accounting for the leading cause of Years Lived with Disability (YLD) [ 2 ]. In the United Kingdom (UK), MSK conditions affect approximately one third of the population, with prevalence rates ranging between 26.9% and 30.1% across all age groups [ 3 , 4 ]. MSK-related issues account for 20% of all General Practitioner (GP) consultations in the UK every year. These conditions account for the third-largest area of expenditure within the National Health Service (NHS), costing approximately £5 billion annually [ 4 ], and are also among the primary cause of work-related absenteeism, contributing to 23.4 million working days lost in 2022 [ 4 ]. MSK conditions including osteoarthritis, back and neck pain are characterised by a range of acute and chronic presentations. Common symptoms include pain, stiffness, fatigue, and reduced mobility, which have substantial impacts on quality of life, independence, and wellbeing [ 5 ]. People with chronic MSK conditions are also more likely to experience mental health conditions, or mental distress (encompassing non-specific symptoms of stress, depression and anxiety, indicating impaired mental health), compared to those without [ 6 , 7 ], and around 30% − 60% of people with chronic MSK conditions are reported to be living with both [ 8 ]. MSK conditions and mental distress influence each other through a bidirectional relationship. Chronic pain and impaired mobility can lead to anxiety, depression or stress, while mental distress can heighten the perception of pain and reduce motivation for physical activity, increasing the risk of exacerbating MSK conditions [ 9 ]. Due to this complex interaction of factors, people with MSK conditions and mental distress are at higher risk of poor clinical outcomes [ 10 – 12 ], posing challenges for rehabilitation. Currently within the NHS, a gap remains between physical rehabilitation and psychologically-orientated care, as physical and psychological health are often managed separately [ 13 ]. Integrative rehabilitation and management interventions, involving physiotherapists, psychologists and other specialist are therefore increasingly important, and there has been rising interest towards developing and evaluating integrative interventions for people with long terms MSK conditions and mental distress. This systematic scoping review aimed to comprehensively map out the breath and range of published literature on non-pharmacological rehabilitation and management interventions for people with chronic/long-term MSK condition(s) and mental distress in terms of: 1) year and location of publication, 2) condition(s) of interest, 3) intervention setting, 4) key interventions and components, 5) intervention provider(s), 6) mode of delivery, 7) study outcome measures 8) dosage, 9) baseline and follow-up assessment time points and 10) economic evaluation. During this mapping process, comparator interventions where available were mapped out. Outcome measures associated with the identified interventions were mapped out including those related to function and disability according to the World Health Organisation (WHO) dimensions [ 14 ], quality of life, economic or financial impact, and symptoms such as pain, fatigue, stiffness, and mental health symptoms e.g. anxiety and depression. Knowledge gaps and recommendations for future research were identified by the team. Methods This scoping review adhered to the methods outlined by Arksey and O’Malley’s methodological framework [ 15 ] and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) [ 16 ] (Additional file 5). A multidisciplinary team including clinical, research, and academic physiotherapists, a psychiatrist, nurse, psychology researcher developed the protocol and conducted the review. Two expert librarians provided support to develop the search strategy and conduct the electronic database searches. Eligibility Criteria The inclusion and exclusion criteria (Table 1 ) were developed from preliminary feasibility searches conducted in accordance with the Joanna Briggs Institute (JBI’s) guidance [ 17 ] (Additional file 1). Inclusion criteria were developed using a PC(ICO)C approach, which combines the Population, Concept, Context (PCC) approach recommended by JBI’s methodological guidance for scoping reviews [ 17 ] and the Population, Intervention, Comparison, Outcomes (PICO) [ 18 ] approach [ 19 ]. Table 1 Inclusion and Exclusion Criteria Category Inclusion Criteria Exclusion Criteria Population/Participants Adults with long-term/ chronic musculoskeletal conditions, pain and mental distress Paediatric population (< 18 yrs old) Patients with cancer-related or other non-musculoskeletal conditions Patients with acute (and not long-term) conditions or trauma Patients suffering only from migraine Concept Interventions Rehabilitation, Physiotherapy/physical therapy, Self-management, supported self-management, multi-modal and/or multidisciplinary interventions, Physical activity, Biopsychosocial approach, Pain management programmes, Psychological therapies (e.g. CBT), CFT, Psychologically informed physiotherapy, Internet-based programmes, Motivational Interviewing, Pain neuroscience education Pharmacological interventions (e.g. opioids, cannabinoids, other pain management medication) Surgical interventions Comparators Collect at literature search/review stage to inform future trials Outcomes Function, Disability according to WHO three dimensions – impairment, activity limitation, participation restrictions in normal daily activities; Economic/financial impact, Quality of Life, return/modify/adapt to work, cost effectiveness, Symptoms (such as pain, fatigue, stiffness), Mental distress/psychological outcomes (depression, anxiety, fear) Studies which do not report interventions or outcomes Context Physical health setting, Global context Mental health setting Study design Systematic reviews of systematic reviews/meta-analyses, systematic reviews, RCTs, CCTs, observational, cohort studies, surveys, qualitative studies. Case studies/series, editorials, commentaries, literature reviews, expert opinion pieces, theoretical approaches, animal trials [Insert Table 1 ] Information sources An iterative and extensive search was conducted to ensure breadth and comprehensiveness of coverage [ 20 – 22 ]. Three electronic databases were searched to identify studies published between 1st April 2003 and 31st May 2023 to capture a broad and meaningful span of literature sufficient to identify trends. Searches were initially conducted between May 2023 and June 2023 by (AA) and a librarian, in four databases: CINAHL, Cochrane Library, PsychInfo and MEDLINE. The search was updates by a second librarian (MK) in May 2024 to ensure that recently published articles were not missed. The reference lists of all included studies were screened to identify any further studies meeting the eligibility criteria that were not identified from the initial searches [ 20 ]. Grey literature were not searched as the review aimed to map out published research. Search An initial search strategy was developed (AA, CML), which was reviewed by the team and refined in consultation with an expert librarian. This search strategy was initially developed for Ovid MEDLINE using MeSH (Medical Subject Headings) and keywords (Additional file 2). Terms included: “Chronic NEAR Pain”, “Musculoskeletal Condition*”, “Persistent NEAR Pain”, “Widespread NEAR Pain”, “Psychological Distress”, “Emotional Distress”, “Emotional Stress”, “Depress*”, “Anxiety”, “Anxiousness”, “Depressive Disorder”, “Pain Management”, “Rehabilitation”, “Intervention*”, “Physical therap*”, “Physiotherap*”, “Quality of Life”, “Fatigue”, “Disabilit*”, “Impairment”, “Activity Limitation”, “Financ*”, “Activities of daily living”. The full electronic search strategy for all databases can be found in Additional file 3. To eliminate irrelevant results, search limitations were imposed based on type (i.e., journal article, government report), methodology (i.e., clinical trials, clinical studies, comparative studies, randomised controlled trials, meta-analyses, systematic reviews), and population (i.e., humans). Selection of sources of evidence After the initial searches, two reviewers (AA, MT) manually screened all articles and sources to remove duplicates. Three reviewers (AA, CML, and MT) independently screened the titles and abstracts of the first 100 articles and discussed any discrepancies until consensus. Once the findings were consistent, the remaining articles were divided between three reviewers (AA, RT and MT) and one other member of the team (CML) provided expertise when there were doubts. Any further uncertainties regarding eligibility were resolved through discussion and consensus with the wider team. Full text articles were subsequently obtained for potentially eligible studies and were independently screened by three reviewers (AM, MT, RT). Any discrepancies were resolved through discussion and consensus among the review team. Data Charting Process and Data Items A data extraction template was developed in MS Excel (AA, CML) and reviewed by the team to ensure it was fit for purpose. This bespoke proforma was piloted before with three studies (AA and CML) and compared for accuracy between reviewers. The extracted data items included; a) date of publication, b) location of research, c) study design, d) condition(s) of interest, e) intervention setting, f) key interventions, g) intervention provider, h) mode of delivery, i) dosage, j) study outcome measure, k) assessment and follow-ups and l) economic evaluation. Once the pilot phase was complete and inter-agreement was determined for 20% of the articles by two reviewers (AM, MT), the remaining data were extracted by three reviewers (AM, MT, RT), then checked for accuracy by a second reviewer. As with the screening, any uncertainty regarding eligibility was resolved though discussion and consensus with all authors. Upon completion of data extraction for all included articles, two senior authors (RT and MT) proceeded to chart the data. Synthesis of results Unlike systematic reviews, which aim to synthesise findings to answer specific research questions, scoping reviews focus on summarising the findings of included studies to provide a comprehensive overview of the topic, mapping the breadth and scope of the existing literature. Data were therefore synthesised narratively and performed as per protocol by two authors (MT and RT), with discussions and review by CML, AJ, PR and AA. Data were synthesised in line with the published protocol and the results were presented and charted using tables, graphs and thematic maps to illustrate key patterns, trends and gaps in the literature. Results Following deduplication, a total of 7,480 unique records were identified from the searches and screened by the titles and abstract, of which 99 were included for full-text. Fifty-eight articles were included after this screening round, and an additional seven articles were found eligible from the bibliographies of the included articles that were retrieved manually, resulting in 65 articles included. The selection process was charted using PRISMA flow diagram in Fig. 1 [ 16 ] and a summary of the included studies are presented within Table 2 . To avoid duplication, data from systematic reviews (n = 8) [ 23 – 30 ] were extracted but excluded from the data synthesis, as some primary studies included within those reviews were also identified in the database search. The data synthesis therefore presented from here onwards includes the 57 primary studies, however a summary of the systematic reviews has been compiled in Additional File 4 to ensure a comprehensive overview. This approach ensured the accuracy and distinctiveness of the data analysed, while the summary of systematic reviews offers an additional resource for contextual understanding. Table 2 – Summary of included studies In-Person Multidisciplinary and Interdisciplinary Approach Author, Year, Country Design & Aim (s) Primary Condition (s) & Participants Intervention (s) Description, Dosage & Evaluation points Mode of Delivery, Setting & Intervention Provider Key Outcome Measure Domains Reported Conclusions Amris K et al. 2014 Denmark [ 81 ] RCT, Single centre (1:1) To evaluate the functional and psychological outcomes of a multicomponent treatment course compared with a waiting list control. Chronic Widespread Pain n = 191 IG n = 96 CG n = 95 IG: multicomponent treatment non-residential course involving medication, cognitive behavioural therapy, patient education, and exercise. CG: Waiting list Dosage : IG: daily programme for 2 weeks (35 hours total). CG: n/a Evaluations points : Baseline & Post Intervention & 6 months Mode : Not reported Setting : IG: Rheumatology service CG: n/a Intervention provider : IG: rheumatologist, psychologist, nurse, physiotherapist and occupational therapist. CG: n/a • Measures of function • Quality of Life • Mental/psychological health measures • Progress and agency The 2-week multicomponent treatment course resulted in observable improvement of functional ability in a subgroup of patients at 6-month follow-up. This improvement, however, was not reflected in secondary patient reported outcomes, including scores of self-reported functional abilities on standardised questionnaires. Borys C et al. 2015 Germany [ 68 ] RCT, Single centre (1:1) To examine the effectiveness of an intensive inpatient multimodal therapy (MMT) programme. LBP n = 155 IG n = 89 CG n = 66 IG: individually-adjusted treatment including: medical treatment (modification of analgesic medication), behavioural management (education, biofeedback and cognitive-behavioural therapy), physiotherapy and active training sessions (Nordic walking). CG: waiting list Dosage : IG: 8 hours per day, 6 days a week for 3 weeks (144h total) CG: n/a Evaluation points : Recruitment, Begin and End of intervention, 3 & 12 months Mode : IG: F2F CG: n/a Setting : IG: In-patient pain centre CG: n/a Intervention provider : IG: pain physicians, psychotherapists, physiotherapists, and pain nurses. CG: n/a • Pain and pain related measures • Mental/ Psychological health measures • Economic Multimodal therapy may be effective with regards to improvements in pain intensity, depression, anxiety, and well-being. Brendbekken R et al. 2016 Norway [ 78 ] RCT, Single Centre (1:1) To compare the effects of a Multidisciplinary Intervention (MI) and a Brief Intervention (BI), on mental and physical health complaints, functioning ability and coping in patients on long-term sick leave due to MSK complaints. Chronic MSK Pain n = 284 IG n = 141 CG n = 143 IG: interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET) to graphically visualise social and physical problems. ISIVET used to decide ways to go forward, and agreement on actions written down to form rehabilitation plan, typically related to cognitive assessment of health, fear avoidance and catastrophic thinking etc. CG: two consultations based on 'non-injury model' to reduce fear and concern through a medical examination, with education about the physiological model on MSK pain. Dosage : IG: 3 sessions (ranging 1-3.5h) over 3 months CG: 2 sessions (ranging 1-2.5h) over 2 weeks. Evaluation points : Baseline, 3 and 12 months Mode : IG: F2F and phone CG: Treatment manuals and video taped Setting : IG & CG: Specialist outpatient clinic Intervention provider : IG – 4 physicians, 2 social workers and 4 physiotherapists CG - a physician and physiotherapist • Mental/psychological health measures • Pain and pain related measures • Measures of function • Progress and agency • Economic MI may represent an important supplement in the treatment of musculoskeletal pain. Hamnes B et al. 2012 [ 76 ] Norway RCT, Single Centre (1:1) To evaluate the effects of a multidisciplinary inpatient self-management programme (SMP) on psychological distress, skills as a consumer of health services, self-efficacy, and functional and symptomatic consequences of fibromyalgia. Fibromyalgia n = 150 IG n = 75 CG n = 72 IG: SMP based on a cognitive behavioural approach and focus on enhancing self-efficacy and coping with the disease and daily life. Participants receive individual consultations with the multidisciplinary team if needed. CG: Waiting list Dosage : IG:23.5 hours over 1 week CG: No reported Evaluation points : Before randomisation & 3 weeks before intervention & 3 weeks after intervention & 6 months (planned, but not collected) Mode : IG: F2F CG: n/a Setting : IG: Inpatient Rheumatology service CG: n/a Intervention provider : IG: OT, dietician, nurse, physiotherapist, representatives from patient organisations, rheumatologist, social worker CG: n/a • Mental /psychological health measures • Measures of function • Progress and agency SMP had no effect on psychological distress, functional and symptomatic consequences and self-efficacy, except for a small short-term effect on skills and behaviour that are important for managing and participating in health care. Hampel P et al. 2019 Germany [ 69 ] RCT, Cluster-block To analyse the long-term effects of the modified combined cognitive-behavioural pain competence and depression prevention training in a different rehabilitation setting. CLBP n = 1306 IG n = 637 CG n = 669 IG: Combined pain competence training, plus four modules of depression prevention training. All 8 modules consisted of group interventions guided by a psychotherapist and group workshop without a psychotherapist. CG: Pain competence training Dosage : IG: 3–4 weeks, plus 75-min group interventions and 25-minutes group workshop. CG: 3–4 weeks Evaluation points : Baseline &12 months Mode : IG & CG - F2F Setting : IG & CG: Inpatient rehabilitation clinic Intervention provider : IG & CG: physiotherapist, psychotherapist and other members not described. • Mental/psychological health measures • Work • Progress and agency Patients with high levels of depressive symptoms showed improvements in depressive symptoms and self-efficacy. However, the beneficial long-term effects of rehabilitation on work ability and pain-related sick leave among the IG support implementation of combined pain competence and depression prevention training. Haugmark T et al. 2021 Norway [ 44 ] RCT, Single Centre (1:1) To study the effects of a community-based multicomponent rehabilitation programme comprising the Vitality Training Programme (VTP) followed by 12 weeks of physical activity (PA) counselling in patients with recently diagnosed Fibromyalgia. Fibromyalgia n = 170 IG n = 85 CG n = 85 IG: A mindfulness and acceptance-based group programme followed by physical activity counselling. Included patient education, mindfulness & meditation, in addition to individual and group physical activity counselling to set goals/ identify barriers to physical activity. CG: Usual treatment. Dosage : IG: 10 weekly 4-hour sessions, with a booster session 6 months after the initial sessions CG: Unorganised intervention Evaluation points : Baseline & 3 months for IG & 12 months for IG and CG Mode : IG & CG - F2F Setting : IG & CG - Rural and urban community Intervention provider : IG: Nurses and physiotherapists CG: Not reported • Progress and Agency • Pain and pain related measures • Mental/psychological health measures • Trial/intervention evaluation • Work • Quality of Life A multicomponent rehabilitation programme combining patient education with a mindfulness-based and acceptance-based group programme followed by physical activity counselling was not more effective than patient education and treatment as usual for patients with recently diagnosed fibromyalgia at 12-month follow-up. Kaapa E et al. 2006 Finland [ 36 ] RCT Single Centre (1:1) To evaluate the effectiveness of low-cost semi-intensive outpatient multidisciplinary rehabilitation (MR) compared with individual physiotherapy (IP) CLBP n = 120 IG n = 64 CG n = 66 IG: Physical training, workplace interventions, back school education, relaxation training, and cognitive-behavioural stress management methods. CG: Physiotherapy Dosage : IG: 70 hours over 8 weeks CG1:10 hours over 6 to 8 weeks Evaluation points : Baseline & two middle treatment (6 & 12 months) & post treatment (24 months) Mode : IG & CG: F2F Setting : IG & CG: Outpatient rehabilitation centre Intervention provider : IG: A physiotherapist, two occupational physiotherapists, a psychologist, and a physician CG: Physiotherapists • Pain and pain related measures • Disability • Mental/ psychological health measures • Work • Economic Semi-intensive outpatient multidisciplinary rehabilitation programme for female chronic low back pain patients does not offer incremental benefits when compared with rehabilitation performed by a physiotherapist having a cognitive-behavioural way of administering the treatment. Lemstra M & Olszynski W 2005 Canada [ 35 ] RCT Single Centre (1:1) To assess the effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia in comparison to standard medical care. Fibromyalgia n = 79 IG n = 46 CG n = 36 IG: 18 group supervised exercise therapy sessions, 2 group pain and stress management lectures, 1 group education lecture, 1 group dietary lecture and 2 massage therapy sessions. CG: medical specialist referral (8%), referral to treatment (53%), education (3%), medication (22%), further diagnostics (3%), and nothing at all (11%). Dosage : IG 25 sessions over 6 weeks (more than 14 hours not all hours reported) CG: Not reported Evaluation points : Baseline & 15 months Mode : IG & CG: F2F Setting : IG & CG: Community-based, non-clinical Intervention provider : IG: Dietitian, massage therapist physical therapist, psychologist and rheumatologist CG: Patients’ family physician • Pain and pain related measures • Mental/psychological health measures • Disability • Progress and agency • Work Positive health-related outcomes can be obtained with a low-cost, group multidisciplinary intervention in a community-based, nonclinical setting. Lera S et al. 2009 Spain [ 39 ] RCT Single Centre (1:1) To compare the ability of two Multidisciplinary Treatments (MTs), with and without Cognitive Behaviour Therapy (CBT), to reduce Fibromyalgia symptoms and increase quality of life. Fibromyalgia n = 83 IG n = 40 CG n = 43 IG: MT combined with CBT. CBT sessions focused on coping with stress, modifying lifestyles, changing pain behaviours, and improving mental health. CG: MT, which included medical intervention, physical training, education, and discussion about the condition. Dosage : IG 1: 15 weeks, with sessions held once a week for a duration of 1 hour each. CG: sessions were 90 minutes long and occurred before each multidisciplinary treatment session, except for the first one. Evaluation points : Baseline & Post-treatment & 6 months Mode : IG & CG: F2F Setting : IG & CG: Tertiary hospital Intervention provider : IG: a rheumatologist, a rehabilitation practitioner, a physiotherapist, and a clinical psychologist trained in CBT techniques. CG: a rheumatologist, a rehabilitation practitioner, a physiotherapist. • Measures of function • Quality of Life • Mental/psychological health measures MT improves functional capability and reduces symptom impact. CBT increases mildly the effect of MT in patients with fatigue. Mangels M et al. 2009 Germany [ 40 ] RCT Single Centre (1:1:1) To investigate whether additional psychologic interventions in the context of multidisciplinary inpatient pain treatment increase treatment efficacy compared with normal orthopaedic rehabilitation. Chronic back pain (CBP) n = 363 IG1 n = 113 IG2 n = 119 CG n = 131 IG 1: A behavioural-medical inpatient rehabilitation programme with a multidisciplinary treatment approach: group session for pain management; muscle relaxation training; and additional psychologic interventions - individual and in group. IG 2: An additional booster session by telephone within 12 months after discharge for the patients who participated in the behavioural-medical rehabilitation treatment CG: Normal orthopaedic rehabilitation Dosage : IG 1: for 4 weeks − 9 group sessions of 90 minutes each and weekly individual sessions with the psychotherapist or in a group size of 10 to 12 patients. IG 2: as peer intervention 1 with an additional 7 booster sessions, 12 months after discharge with the duration of 20 minutes each CG: for 4 weeks − 9 group sessions of 90 minutes each Evaluation points : Baseline & post-treatment & 1-year follow-up Mode : IG1 & CG: F2F IG2: F2F and phone Setting : IG1 & IG2 & CG: Orthopaedic Rehabilitation Hospital Intervention provider : IG1 & IG2: Multidisciplinary team and two trained clinical psychologists CG: Multidisciplinary team • Disability • Mental/ psychological health measures • Pain and pain related measures • Progress and agency • Quality of Life • Measures of function All 3 treatment conditions were effective in improving core outcome measures in chronic back pain patients in the short term. However only slight advantages for the behavioural-medical treatment with subsequent booster sessions compared with the condition without a further maintenance. Martin et al. 2012 Spain [ 64 ] RCT Single Centre (1:1) To assess the efficacy of a 6-week interdisciplinary treatment that combined coordinated psychological, medical, educational, and physiotherapeutic components (PSYMEPHY) over time, compared to standard pharmacologic care. Fibromyalgia n = 180 IG n = 54 CG n = 56 IG: PSYMEPHY, combined & coordinated psychological, medical, educational, and physiotherapeutic components. The programme targeted three domains: cognitive, physiological, and behavioural included on the psychological component focused on CBT interventions. CG: Standard pharmacologic care, which included pharmacological treatment with a tricyclic antidepressant (amitriptyline, an analgesic (paracetamol,), and an opioid central analgesic (tramadol), Dosage : IG: 6 weeks with 12 sessions, with each patient attending twice-weekly group sessions of 105 minutes for 6 weeks CG: Not reported Evaluation points : Baseline & The follow-up times were at 6 months for IG and CG & 12 months for IG Mode : IG: F2F CG: Not reported Setting : IG & CG: Pain management unit an hospital Intervention provider : IG: A physician, clinical psychologist, and a physiotherapist CG: Not reported • Measures of function • Quality of life • Mental/psychological health measures An interdisciplinary treatment for Fibromyalgia was associated with improvements in quality of life, pain, physical function, anxiety and depression, and pain coping strategies up to 12 months after the intervention. Neumann A and Hampel P 2022 Germany [ 51 ] RCT Cluster-block To examine the effects of a combined pain competence and depression prevention training compared to the pain competence training and as well as the patients’ stages of pain on the long-term psychosocial rehabilitation programme. CLBP n = 1036 IG n = 637 CG n = 669 IG: Treatment as usual plus cognitive-behavioural pain management and depression prevention training, (called Debora), in addition to elements of mindfulness-based interventions. Group workshops without educators were also included. CG: Treatment as usual plus relaxation exercises. Dosage : IG 3–4 weeks, 4–8 group sessions lasting 75 mins each. Group workshops 25 mins each. CG: 3 to 4 weeks. Evaluation points : Baseline & 6 & 12 months Mode : IG & CG: F2F Setting : IG & CG: Inpatient multidisciplinary rehabilitation clinics. Intervention provider : IG: physicians, nursing staff, physiotherapists and psychotherapist & CG - physicians, nursing staff and physiotherapists • Mental/ psychological health measures • Pain and pain related measures • Quality of Life Multidisciplinary rehabilitation seems to be appropriate for patients with CLBP in stage of pain I and II. However, patients in stage of pain III need more psychological treatments to manage their mental comorbidities Saral I et al. 2016 Turkey [ 74 ] RCT Single Centre (1:1:1) To investigate the effects of long- and short-term interdisciplinary treatment approaches for reducing symptoms and improving HRQoL and physical functions of patients with fibromyalgia. . Fibromyalgia n = 66 Intervention Group Long Term (IGLT) n = 22 Intervention Group Short term (IGST) n = 22 CG n = 22 IGLT & IGST approaches combined CBT, exercise training, and educational programmes related to fibromyalgia. IGLT: CBT focused on enhancing awareness of the relationship between stressful life events, emotions/ thoughts/ behaviours, and symptomatic patterns. It also aimed to develop coping skills for stressful life events and pain, and increase the ability to express emotions and opinions. Participants were given time to practice aerobic, stretching, and strengthening exercises. IGST: Same as IGLT, but shorter duration. CG: advised to continue previous treatments without change. Dosage : IGLT: CBT: 3 hours per session, once a week for 10 weeks. Total of 30 hours. One full day of education and practice. Patients were prescribed home exercise programmes, including aerobic exercises (walking) 3 days a week for 20–30 minutes, and strengthening and stretching exercises twice a day, 5 days a week, with 5 repetitions for each exercise. Education: 1 full day of education about fibromyalgia, its treatment, and the benefits of exercise. IGST: Education: 4 hours. Exercise Training: 4 hours. CBT: Two 3-hour sessions over two consecutive days. Total of 6 hours. CG: Not reported Evaluation points : Baseline & 6 months Mode : IGLT &IGST: F2F CG: n/a Setting : IGLT &IGST & CG: Outpatient clinic Intervention provider : IGLT & IGST: A psychologist specialising in clinical psychology and CBT: A physical therapist, and a team of specialists not stated. CG: Not reported • Pain and pain related measures • Measures of function • Mental/psychological health measures Both, long and short-term interdisciplinary treatments were effective in reducing the severity of some symptoms and disease activity in patients with fibromyalgia. However, a long-term program may be beneficial in reducing fatigue and improving physical function to a higher extent. Schmidt A et al. 2020 Denmark [ 73 ] RCT Single Centre (1:1) To compare the effectiveness of an integrated programme with the existing programme in terms of back-specific disability. CLBP n = 164 IG n = 82 CG n = 82 IG a mix of homebased activities and inpatient stay (a total of 15 inpatient days). CG: a four-week inpatient stay and 26-week follow-up. Dosage : IG: three weeks of inpatient stay (8–10 hours per day) and 12 weeks of home-based activities. CG: four weeks of inpatient stay & 26-week follow-up (a total of 21 inpatient days). Evaluation points : Baseline & 26-weeks Mode : IG & CG: F2F Setting : IG & CG: Rheumatology inpatient rehabilitation centre Intervention provider : IG & CG: Multidisciplinary team job titles not reported • Disability • Pain and pain related measures • Quality of Life • Mental/ psychological health measures • Progress and agency • Physical activity/performance/ exercise related measures An integrated rehabilitation programme was no more effective than an existing rehabilitation programme at the 26-week follow-up. Serrat M et al. 2021 Spain [ 43 ] RCT, Single Centre (1:1) To analyse the effectiveness of a multicomponent treatment based on Pain Neuroscience Education (PNE), CBT, and mindfulness training, as an add-on to treatment as usual (TAU) to improve functional impact as well as pain, fatigue, kinesiophobia, physical function, anxiety, and depressive symptoms. Fibromyalgia n = 272 IG n = 135 CG n = 137 IG: The multicomponent treatment included four main components including: (1) PNE, which aimed to change how patients understood pain, (2). Therapeutic Exercise, involving stretching, balance training, posture correction, and low-impact walking, (3) CBT and (4 Mindfulness Training. CG: Treatment as usual. Dosage : IG: groups of 20 patients per session, with a frequency of one 2-hour weekly session for 12 weeks. CG; advised to follow treatment for 3 months/ 12 weeks. Evaluation points : Baseline& post-treatment & 6 and 9 months Mode : IG: F2F CG: Not reported Setting : IG & CG: Tertiary care hospital Intervention provider : IG: Physical therapist & a health psychologist CG: Not reported • Measures of function • Pain and pain related measures • Mental/psychological health Compared with usual care, there was evidence of short-term (up to 3 months) positive effects of the multicomponent treatment for fibromyalgia. Some methodological shortcomings (eg, absence of follow-up in the control group and monitoring of treatment adherence, potential research allegiance) preclude robust conclusions regarding the proposed multicomponent program. Teixeira M et al. 2024 United Kingdom [ 61 ] RCT Single Centre (1:1) To determine the feasibility and acceptability of conducting a future RCT evaluating the clinical and cost- effectiveness of the Collaborative Care Model (CCM) for people with MSK and co-existing mental health conditions. Chronic MSK conditions n = 40 IG n = 20 CG n = 20 IG: CCM involved a tailored mental and physical healthcare intervention, co-ordinated by a Case Manager. The Case Manager organised tailored mental health support according to individual needs identified during initial screening, in addition to develop personalised care plans, co-ordinating psychological and MSK outpatient appointments, monitoring progress adjusting support and streamlining communication between physical and mental healthcare providers CG: usual care involving physiotherapy and occupational therapy. Dosage : IG: A monthly basis, with weekly contacts sometimes needed monthly basis for 6 months. CG: Not reported. Evaluation points : Baseline & post-treatment & 6 months Mode : IG: F2F, phone and video calls CG: F2F Setting : IG & CG: Tertiary hospital outpatient Intervention provider : IG: Physiotherapist & designated case manager, an assistant psychologist CG: Physiotherapists and or occupational therapist • Intervention/trial evaluation • Mental/psychological health measures • Quality of life • Pain and pain related measures • Disability • Economic • Progress and Agency The trial and intervention were acceptable to patients and healthcare professionals. While the findings demonstrate the feasibility of trial recruitment, a future trial will require optimised retention strategies to improve adherence and withdrawal rates. Wippert P et al. 2020 Germany [ 72 ] RCT Multi Centre (1:1:1) To assess the effectiveness of a self-management programme for people with higher pain and to compare it to regular routines. LBP n = 660 IG1 n = 222 IG2 n = 222 CG n = 216 IG1: Sensorimotor Training (SMT) and Behavioural Training (BT). The SMT involved a motor control exercise programme including 4 different exercises aiming to enhance core stability. The BT included a cognitive distraction task during SMT, a body scan after SMT, and psychoeducation component. IG2: SMT CG: Standard care (not described) Dosage : IG1: a 3-week centre-based programme and a 9-week home-based programme. Participants trained three times per week for approximately 30 minutes. IG2: a 3-week centre-based programme and a 9-week home-based programme. CG: Not reported Evaluation points : Baseline & middle (3 weeks) & post- intervention (12 weeks) & 24 weeks Mode : IG1: F2F and home base self- guide & IG2: F2F CG: Not reported Setting : IG1 & IG2 & CG: Orthopaedic outpatient clinics Intervention provider : IG1 & IG2: Experienced sports therapists and physiotherapists CG: Not reported • Pain and pain related measures • Mental/ psychological health measures • Physical activity/performance/ exercise related measures Compared to regular routines, the self-management multidisciplinary treatment led to a clinically relevant reduction of pain–disability and significant mental health improvements. Yamada A et al. 2023 Brazil [ 56 ] RCT, Single centre (1:1) To verify whether physiotherapeutic treatment associated with Pain Neuroscience Education (PNE) could contribute to the reduction of functional disability in patients with nonspecific chronic low back pain (CNLBP). Chronic non-specific lower back pain (CNLBP) n = 40 IG n = 20 CG n = 20 IG: Combination of physical therapy treatment and PNE. The physical therapy protocol focused on kinesiotherapy, which was provided for both the IG and the CG. However, the IG also received 3 individual PNE sessions CG: Only the physical therapy component of the IG. Dosage : IG: 12 physiotherapy sessions, twice a week for a period of 6 weeks. Each session was 50 minutes long. PNE: 3 educational sessions before the 12 kinesiotherapy sessions, totalling 15 sessions. CG: 12 physiotherapy sessions, twice a week for a period of 6 weeks. Each session was 50 minutes long. Evaluation points : Not reported Mode : IG & CG: F2F Setting : IG & CG: Physiotherapy clinic Intervention provider : IG: physical therapist & education researcher CG: physical therapist • Pain and pain related measures • Disability • Mental/ psychological health measures The IG showed significant improvement for all variables. The association showed better results compared to only therapeutic exercises to reduce kinesiophobia and change the perception of pain intensity in the lumbar region. Yeldan I et al. 2024 Turkey [ 62 ] RCT, Single Centre (1:1) To compare the effects of biofeedback sensor and conventional physiotherapist (PT) feedback during core stabilization and activity training in patients with Chronic Non-Specific Low Back pain (CNLBP) CNLBP n = 40 IG n = 20 CG n = 20 Core intervention for both groups included a standard core stabilization and activity training programme. IG: Biofeedback group received auditory and tactile feedback through a validated tilt sensor integrated with an application called Perfect Practice. The application provided feedback when movements exceed a set threshold. CG: Physiotherapist (PT) Feedback group received extensive verbal and tactile feedback from an experienced PT to guide patients to maintain a neutral position. Dosage : Core programme: 12 sessions, spread over 4 weeks, with each session lasting approximately 30 minutes. Core stabilisation and activity training three times a week. The core stabilisation training included progressively graded 9 exercises performed 10 repetitions/3 sets. The activity training programme consisted of 6 daily living activities in each session. All six daily living activities performed for 1–2 min, 10 min in total for each session. Evaluation points : Baseline & Post-treatment Mode : IG & CG: F2F Setting : IG & CG: Department of Orthopaedics and Traumatology, tertiary hospital Intervention provider : IG & CG: Physiotherapist • Disability • Pain and pain related measures • Physical activity/performance/ exercise related measures Biofeedback sensor or PT feedback during core stabilization training equally improves pain, disability, muscle activity, depressive symptoms, patient beliefs, and quality of life in patients with CNLBP. Chatzitheodorou, D et al. 2007 Greece [ 37 ] Pilot RCT To investigate the effects of high intensity aerobic exercise on pain, disability, anxiety or depression, and serum cortisol concentrations in people with chronic musculoskeletal lumbar pain. LBP n = 20 IG n = 10 CG n = 10 IG: warm-up, followed by aerobic exercises on a treadmill with increasing intensity before session ended with cool down. CG: Passive modalities with no exercise. Dosage : IG: 12 weeks − 15 minutes warm-up, 3 minute cool down. CG: 12 weeks Evaluation points : Baseline & Post-treatment Mode : IG & CG: F2F Setting : Not reported Intervention provider : IG: Physiotherapist & Physician CG: Physiotherapist • Pain and pain related measures • Disability • Miscellaneous/other Regular high-intensity aerobic exercise alleviated pain, disability, and psychological strain in participants with chronic low back pain, but did not improve serum cortisol concentrations. Ollevier A et al. 2020 Belgium [ 86 ] Pilot Cohort prospective To evaluate the effect of multicomponent therapy for fibromyalgia and to explore the predictors for dropout. Fibromyalgia n = 64 The therapy combined physical and psychological components, including exercises using devices and group exercises, relaxation techniques, and workshops. Dosage : 12-week multicomponent therapy programme, involving two-hour sessions twice a week, totalling 24 sessions. Evaluation points : Baseline & Middle (6 weeks) & Post-treatment (2 weeks after) Mode F2F Setting Rehabilitation Centre, secondary care Delivered by OTs physiotherapists, and psychologists under the supervision of a rheumatologist. • Measures of function • Pain and pain related measures • Mental/Psychological health measures • Physical activity/performance/ exercise related measures trial/intervention evaluation A 12-week multicomponent therapy for fibromyalgia, well described and gradually applied, showed improvement in health-related outcomes. Pfeiffer A et al. 2003 USA [ 31 ] Pilot Quasi experimental To determine the effect of a multidisciplinary fibromyalgia treatment program on the impact of illness, depression, and life fulfilment. Fibromyalgia n = 100 A multidisciplinary group treatment programme (Fibromyalgia Treatment Program (FTP)) aimed to increase physical and mental health functioning, provide accurate and research-based information, and create a standardised treatment approach. Programme content included Introductory session about pain and fibromyalgia, self-management utilising a cognitive behavioural approach, focusing on wellness and lifestyle management, OT focusing on energy conservation; and Physical therapy involving exercises such as stretching, strength and aerobic exercise. Dosage : 1.5 day outpatient programme: introductory educational session is 1 hr in length.; 2 self-management sessions lasting 2.5 hr; 1 OT lasting 1 hr; 1 group physical session lasting 1 hour. Evaluation points : Baseline & 1 month Mode : F2F Setting : Outpatient, tertiary medical centre Intervention provider : Registered nurses, rheumatologists, physiatrists, occupational therapists, physical therapists, and ancillary staff. • Measures of function • Mental/psychological health measures A 1.5-day multidisciplinary fibromyalgia treatment program does have a significant positive effect on the impact of illness among patients with fibromyalgia with or without concomitant depression and may be a cost-effective model for the treatment of these patients. McCormick Z et al. 2021 USA [ 46 ] Cohort To investigate whether Complex Regional Pain Syndrome (CRPS) can be effectively treated in a comprehensive interdisciplinary pain management programme. CRPS n = 42 Self-management of chronic pain: relaxation training assisted by biofeedback, pain psychology, occupational therapy, physical therapy, pool therapy, medical management and nursing education. Dosage : 8 hours per day (8 am to 4 pm) & 5 days a week for 4 weeks. Evaluation points : Baseline & Post-treatment & 1 month Mode : F2F (individual or group) Setting : Outpatient urban interdisciplinary pain management programme. Intervention provider : Occupational therapist, nurse, physiotherapist, but other professionals not reported. • Disability • Pain and pain related measures • Physical activity/performance/exercise related measures • Mental/ psychological health measures • Agency and progress • Work This study demonstrates short-term improvements in physical and emotional functioning, pain coping, and medication usage. These findings are consistent with the rehabilitation philosophy of improving functioning and sense of well-being as of equal value and relevance to pain reduction. Cheng S et al. 2017 China [ 87 ] Protocol, RCT Cluster Double blind, 1:1 To investigate the long-term effects (up to 6 months post-intervention) of a multimodal intervention combining physical exercise and cognitive behavioural techniques on alleviating the intensity of pain in older adults with chronic musculoskeletal pain. Chronic MSK pain n = 150 IG n = 75 CG n = 75 IG: physical exercise, cognitive behavioural techniques CG: pain education programme (usual care). Dosage : IG: 10 sessions - physical exercises - each of the ten sessions begins with a 45-minute physical exercise programme that includes a 5-minute warmup and 10-minute stretching, 15-minute strengthening, 10-minute balance, and 5-minute cooldown exercises40-minute training on cognitive behavioural techniques before a 5-minute conclusion. CG: 10 sessions with similar duration to the IG. Evaluation points : Baseline & Post-treatment & month 2 & month 5 Mode : IG: F2F (on group sessions of 6–12 participants) CG: Not reported Setting 20 social centres for older people and outpatient geriatric/ pain clinics. Intervention provider : IG: Research assistant with supervision of a psychologist, physiotherapist and a nursing specialist. CG: Not reported • Pain and pain related measures • Mental/ psychological health measures • Measures of function • Progress and agency • Physical activity/performance/ exercise related measures n/a Oliveira C et al. 2018 Brazil [ 83 ] Protocol, RCT, Single-Centre (1:1) To investigate the efficacy of a multimodal physical activity intervention compared to supervised exercises plus sham coaching and sham activity monitor in patients with chronic, nonspecific CLBP. CLBP n = 160 IG n = 80 CG n = 80 IG: multimodal physical activity intervention consisting of supervised exercises, health coaching and provision of an activity monitor on physical activity levels, pain intensity and disability. CG: the same exercise programme as IG, but with sham health coaching and a sham activity monitor. Dosage : Session with up to 10 people, delivered twice a week for 3 months plus a total of 12 health coaching sessions, each session lasting for 30–60 min, will be provided over a 3-month period & the activity monitor, Fitbit Flex continuous for 3 months during the walking hours. CG: Same exercise programme as IG plus 1 weekly session, each session lasting for 30–60 min, over a 3-month period. Evaluation points : Baseline & post-treatment & 6- and 12-months post-randomisation Mode : IG & CG: F2F and telephone contacts Setting : IG & CG: 2 outpatient physical therapy clinics. Intervention provider : IG & CG: physiotherapists • Physical activity/performance/exercise related measures • Disability • Pain and pain related measures • Mental/ psychological health measures n/a Internet, Digital and Telephone Alzahrani H et al. 2021 Australia [ 45 ] RCT, Single centre (1:1) To examine the feasibility and initial efficacy of a wearables-based walking intervention in addition to usual physiotherapy care in people with LBP at risk of chronicity. LBP n = 26 IG n = 12 CG n = 14 IG: Usual care plus wearable-based walking intervention CG: Usual physiotherapy care involved a combination of home exercises, manual therapy, education and advice to maintain usual physical activity. Dosage : IG: 8 weeks CG: 8 weeks Evaluation points : Baseline & Post- intervention − 9 weeks & 26 weeks post-randomisation Mode : IG: F2F and data collection from remote device CG: Not reported Setting : Private physiotherapy practices Intervention provider : IG: Physiotherapists CG: Physiotherapists • Disability • Pain and pain related measures • Physical activity/performance/ exercise related measures • Mental/psychological health measures Usual physiotherapy care plus a wearables-based walking intervention program was safe and moderately feasible, and provided significant reduction in pain at 26 weeks as well as increasing the total volume of light- and moderate-intensity physical activity, and daily walking steps immediately post-intervention. Bennell K et al. 2018 Australia [ 79 ] RCT, Single centre (1:1) To investigate the hypothesis that an 8-week internet-based Pain Coping Skills Training PCST programme before a physiotherapist instructed home exercise programme would significantly improve walking pain and physical function at 24 weeks compared with the exercise program alone in people with hip OA. Hip OA n = 144 IG n = 73 CG n = 71 IG: Education and pain coping skills training (PCST) and physiotherapy for home exercises prescription. CG: Education and physiotherapy for home exercises prescription. Dosage : IG: First 8 weeks complete the eight 35- to 45-minute modules at a rate of 1 per week and to practice skills daily and on week 8 to 24, physiotherapy 3 times per week, 30 minutes individual sessions (5 sessions). CG: First 8 weeks educational material, 1 sheet per week and on week 8 to 24 physiotherapy 3 times per week, 30 minutes individual sessions (5 sessions). Evaluation points : Baseline & Middle (8 weeks) & Post-treatment (24 weeks) & 52 weeks Mode : IG & CG: F2F and Online Setting : Community-dwelling Intervention provider : IG & CG: MSK physiotherapists • Pain and pain related measures • Additional measures of Osteoarthritis • Quality of Life • Mental/ psychological health measures • Progress and agency • Physical activity/performance/ exercise related measures Online PCST immediately improved pain coping and function but did not confer additional benefits to a subsequent exercise program, despite sustained pain coping improvements. Pak S et al. 2023 USA [ 58 ] RCT Single centre (1:1) To compare clinical outcomes between digital physical therapy and conventional in-person physical therapy in patients with CSP. Chronic shoulder pain (CSP) n = 87 IG n = 46 CG n = 41 IG: The digital intervention consisted of home exercise, education, and CBT, using a device with movement digitalization for biofeedback and asynchronous physical therapist monitoring through a cloud-based portal. CG: Received in-person physical therapy, including exercises, manual therapy, education, and CBT. Dosage : IG: 8 weeks - perform three 20-minute exercise sessions per week (total of 24 sessions). CG: 8 weeks - Two 30-minute sessions per week were prescribed (total of 14–16 sessions). Evaluation points : Baseline & Middle (week 4) & Post-treatment (week 8) Mode : IG: Video- call and smartphone app CG: F2F, telephone and email Setting : IG & CG - Outpatient physical therapy Intervention provider : IG & CG: physical therapist • Disability • Pain and pain related measures • Mental/psychological health measures • Trial/intervention evaluation Fully remote digital programs can be viable care delivery models for CSP given their scalability and effectiveness, assessed through comparison with high-dosage in-person rehabilitation Tore N et al. 2023 Turkey [ 57 ] RCT Single centre (1:1) To examine the effects of simultaneous telerehabilitation with a physiotherapist in patients with Knee OA and to evaluate the quality of the physiotherapy and rehabilitation programme received through telerehabilitation. Knee OA n = 50 IG n = 25 CG n = 25 Same exercises provided for both groups, including knee strengthening, ROM and stretching exercises. IG: telerehabilitation was delivered using the Zoom Meetings application, via video conference simultaneously, accompanied by a physiotherapist. CG: Provided with brochure with guidance on how to perform exercises. Dosage : G: 8 weeks - Zoom Meetings application used it 24 times in total for telerehabilitation, excluding their evaluations. The duration and repetitions of these exercises were increased on a weekly basis. Telerehabilitation was carried out 3 days a week, for 45–60 min a day and for 8 weeks, CG: 8 weeks - Participants made their exercises by themselves. Evaluation points : Baseline & Post-treatment (only 8 weeks after treatment) Mode : IG: Video call CG: Brochure Setting : IG & CG: Not clear Intervention provider : IG: Physiotherapist CG: self-management • Physical activity/performance/ exercise related measures • Additional measures of osteoarthritis • Pain and pain related measures • Mental/psychological health measures • Trial/intervention evaluation This study indicated that telerehabilitation is superior to self-management. Moreover, through this innovative and population specific web-based approach for KOA, a vast number of patients who have internet access could be reached. Thus, patients with KOA received effective treatment. Serrat M et al. 2022 Spain [ 52 ] RCT Single Centre (1:1:1) To examine the effectiveness of two video-based multicomponent programmes (FIBROWALK) and the Multicomponent Physiotherapy Program (MPP) for patients with fibromyalgia (FM) compared to treatment-as-usual (TAU) only. Fibromyalgia n = 330 IG1 n = 110 IG2 n = 110 CG n = 110 IG1: FIBROWALK is a multicomponent treatment programme with 5ve components, including Pain Neuroscience Education (PNE), therapeutic exercise, self-management patient education, CBT, and mindfulness training in a group-based format & TAU IG2: Multicomponent Physiotherapy Programme (MPP) involving only physiotherapy techniques & TAU CG: TAU including medications, and written advice on PNE and aerobic exercise adapted to individual capabilities. Dosage : IG1: 1-hour weekly video for over 12 weeks. IG2: 1 h per week for 12 weeks CG: Not reported Evaluation points : Baseline & Post-treatment Mode : IG1 & IG2: Video based CG: Not reported Setting : IG1, IG2 & CG: Tertiary hospital Intervention provider : IG1: Physiotherapist, health psychologist and rheumatologist IG2: Physiotherapist CG: Rheumatologist and other professionals which role not reported • Measures of function • Pain and pain related measures • Mental/psychological health measures This RCT supports the short-term effectiveness of the video-based multicomponent programs FIBROWALK and MPP for FM and provides evidence that cognitive-behavioural and mindfulness-based techniques can be clinically useful in the context of physiotherapeutic multicomponent treatment programs. Serrat M et al. 2021 Spain [ 47 ] RCT Single centre (1:1) To evaluate the efficacy of a virtual FIBROWALK compared to Treatment-As-Usual (TAU) in patients with fibromyalgia. Fibromyalgia n = 151 IG n = 76 CG n = 75 IG: FIBROWALK arm underwent a multicomponent strategy based on therapeutic exercise, pain neuroscience education, CBT and mindfulness training and TAU CG: TAU mainly based on medication, individualised advice on aerobic exercise and basic health education about their condition. The prescribed medications were not modified during the 12week study for both groups. Dosage : IG: 60 min video (hosted on a private YouTube channel) was sent by email once a week for 12 weeks. CG: Not reported Evaluation points : Baseline & Post-treatment Mode IG: F2F & Video based CG: Not reported Setting IG & CG: Tertiary hospital Intervention provider : IG: Therapists CG: Not reported • Measures of function • Pain and pain related measures • Mental/psychological health measures The results of this proof-of-concept RCT preliminarily support the efficacy of virtual FIBROWALK in patients with FM during the Spanish COVID-19 lockdown. Toelle et al. 2019 Germany [ 71 ] RCT Single centre (1:1) To investigate the clinical effects of a multidisciplinary mHealth back pain App (Kaia App). LBP n = 101 IG n = 53 CG n = 48 IG: The mHealth app (Kaia) facilitated an evidence-based Multidisciplinary pain treatment (MPT) programme focusing on physical, psychological, and educational interventions for non-specific LBP in accordance with current international disease management guidelines. CG: Therapy programme consisting of physiotherapy guided exercises plus online back pain education group. Dosage : IG: 6 weeks CG: 6 weeks - six individual physiotherapy sessions & high-quality online education Evaluation points : Baseline & Post-treatment & 12 weeks Mode : IG: Kaia App CG: F2F and online Setting : IG & CG: Online Intervention provider : IG: APP CG: physiotherapist • Pain and pain related measures • Measures of function • Trial/intervention evaluation Results indicate that the Kaia App as a multidisciplinary back pain app is an effective treatment in LBP patients and is superior to physiotherapy in combination with online education Yang J et al. 2019 China [ 85 ] RCT Single centre (1:1) To assess the additional effect of self-management on physiotherapy through the application smart-phone APPs on management of chronic low back pain. CLBP n = 8 IG n = 5 CG n = 3 IG: Self-management - Individualised exercise was prescribed to each participant by their own APP plus physiotherapy. CG: Physiotherapy may consist of manual therapy, electrophysical therapy, and traction as prescribed by the physiotherapist. Dosage : IG: perform exercises 4 times daily for 4 weeks; an hour per day in total. CG: 4-week physiotherapy Evaluation points : Baseline & Middle (2 weeks) & Post-treatment (4 weeks after) Mode : IG: APP & F2F CG: F2F Setting : IG & CG: Rehabilitation Clinic at University Hospital Intervention provider : IG & CG: Physiotherapists • Pain and pain related measures • Disability • Quality of Life This pilot study indicated that smartphone APPS-based self-management program appears to bring additional benefits to physiotherapy for patients with CLBP. Self-management is a potential approach for people with CLBP. Garreta-Catala I et al. 2023 Spain [ 60 ] Feasibility RCT Multi centre (1:1) To provide evidence of multidisciplinary group videoconferencing approach (MGVA) feasibility in managing CNSLBP and its impact on clinical practice. Chronic non-specific low back pain (CNSLBP) n = 18 IG n = 9 CG n = 9 IG: Standard care plus 8 group MGVA consisting of integrated sessions for physical rehabilitation/ physiotherapy, psychology, and social work treatments. CG: Standard care consisted of patient referral for follow-up at the discretion of the healthcare providers involved. Dosage : IG: weekly 2-h group videoconference sessions; Physical Rehabilitation/ Physiotherapy (Total of 8 Sessions); Psychology Treatment (Total of 8 Sessions); Social Work Treatment (Total of 8 Sessions) CG: Not reported Evaluation points : Baseline & 6 months Mode : IG: F2F & videoconference CG: F2F Setting : IG & CG - Tertiary and secondary hospitals and one mental hospital. Intervention provider IG: physiatrist/physiotherapist, pain clinic specialist, general practitioner, and/ or spine surgeon, psychologist, and a social worker. CG: physiatrist/physiotherapist, pain clinic specialist, general practitioner, and/ or spine surgeon. • Trial/intervention evaluation • Quality of life • Disability • Mental/psychological health measures • Physical activity/performance/ exercise related measures The multidisciplinary group videoconferencing approach to managing chronic non-specific low back pain was feasible, suggesting overall beneficial effects on patients’ health and could play a role in changing a patient’s status from “candidate” to “non-candidate” for surgery. Amirabadi N et al. 2024 Iran [ 63 ] Protocol, RCT, Single centre, (1:1) To determine whether exercise therapy via telerehabilitation and mHealth is as effective as the same F2F physical therapy programme in reducing pain and improving physical function and quality of life in people with patellofemoral pain syndrome. People with Patellofemoral pain syndrome (PwFPS) n = 60 IG n = 30 CG n = 30 IG: Three stages of therapeutic exercises including stretching, strengthening, balance, and functional exercises delivered via smartphone app. CG: Same as IG, but delivered F2F. Dosage : IG: 6 weeks − 3 sessions per week (18 sessions and each session lasts half an hour). CG: 6 weeks & sessions descriptions not reported Evaluation points : Baseline & Post-treatment (6 weeks and 18 sessions) & 1 month after Mode : IG: Smartphone app CG: F2F Setting : IG & CG: Telerehabilitation Intervention provider : IG: Assigned physical therapist to explain the application (APP). CG: Physical therapist • Pain and pain related measures • Mental/psychological health measures • Physical activity/performance/ • exercise related measures • Additional measures of osteoarthritis n/a Bijker et al. 2022 Netherlands [ 54 ] Protocol RCT Cluster (1:1) To evaluate the effectiveness of an eHealth intervention blended with physiotherapy compared with physiotherapy alone. People with non-specific subacute or persistent spinal pain Sample size not stated IG: Physiotherapy blended with eHealth intervention incorporating six modules, with a focus on pain education and behavioural activation. Modules include (1) ‘understanding pain’, (2) ‘feeling safe’, (3) ‘feeling balanced’, (4) ‘your story’, (5) ‘feeling motivated’ and (6) ‘future goals’. CG: Usual care physiotherapy according to the Dutch Clinical Practice Guidelines for low back pain. Dosage : IG: over 6 weeks, with a maximum treatment duration of 8 weeks. CG: 6–9 physiotherapy sessions Evaluation points : Baseline & Post-treatment & 12 months after baseline. Mode : IG: Online and F2F CG: F2F Setting : IG & CG: Primary Care Intervention provider : IG & CG: Physiotherapists • Disability • Pain and pain related measures • Economic • Other/miscellaneous n/a Neves A et al. 2023 Brazil [ 59 ] Protocol RCT, Multicentre (1:1) To investigate if telerehabilitation is just as effective as the same face-to-face exercise programme in patients with chronic neck pain (CNP) regarding pain, disability, psychological factors and pain self-efficacy. Chronic neck pain (CNP) n = 140 IG n = 70 CG n = 70 IG: Home exercises facilitated by pre-recorded videos, which contains guidelines for performing the exercise, rest time, number of sets and repetitions. A weekly scheduled call will be made to ask nine monitoring questions, including adverse events, according to preference. CG: Same exercises as IG under supervision of physical therapist. Dosage : G: 12 sessions of 30–40 min each for 6 weeks, receive one video every 2 weeks. To perform the exercises twice a week, with at least one day between them. CG: 12 sessions of 30–40 min each for 6 weeks. Evaluation points : Baseline & Middle(6 weeks) & Post-treatment (6 months) Mode : IG: Telerehabilitation CG: F2F Setting : IG & CG: Community centres Intervention provider : IG: Videos & phone calls CG: Physical therapist • Pain and pain related measures • Disability • Mental/psychological health measures • Progress and agency n/a Additional In-Person Psychological Interventions Bennell K et al. 2016 Australia [ 80 ] RCT, Multicentre (1:1:1) To investigate whether a 12-week physio–delivered intervention combined pain coping skills training (PCST) and exercise (PCST/exercise) is more effective and cost effective than either treatment alone for knee OA. Knee OA n = 222 IG1 n = 73 IG2 n = 74 CG n = 75 IG1: PCST integrated with exercises: Facilitated by using exercise and examples and encouraged to incorporate at home. IG2: 10 physio–delivered modules, covering pain education and training in cognitive and behavioural pain coping skills (activity-rest cycling, pleasant activity scheduling, problem solving etc). CG: Exercises only (provision of 6 exercises to strengthen quads, hip abductors and hamstrings) Dosage : IG1: 10 x 70min sessions over 12 weeks, then 3 x per week exercises and PCST home practice thereafter IG2: 10 X 45min sessions over 12 weeks, then PCST home practice CG: 10 x 25 min sessions over 12 weeks, then exercises 3 x per week the rafter Evaluation points : Baseline & Post-treatment & 32 and 52 weeks Mode : IG1 & IG2 & CG: F2F Setting : IG1 & IG2 & CG: University Intervention provider IG1 & IG2: Physiotherapists, psychologists CG: Physiotherapists • Pain and pain related measures • Additional measures of osteoarthritis • Mental/psychological health measures • Progress and agency • Quality of life • Physical activity/performance/ exercise related measures This model of care could improve access to psychological treatment and augment patient outcomes from exercise in knee OA, although it did not appear to be cost effective. Helminen E et al. 2015 Finland [ 75 ] RCT, Single Centre (1:1) To assess the effectiveness of a six-week cognitive–behavioural group intervention in patients with knee OA Knee OA n = 111 IG n = 55 CG n = 56 IG: Alongside usual General Practitioner (GP) care, group sessions were provided, including introduction, lecture and insight, problem solving, skills training and homework task led by psychologist. Role of physio was to provide relaxation classes, information on pain mechanisms, and advice on exercises. CG: usual care provided by GP Dosage : 2 hours per week for 6 weeks Evaluation points : Baseline & 3 months & 12 months Mode : IG & CG: F2F Setting : IG & CG: not reported Intervention provider : IG: Physiotherapist and Psychologist CG: GP • Pain and pain related measures • Measures of function • Quality of life • Economic • Mental/psychological health measures This trial could not confirm the hypothesized advantage of a cognitive–behavioural training programme over ordinary GP care in knee OA pain patients. Nagasawa Y et al. 2022 Japan [ 53 ] RCT, Single Centre (1:1) To investigate the effectiveness of physical therapist-delivered acceptance and commitment therapy (PACT) in older outpatients with knee osteoarthritis and chronic pain. Knee OA n = 30 IG n = 15 CG n = 15 IG: PACT and exercise therapy (strengthening excs). PACT aimed promote pain acceptance and improve maladaptive pain coping strategies and facilitate psychological flexibility. Homework delivered after each session. CG: usual care exercise therapy. Dosage : IG:1 hour, 1 x per week for 8 weeks CG: 1 x per week for 8 weeks Evaluation points : 4 weeks pre intervention 7 baseline & 4 weeks and 8 weeks post Mode : IG & CG: F2F Setting : IG & CG: Outpatients, secondary care Intervention Provider : IG: Physiotherapist and Psychologist CG: Physiotherapist • Additional measures of osteoarthritis • Mental/psychological health • Physical activity/performance/ exercise related measures Physical therapist-delivered acceptance and commitment therapy did not appear to show significant effects in the present study. Godfrey E et al. 2020 UK [ 66 ] RCT Multicentre (1:1:1) To evaluate the efficacy of Physiotherapy informed by Acceptance and Commitment Therapy (PACT) on functioning at the primary end point of 3 months’ follow-up, compared with standard, usual care physical therapy. LBP n = 248 IG n = 124 CG n = 124 IG: Brief physical therapy intervention, guided by principles of ACT. Treatment included an initial physical assessment with feedback, identification of value-based goals, individualized physical exercise prescription, addressing barriers and facilitators to self-management, and skills training to promote psychological flexibility. CG: Any treatment considered suitable by the treating physical therapist, including individual physical therapy and/or back rehabilitation classes, dynamic control classes, manual therapy, and hydrotherapy. Dosage : IG: two 60-minute face-to-face sessions 2 weeks apart conducted in a private room, plus one 20-minute telephone call 1 month later CG: Not reported Evaluation points : Baseline, 3 & 12 months Mode : IG & CG: F2F Setting : IG & CG: Physiotherapy outpatients Intervention provider : IG & CG: Physiotherapists • Disability • Mental health/psychological health measures • Measures of function • Progress and agency • Work • Quality of life Psychologically informed physical therapy has great potential but there are challenges in implementation. The training and support included in the PACT trial enabled the intervention to be delivered as planned. This successfully reduced disability in the short but not long term. Findings could inform physical therapists’ treatment of CLBP. Redondo et al. 2004 Spain [ 33 ] RCT Single Centre (1:1) To analyse the long-term efficacy of 2 interventions for female fibromyalgia patients: 1) cognitive behavioural therapy (CBT), and 2) a physical exercise (PE)–based strategy. Fibromyalgia n = 40 IG n = 21 CG n = 19 All patients were offered pharmacologic treatment. IG: Provision of information about: chronic pain, emotional aspects,, relaxation techniques, chronic pain and daily activity coping strategies, s, social abilities, sleep and resting, problem solving, and prevention of relapses. CG: fitness, muscular endurance, and flexibility. Each session included a preliminary warm-up exercise followed by the specific objective proposed in that session. Each week there was 1 session of exercises in a warm-water pool, 2 sessions of flexibility and endurance exercises, and 2 sessions of cardiovascular fitness by means of a cycle ergometer and isokinetic exercises with weights for upper limbs. Dosage : IG: 8 consecutive weeks with a once-weekly session of 2.5 hours. CG: 45-minute session of PE 5 times weekly for 8 weeks Evaluation points : Baseline & Post-treatment & 6 month and 12 months after treatment Mode : IG: not reported CG: F2F Setting : IG & CG: Rheumatology Unit, Tertiary care Intervention provider : IG: Physiotherapists & psychologists CG: Not reported • Pain and pain related measures • Measures of function • Mental/psychological health measures • Physical activity/performance/ exercise related measures PE and CBT improve clinical manifestations in FM patients only for short periods of time. Improvement in self-efficacy and physical fitness are not associated with improvement in clinical manifestations. Wellburn S et al. 2022 UK [ 55 ] Quasi-experimental Single Centre To evaluate the outcomes and explore experiences of patients undergoing a residential Combined Physical and Psychological Programme (CPPP) for chronic LBP. LBP n = 100 Residential CPPP involved a multidisciplinary biopsychosocial rehabilitation intervention that included physical, psychological and educational components as recommended by the National Institute for Health and Care Excellence (NICE). Dosage : 3 weeks Evaluation points : Quantitative: Baseline & Post-treatment & 6 and 12 months Qualitative: 6–10 weeks post intervention Mode : F2F Setting : Residential rehabilitation centre Intervention provider : Multidisciplinary: job titles not reported • Pain and pain related measures • Disability • Quality of Life • Mental/psychological health measures Participants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting. van Erp R et al. 2015 Netherlands [ 82 ] Protocol, RCT, Multicentre cluster (1:1) To investigate the difference in (cost) effectiveness between a biopsychosocial primary care intervention, Back on Track, and primary care physiotherapy as usual in a subgroup of adults with chronic low back pain. LBP N = 86 participants IG n = 43 CG n = 43 IG: Intervention based on principles used in cognitive behavioural interventions, for example Graded Activity and Graded exposure. Graded Activity involved an operant conditioning approach to gradually, increase activity level. Graded Exposure involved a classical conditioning approach to expose patients to fearful activities stimulating them to recognize the inconsistency between their unrealistic thoughts about fearful activities. CG: Primary care as usual according to their current knowledge and the Dutch profession-specific guideline for LBP Dosage : G: 4 individual sessions (30 minutes) and 8 group sessions (60 minutes). In 8 weeks CG: max of 12 sessions (30 minutes) within eight week. Evaluation points : Baseline & 8 weeks, 3 & 12 months Mode : IG: F2F CG: Not reported Setting IG & CG: Physiotherapy outpatients Intervention provider : IG & CG: Physiotherapists • Disability • Pain and pain related measures • Mental /psychological health measures • Progress and agency • Quality of Life • Economic n/a Education-Based Interventions Dragesund T et al. 2021 Norway [ 48 ] RCT Single Centre (1:1) To investigate if individual Norwegian Psychomotor Physiotherapy (NPMP) improves pain as a primary outcome and physical function, mental health, sleep, and quality of life as secondary outcomes, compared to Cognitive Patient Education in combination with active physiotherapy (COPE-PT). Widespread MSK Pain n = 128 IG n = 64 CG n = 64 IG1: Key elements of NPMP included: readjusted posture, harmonised muscle tension, breathing and movements and body awareness. CG: COPE-PT was an education programme which aimed to reduce fear of pain, improve understanding of pain & exposure to threatening inputs. These sessions were followed by individualised physiotherapy according to pain problems. Dosage : IG: 45-60min session, 1 x per week for 3–6 months. CG: 30 min session, 1x per week for 4 weeks, followed by individualised physiotherapy 1x per week for 3–6 months. Evaluation points : Baseline & Middle (3 month) & Post-treatment & 12 months Mode : IG & CG: F2F Setting : IG & CG: Physiotherapy clinic Intervention provider: IG & CG: Physiotherapist • Pain and pain related measures • Measures of function • Mental/Psychological health measures • Quality of life • Sleep • Disability COPE-PT, which is targeted towards pain‐coping and increasing activity, contribute to more improvements than NPMP. Areso-BÃveda P et al. 2021 Spain [ 49 ] Quasi-experimental Multicentre To explore the efficacy of an intervention based on Pain Neuroscience Education (PNE) and exercise compared to treatment as usual in Primary Care. Fibromyalgia n = 64 IG n = 45 CG n = 19 IG: Combination of education sessions, including neurophysiology of pain in combination with physiotherapist guided exercises, including graded exposure to movement and relaxation. Patients received a summary of the session and reading materials CG: No additional therapy beyond the treatment they were undergoing (pharmacotherapy), although informed that in the future, they could receive the group intervention if they wished. Dosage : IG: 2h weekly sessions for 6 weeks CG: Not applicable Evaluation points : Baseline, 2, 6 & 12 months Mode : IG: F2F CG: n/a Setting : IG & CG: Urban Health Centres, primary care Intervention provider : IG: Physician, Physiotherapist, Nurse CG: None • Pain and pain related measures • Measures of function • Mental /psychological health measures An intervention based on PNE and exercise in patients with Fibromyalgia is feasible and seems effective in Primary Care. Stanton T et al. 2021 Australia [ 50 ] Protocol RCT, Multicentre To determine the clinical and cost-effectiveness of a Pain Science Education (PSE)-driven individualised walking, strengthening and education program, called EPIPHA-KNEE, in people with painful knee OA, compared to an individualised current practice. Knee OA n = 198 IG n = 99 CG n = 99 IG: the EPIPHA-KNEE group received contemporary PSE underpinned by principles of self-regulated learning and conceptual change theory in addition to current practice (control). CG: standardised general OA/activity education, graded walking and strengthening components. Dosage : IG and CG: 4 x 60–90 min session over 4 weeks, followed by 4 weeks of home activities. Weekly video calls lasting 20mins. In person follow-up with physio at month 5& Evaluation points : Baseline & Middle (1 week) & Post-intervention (12 week) & 6 and 12 months Mode : IG & CG: F2F & Video call Setting : IG & CG: Community physiotherapy clinics, primary care Intervention provider : IG & CG: Physiotherapists • Physical activity • Pain • Measures of function • Mental health/psychological n/a Predominantly Self-Management Cedraschi C et al. 2004 Switzerland [ 34 ] RCT, Single Centre (1:1) To evaluate a multidisciplinary self-management programme on quality of life and satisfaction with treatment for people with Fibromyalgia, compared with a wait list control group Fibromyalgia n = 164 IG n = 84 CG n = 80 IG: Group sessions including swimming, relaxation exercise, and low impact land exercises, sessions on activities of daily living and education-discussion sessions. CG: Waiting list Dosage : IG: 12 90 min sessions, 2 x a week for 6 weeks. CG: Not reported Evaluation points : Baseline & Post-treatment & 6 months Mode : IG: F2F CG: n/a Setting : IG & CG: Outpatients, tertiary care Intervention provider : IG: Physiotherapist, Occupational Therapist, Rheumatologist & Psychologist CG : n/a • Mental/psychological health measures • Pain and pain related measures • Trial/intervention evaluation A 6 week self-management based programme of pool exercises and education can improve the quality of life of patients with FM and their satisfaction with treatment. These improvements are sustained for at least 6 months after programme completion. Gustavsson C et al. 2010 [ 77 ] Sweden RCT Multicentre (1:1) To compare treatment effects of (a) a multi-component pain and stress self-management group intervention (PASS) and (b) individually administered physical therapy (IAPT) for patients with persistent musculoskeletal tension-type neck pain. Neck pain n = 156 IG n = 77 CG n = 79 IG :PASS information and training programme performed with groups of patients. Each session consisted of applied relaxation training, body awareness exercises, lectures and group discussions. Short lectures combined with group discussions on issues related to pain and pain self-management: anatomy, aetiology, physiology and the psychology of pain and stress. CG: Individual physical therapy sessions according to current practice and was not a standardised treatment procedure. Dosage : IG: 7 x 1.5 hours (plus homework) over 7 weeks. Booster session at 20 weeks. CG: Not reported Evaluation points : Baseline & 10 and 20 weeks Mode : IG & CG: F2F Setting : IG & CG: Health Centre Intervention provider : IG & CG: Physiotherapists • Economic • Pain and pain related measures • Mental/psychological health measures • Progress and agency • Disability PASS had a better effect than IAPT in the treatment of persistent musculoskeletal tension-type neck pain regarding coping with pain, in terms of patients’ self-reported pain control, self-efficacy, disability and catastrophizing, over the 20-week follow-up. Others Frih Z et al. 2009 Tunisia [ 42 ] RCT, Single Centre (1:1) To assess the efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain (CLBP) CLBP n = 107 IG n = 54 CG n = 53 IG: Home based rehabilitation programme involving group practical supervised rehabilitation of 18 exercises (positioning, strengthening and stretching). Advised to perform daily at home with support of illustrative booklet. CG: The programme included analgesic electrotherapy, flexibility training, pain management, stretching and proprioception exercises and muscle strengthening exercises. All patients received an individual session by the same physiotherapist. Dosage : IG weekly 2-hour sessions with physio, then daily exercises for 2 months. Participants reviewed after 1 month then given 9 exercises to perform each day for 1 month. CG: 90 mins per day, 3 x per week Evaluation points : Baseline & Middle (4 weeks) & Post-treatment (3 months) & 6 and 12 months Mode : IG & CG: F2F Setting : IG & CG: Physical Medicine Rehabilitation or Rheumatology unit, Tertiary care Intervention provider : IG & CG: Physiotherapists • Pain and pain related measures • Measures of function • Physical activity/performance/ exercise related measures • Trial/intervention evaluation A home-based rehabilitation programme is as effective as standard physical therapy. However, this type of programme requires patient motivation and regular follow-up Jessep S et al. 2009 UK [ 41 ] RCT, Single Centre (1:1) To establish the feasibility of Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain) and compare its clinical effectiveness and costs with outpatient physiotherapy. Chronic Knee Pain n = 64 IG n = 29 CG n = 35 IG: The programme aimed to change behaviour by challenging inappropriate beliefs regarding condition and physical activity, encouraging regular exercise and enabling self-management though informal group discussions, information about coping and exercise regimen. After completion, a written, tailored home exercise regimen and information about local community exercise facilities/ self-help groups was provided. CG: Outpatient physiotherapy Dosage : IG: 10 sessions (2 x per week for 5 weeks) CG: 1 x 30–45 min assessment then up to 10x PT sessions Evaluation points : Baseline & Post-intervention & 12 months. Mode : IG & CG: F2F Setting : IG & CG: Outpatient physiotherapy department and community centre, primary care Intervention provider : IG & CG: Physiotherapists • Additional measures of Osteoarthritis • Pain and pain related measures • Progress and agency • Measures of function • Mental/psychological health measures • Economic ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective. Valim et al. 2003 Brazil [ 32 ] RCT, Single Centre (1:1) To compare two exercise modalities, aerobic fitness training and stretching exercises, in patients with Fibromyalgia. Fibromyalgia n = 60 IG n = 30 CG n = 30 IG: walking programme monitored with frequency meters. Each training session was preceded by a warm-up period and cool down upon completion. CG: General exercises involving the face, cervical spine, trunk and extremities, which were chosen to provide overall flexibility. Dosage : IG: 3 times a week, of 45 min duration, for 20 weeks. CG; 3 sessions a week of 45 min duration each and included 17 exercises, for 20 weeks. Evaluation points : Baseline & week 10 and 20 Mode : IG & CG: F2F Setting : IG & CG: Rheumatology outpatient, Tertiary care Intervention provider : IG & CG: Physiotherapists • Measures of function • Pain and pain related measures • Mental/psychological health measures • Quality of life • Physical activity/performance/ exercise related measures Results confirm that aerobic exercise is beneficial to patients with Fibromyalgia, but the cardiorespiratory fitness gain is not related to improvement of Fibromyalgia symptoms Trapp W et al. 2015 UK [ 65 ] RCT Single Centre (1:1) To examine the effects of a combined intervention that utilises visual feedback, motion and sensory discrimination training in patients with Chronic Low back Pain (LBP). CLBP n = 30 IG n = 15 CG n = 15 IG: In addition to standard treatment, the Feedback Group (FG) received 6 feedback sessions where they watched the image of their back during a brief 2-point discrimination training. They were then advised to perform pelvic tilts using isolated lumbar and multifidus muscles. CG: Units of physiotherapy, relaxation training and movement training (walking) - relaxation training, movement therapy, massage, pain education intervention & psychological consultation. Dosage : IG: 6h per day (standard treatment) − 3 times per week) plus 6 x 20 min sessions over 2 weeks. CG: 6 h per day (standard treatment), plus 6 x 30 min sessions over 2 weeks Evaluation points : Baseline & Post-treatment Mode : IG & CG: F2F Setting : IG & CG: Inpatient rehabilitation ward Intervention provider : IG & CG: Not reported • Pain and pain related measures • Mental /psychological health measures Findings imply that very simple feedback interventions without major technical requirements could be a valuable supplement to standard treatment in CLBP. Leonhardt C et al. 2017 Germany [ 70 ] Pilot Quasi experimental To develop a standardised graded exposure treatment according to the fear-avoidance model of musculoskeletal pain for older patients with CLBP and to examine its effectiveness and feasibility in the German health care system. CLBP n = 16 Key components included determination of functional goals (session 1), establishment of a fear hierarchy (session 2), patient education (sessions 2–4), graded exposure to activities causing fear (from session 3 to 11), and transfer into everyday life and re-evaluation of the fear hierarchy. Dosage : 12 sessions of 45-minutes over 9 weeks. Evaluation points : Baseline & Post-treatment Mode : F2F Setting : Rehabilitation centre, primary care Intervention provider : Physiotherapists with previous psychological training (form psychologist). • Measures of function • Pain and pain related measures • Mental/psychological health • Progress and agency The treatment appears effective and feasible. In addition to the benefits achieved by the participants, the study provides a basis for designing future studies at a higher level of evidence. George S et al. 2010 USA [ 84 ] Quasi-experimental Single Centre To determine whether pain intensity and disability outcomes were associated with treatment received (graded exercise or graded exposure) and if changes in selected psychological factors were associated with pain and disability outcomes. CLBP n = 33 IG n = 15 CG n = 18 All participants enrolled on to a chronic pain management programme to limit medication use, receive education, relaxation and intensive physical therapy with the interdisciplinary team. IG: (Graded Exercise) included general therapeutic activities, which were progressed with a quota-based system. CG: Graded exposure included specific activities that were feared due to back pain, which were progressed with a hierarchical exposure paradigm. Dosage : 7 hours per day/ & 5 days per week. Duration: 3–5 weeks depending on participant Evaluation points : Baseline & Post-treatment (3 or 5 weeks) Mode : IG & CG: F2F Setting : IG & CG: Not reported Intervention provider : IG 1 & CG: Interdisciplinary team: clinical psychologists, physiotherapists, physicians, nurses, biofeedback therapists and occupational therapists. • Pain and pain related measures • Disability • Mental/psychological health measures Physical therapy supplemented with graded exercise or graded exposure resulted in equivalent clinical outcomes for pain intensity and disability. The overall treatment effects were modest in this setting. Instead of being associated with a specific behavioural intervention, reductions in pain and disability were associated with reductions in depressive symptoms and pain catastrophizing, respectively. Hay E et al. 2008 UK [ 38 ] Protocol RCT Multicentre (1:1) To compare the overall effectiveness of a "subgrouping for targeted treatment STarT" approach with "best current care" (non-targeted) physiotherapy practice, over a 12-month period, for LBP. LBP n = 800 IG & CG: not stated IG: (targeted treatment). The STarT Back tool score is used to identify/address specific concerns. A 'Back Book' is given with an information about local services (ie, swimming), plus video to re-enforce message. Patients then triaged according to 'low risk' (no further treatment, 'medium risk' (physiotherapy approaches) or 'high risk' (psychological and physio approach). CG: Best practice usual care - a consultation with an experienced community physiotherapist who is blinded to the results of the STarT Back tool. A management plan is formulated according to normal clinical practice. This may include referral to community physiotherapy. Dosage : IG: 30 mins plus 15 min video to re-enforce message. CG: 30-minute consultation Evaluation points : Baseline & 4 and 12 months Mode : IG & CG: F2F Setting : IG & CG: Primary care centre Intervention provider : IG & CG: Physiotherapists • Disability • Pain and pain related measures • Mental/psychological health measures • Quality of Life • Economic n/a Hurley M et al. 2010 [ 67 ] UK Protocol RCT, Single Centre (1:1:1) To evaluate the feasibility of an RCT, exploring the effects of three forms of physiotherapy on sleep quality in people with chronic low back pain. CLBP n = 60 IG1, IG2 & CG: not stated IG1: Supervised exercise class (SEC) group-based format based on the 'Back to Fitness' programme underpinned by cognitive behavioural therapy principles, agreement on goals, exercise therapy sessions & promotion of self-management. IG2: Waking programme (WP) to increase physical activity through a graded walking & agreement on goals. Participants to be given education manual and pedometer. CG: Usual Physiotherapy (UP): multimodal approach of education/ advice, manipulative therapy and exercise therapy, plus individualised home exercise programme. Dosage : IG 1: once per week for 8 weeks, group based IG 2: 8 weeks. Participants to encourage minimum of 10 min walk 4 days per week. Aim to progress to 30mins 5 x week. CG: baseline plus 3 F2F sessions and 1 x 6 month follow up Evaluation points : Baseline & 3 and 6 months Mode : IG1: F2F IG2 & CG: F2F & Home Setting : IG1 & IG2 & CG: Physiotherapy outpatients department Intervention provider : IG1: Physiotherapist IG2: Self-management CG: Not clear • Sleep • Disability • Pain and pain related measures • Mental/psychological health measures • Progress and agency • work • Physical activity/performance/ exercise related measures n/a ACT - Acceptance and Commitment Therapy; ASE - Arthritis Self-Efficacy; BI - Brief Intervention; BPS - Biopsychosocial; CBT - Cognitive Behavioural Therapy; CBE - Centre-Based Exercise; CG - Control Group; CLBP - Chronic Low Back Pain; CNSLBP - Chronic Non-Specific Low Back Pain; CPPP - Combined Physical and Psychological Program; FM - Fibromyalgia; F2F - Face-to-Face; FG - Feedback Group; GP - General Practitioner; HBE - Home-Based Exercise; HRQoL - Health-Related Quality of Life; IG - Intervention Group; IAPT - Individually Administered Physical Therapy; IGLT - Intervention Group Long Term; IGST - Intervention Group Short Term; IMPT - Interdisciplinary Multimodal Pain Treatment; IP - Individual Physiotherapy; ISIVET - Interdisciplinary Structured Interview with a Visual Educational Tool; KOA - Knee Osteoarthritis; LBP - Low Back Pain; MBR - Multidisciplinary Biopsychosocial Rehabilitation; MI - Multidisciplinary Intervention; MMT - Multimodal Therapy; MPVA - Multidisciplinary Pain Videoconferencing Approach; MSK - Musculoskeletal; MT - Multidisciplinary Treatment; MPP - Multicomponent Physiotherapy Programme; MR - Multidisciplinary Rehabilitation; MSMP - Multidisciplinary Self-Management Program; NPMP - Norwegian Psychomotor Physiotherapy; OA - Osteoarthritis; OT - Occupational Therapy; PACT - Physiotherapy informed by Acceptance and Commitment Therapy; PASS - Pain and Stress Self-Management; PCST - Pain Coping Skills Training; PE - Physical Exercise; PNE - Pain Neuroscience Education; PSYMEPHY - Psychological, Medical, Educational, and Physiotherapeutic Programme; PT - Physiotherapy; QOL - Quality of Life; RCT - Randomised Controlled Trial; ROM - Range of Motion; SMP - Self-Management Program; SMT - Sensorimotor Training; STarT - Subgrouping for Targeted Treatment; TAU - Treatment As Usual; UP - Usual Physiotherapy; VTP - Vitality Training Program; WOMAC - Western Ontario and McMaster Universities Arthritis Index [Insert Fig. 1 PrismaScR flowchart] [Insert Table 2 ] Figure 2 presents the data by year of publication, study design, setting and MSK conditions of interest. [ Insert Fig. 2a. study design b. year of publication c. setting d. condition of interest and Number of studies and total number of participants] Timeline of Publication The annual publication rate shows noticeable fluctuations, indicating variable levels of research activity on the topic across a 22-year period. Between 2003–2008 [ 31 – 38 ], publication rates remained low, with one to two publications per year. In 2009, there was a temporary peak (n = 4) [ 39 – 42 ], followed by gradual growth until 2019. A more significant rise began in 2020, peaking in 2021 (n = 8) [ 43 – 50 ], the highest in the 22-year period. Although output declined slightly after 2021, research activity remained higher, with five articles published in both 2022 [ 51 – 55 ] and 2023 [ 56 – 60 ]. In 2024, the number decreased to three [ 61 – 63 ]. Overall, the data reflects growing interest on the topic since 2003. Location of research Nearly two thirds of publications (n = 37, 65%) originated from Europe, with Spain (n = 8), [ 33 , 39 , 43 , 47 , 49 , 52 , 60 , 64 ], the UK (n = 7) [ 38 , 41 , 55 , 61 , 65 – 67 ] and Germany (n = 7), [ 40 , 51 , 68 – 72 ], producing 22 publications combined, representing 39% of all articles. Figure 3 presents the global distribution of studies in more detail, illustrating a global interest across 20 countries and five continents. [Figure 3 Global Map of Included Studies] Study design A range of study designs were employed amongst the primary studies, although most were RCTs (n = 40, 70%) [ 32 – 36 , 39 – 45 , 47 , 48 , 51 – 53 , 56 – 58 , 60 – 62 , 64 – 66 , 68 , 69 , 71 – 81 ], five of which had three arms [ 40 , 52 , 72 , 74 , 80 ]. Fewer (n = 9, 16%) were protocol [ 27 , 38 , 50 , 54 , 59 , 63 , 67 , 82 , 83 ], pilot (n = 4, 7%) [ 31 , 37 , 70 , 83 ] and quasi-experimental studies (n = 3, 5%) [ 49 , 55 , 84 ] and one used a cohort design [ 46 ]. Condition(s) of Interest Interventions were targeted towards a wide range (n = 10) of MSK conditions. However, over a third of the studies (n = 24) involved patients with chronic low back pain (4,561 participants) [ 36 – 38 , 40 , 42 , 45 , 51 , 55 , 56 , 60 , 62 , 65 – 73 , 82 – 85 ], followed by fibromyalgia (n = 15) (1,973 participants) [ 31 – 35 , 39 , 43 , 44 , 47 , 49 , 52 , 64 , 74 , 76 , 86 ], mild-moderate knee osteoarthritis (n = 6) (675 participants) [ 41 , 50 , 53 , 57 , 75 , 80 ] and chronic primary musculoskeletal pain (n = 5) (575 participants) [ 48 , 61 , 78 , 81 , 87 ]. See Fig. 2 for less common conditions. Intervention Setting Thirty seven studies (65%) were single centre [ 32 – 36 , 39 – 45 , 47 , 48 , 52 , 53 , 55 – 58 , 61 – 65 , 67 , 68 , 71 , 73 – 76 , 78 , 79 , 81 , 83 – 85 ], while 14 (25%) were multicentre [ 27 , 38 , 49 – 51 , 54 , 59 , 60 , 66 , 69 , 72 , 77 , 80 , 82 ]. Six studies (10%) did not report the number of sites [ 31 , 37 , 46 , 70 , 86 ]. Interventions were delivered across a wide range of predominantly clinical settings, apart from one study that was conducted on a university [ 80 ] and another which involved a digital application [ 71 ]. Amongst the studies with clearly defined settings, the majority were delivered in the primary (n = 10) [ 35 , 38 , 44 , 49 , 50 , 54 , 59 , 70 , 77 , 79 ] and tertiary care setting (n = 9) [ 31 , 34 , 39 , 43 , 47 , 52 , 61 , 63 , 85 ], while two were conducted in secondary care [ 53 , 86 ]. It was not possible to categorise the study setting according to primary, secondary or tertiary care definitions for more than half of all studies (n = 34; 60%) due to differences in terminology across the studies. These settings are therefore reported as described by the articles and are presented within Fig. 2. Key interventions Sixty-two intervention groups were delivered across the 57 primary studies (Table 2 ). These interventions were categorised according to five major approaches, namely; 1) in-person multidisciplinary and interdisciplinary (n = 25) [ 31 , 35 – 37 , 39 , 40 , 43 , 44 , 46 , 51 , 56 , 61 , 62 , 64 , 68 , 69 , 72 – 74 , 76 , 78 , 81 , 83 , 86 , 87 ], 2) internet, digital and telephone (n = 12) [ 45 , 47 , 52 , 54 , 57 – 60 , 63 , 71 , 79 , 85 ], 3) additional in-person psychological programme (n = 7) [ 33 , 53 , 55 , 66 , 75 , 80 , 82 ]; 4) Education-based (n = 3) [ 48 – 50 ] and 5) predominantly self-management (n = 2) [ 34 , 77 ]. The interventions described in eight studies [ 32 , 38 , 41 , 42 , 65 , 67 , 84 ], did not fit into a clearly defined category and were therefore categorised as ‘other’. Key intervention components All Intervention included at least one or more physical training component, such as exercise therapy and/or physical activity. Sixty-five percent (n = 37) incorporated at least one or more psychological strategy or talking therapy, 42% (n = 24) of which were clearly defined. The most common, was Cognitive Behavioural Therapy (CBT) (n = 13) [ 24 , 31 , 36 , 39 , 47 , 52 , 58 , 64 , 68 , 74 , 76 , 81 , 87 ], while there was significant heterogeneity in the remaining strategies, including; Combined pain competence and depression prevention training [ 79 , 80 ], combined pain education and behavioural activation [ 54 , 84 ], depression prevention training [ 69 ], mindfulness and meditation (n = 1) [ 44 ], stress management (n = 1) [ 35 ], cognitive-behavioural pain management and depression prevention training (n = 1) [ 51 ]; CBT or mindfulness (n = 1) [ 47 ], mental health support if required (n = 1) [ 61 ], and behavioural training (n = 1) [ 72 ]. There was a group of undefined psychological interventions (n = 13) [ 33 , 40 , 46 , 53 , 55 , 60 , 65 , 67 , 70 , 71 , 75 , 77 , 86 ], 17 studies did not include any psychological strategy [ 32 , 34 , 38 , 41 , 42 , 45 , 48 – 50 , 56 , 57 , 59 , 62 , 63 , 66 , 83 , 85 ], and three studies did not report clearly [ 37 , 73 , 78 ]. There was also substantial heterogeneity amongst the studies in terms of the content of the comparator groups. Most (n = 21) employed ‘usual care’ [ 24 , 38 , 40 , 41 , 43 – 45 , 47 , 50 , 52 , 53 – 54 , 60 , 61 , 67 , 72 , 74 , 75 , 80 , 87 , 88 ], while others comprised of: physiotherapy (n = 7) [ 32 , 33 , 36 , 56 , 66 , 80 , 85 ]; waiting list (n = 4) [ 34 , 68 , 76 , 81 ]; in person exercises (n = 3) [ 59 , 62 , 63 ] individual physiotherapy sessions (n = 2) [ 42 , 77 ]; multidisciplinary team approach (n = 2) [ 39 , 65 ]; non-injury model (n = 1) [ 78 ]; medication (n = 1) [ 64 ]; treatment as usual with relaxation exercises (n = 1) [ 51 ]; inpatient programme (n = 1) [ 73 ]; physiotherapy with education and CBT (n = 1) [ 58 ]; cognitive patient education with physiotherapy (n = 1) [ 48 ]; brochures with exercises (n = 1) [ 57 ]; education and physiotherapy at home (n = 1) [ 79 ]; graded exposure (n = 1) [ 84 ] passive modalities with no exercise (n = 1) [ 37 ]; pain education programme (n = 1) exercise programme with sham health coaching and a sham activity monitor (n = 1) [ 83 ]; in-person exercises (n = 1) [ 63 ]; and physiotherapy and pain education group (n = 1) [ 71 ]. Intervention providers A diverse range of healthcare professionals delivered interventions. Physiotherapists solely delivered interventions amongst 16 studies, [ 32 , 34 , 38 , 41 , 42 , 45 , 48 , 52 , 57 , 58 , 62 , 67 , 70 , 77 , 79 , 83 ], however most studies employed a combination of healthcare professionals including; Physiotherapists and psychologists (n = 6) [ 43 , 50 , 54 , 66 , 82 , 85 ], physiotherapists and one other non-psychology healthcare professional (n = 4) [ 37 , 44 , 56 , 72 ], and physiotherapists and more than two other healthcare professionals (n = 21) [ 35 , 36 , 39 , 40 , 46 , 49 , 51 , 52 , 55 , 60 , 61 , 64 , 68 , 69 , 73 , 74 , 76 , 78 , 81 , 84 , 86 ]. On one study was delivered by a psychologist and a nurse team [ 87 ] and it was unclear who delivered the intervention in another [ 65 ] and the other through self-management [ 67 ]. Amongst the 37 studies that included a psychological strategy, five were delivered by a physiotherapist [ 54 , 67 , 77 , 79 , 82 ], while it was not clear who delivered the psychological component amongst four of the studies [ 44 , 46 , 65 , 69 ]. Over a third of comparator groups (n = 25) were exclusively provided by physiotherapists [ 32 , 36 – 38 , 41 , 42 , 45 , 48 , 50 , 53 , 54 , 56 , 58 , 59 , 62 , 63 , 66 , 70 , 71 , 77 , 79 , 80 , 82 , 83 , 85 ], while others were provided by a combination of health care professionals including; A physiotherapist and two or more health care professionals (n = 6) [ 39 , 40 , 60 , 69 , 73 , 84 ], a physiotherapist and another health care professional (n = 2) [ 61 , 78 ], GPs (n = 2), and one study was self-management [ 57 ]. It was unclear who provided the comparator groups for 16 studies [ 33 , 34 , 43 , 44 , 47 , 49 , 52 , 64 , 65 , 67 , 68 , 72 , 74 , 76 , 81 , 87 ]. Mode of delivery Over two thirds of studies (n = 39) were exclusively delivered in-person [ 31 , 32 , 34 – 42 , 44 , 46 – 49 , 51 , 53 , 55 , 56 , 62 , 64 – 70 , 73 – 77 , 80 , 82 , 84 , 86 , 87 ], while fewer employed a hybrid approach (n = 9) [ 40 , 50 , 54 , 60 , 61 , 72 , 78 , 79 , 83 ]. Interventions were also delivered using various technologies, including digital applications (n = 2) [ 63 , 71 ]; telerehabilitation (n = 1) [ 59 ]; videos (n = 1) [ 52 ]; video calls (Zoom) (n = 1) [ 57 ]; videos calls and digital applications (n = 1) [ 58 ] and combination on in-person and digital application (n = 1) [ 85 ]. The mode of delivery was undefined amongst two studies [ 33 , 81 ]. A similar trend was observed for the comparator groups. In-person (n = 29) [ 32 , 33 , 35 – 42 , 44 , 48 , 51 , 53 , 54 , 56 , 59 – 63 , 65 , 66 , 73 , 75 , 77 , 80 , 84 , 85 ] and hybrid approach (n = 7) [ 43 , 50 , 58 , 67 , 71 , 79 , 83 ] were most common, in comparison to video (n = 1) [ 78 ]; and brochures (n = 1) [ 57 ], however 15 comparator groups were not clearly defined [ 34 , 43 , 45 , 47 , 49 , 52 , 64 , 68 , 69 , 72 , 74 , 76 , 82 , 87 , 81 ]. Intervention duration Intervention durations were heterogeneous, ranging from less than one week to more than six months. The duration most commonly ranged between four and twelve weeks (26/57 studies) [ 33 – 36 , 40 , 41 , 44 – 46 , 49 , 50 , 53 , 56 – 58 , 62 – 64 , 67 , 70 , 71 , 74 , 75 , 77 , 82 , 85 ], followed by interventions lasting between three and six months (14/57 studies) [ 32, 37, 39, 42, 43, 47, 52, 59, 72, 73, 78, 80, 83, 86]. Eight interventions were shorter, ranging from less than one week to four weeks [ 31 , 38 , 55 , 65 , 66 , 68 , 76 , 81 ], while only two lasted more than six months [ 39 ], [ 55 ]. Seven studies did not clearly specify duration [ 48 , 51 , 54 , 60 , 69 , 84 , 87 ]. The majority of comparator groups (n = 27) had durations equivalent to those in the intervention groups [ 33 , 36 – 38 , 40 , 41 , 45 , 47 , 48 , 50 – 53 , 56 – 59 , 63 , 65 , 71 , 75 , 79 , 80 , 82 , 83 , 85 , 87 ], while six differed [ 39 , 42 , 54 , 67 , 73 , 78 ]. A large number of comparator groups (n = 19) did not specify or clearly report the duration [ 34 , 35 , 44 , 49 , 50 , 55 , 60 – 62 , 64 , 66 , 68 , 72 , 74 – 77 , 81 , 84 ]. Number of intervention sessions and intensity The number of sessions varied substantially. Over a third of studies (n = 23) ranged between 1–12 sessions [ 33 , 34 , 38 , 40 , 41 , 43 , 44 , 47 , 49 , 52 , 53 , 59 , 62 , 64 , 66 , 67 , 71 , 73 , 74 , 80 , 82 , 83 , 85 ], followed by 12–24 sessions (n = 13) [ 39 , 56 – 58 , 60 , 61 , 63 , 65 , 79 – 81 , 83 , 86 ], and more than 25 sessions (n = 5) [ 32 , 35 , 46 , 68 , 85 ]. The number of sessions was variable amongst three studies [ 48 , 51 , 84 ], while 13 either did not clearly report or report the number of sessions [ 31 , 36 , 37 , 42 , 45 , 50 , 54 , 55 , 69 , 71 , 73 , 75 , 76 ]. The intensity of the interventions (defined as the total number of hours/minutes) also demonstrated diversity. In one study the shortest intensity was less than one hour [ 38 ], however the most common intensity range was between 1–12 hours [ 31 , 33 , 51 , 53 , 56 , 58 , 62 , 63 , 66 , 69 , 70 , 73 , 77 , 78 , 80 , 82 ], 12–24 hours [ 34 , 39 , 40 , 43 , 49 , 52 , 57 , 64 , 65 , 72 , 75 , 76 , 87 ], > 48 hours [ 36 , 46 , 60 , 68 , 85 , 86 ] and 24–48 hours [ 32 , 47 , 74 , 81 ] respectively. Additionally, eight studies delivered interventions across variable intensities [ 35 , 44 , 48 , 68 , 82 , 84 , 87 , 59 ] and nine did not clearly define or report the intensity of the intervention [ 37 , 41 , 42 , 45 , 50 , 54 , 55 , 61 , 71 ]. In the comparator groups, the number of sessions and intensity were equivalent to the intervention group (n = 10) [ 32 , 38 , 40 , 50 , 52 , 56 , 59 , 82 , 84 , 85 ]; different from the intervention (n = 18) [ 24 , 33 , 36 , 39 – 42 , 47 , 48 , 57 , 58 , 62 , 65 , 71 , 73 , 75 , 78 , 80 ], or not reported/unclear (n = 25) [ 34 , 35 , 37 , 43 , 44 , 49 , 51 , 53 , 54 , 57 , 60 , 61 , 63 , 64 , 66 , 68 , 71 – 77 , 81 , 85 ]. Study Outcome measures There was substantial heterogeneity amongst the outcome measures used to evaluate the effectiveness of the interventions included within the review as shown in Table 3 . A total of 202 outcome measures/assessment tools were identified amongst the 57 primary studies, which were categorised according to 13 overarching domains and 23 sub-domains. The ‘pain and pain related measures’ domain had the highest number of outcome measures (n = 43), where ‘self-reported measures of pain/intensity/duration and ‘pain related psychological measures’ were the most commonly evaluated. The second largest overarching domain was ‘mental and psychological health measures’ (n = 37), followed by ‘Physical activity/performance/exercise related measures’ (n = 26), and ‘progress and agency’ (n = 18). The overarching domains with the smallest range of outcome measures was ‘economic’ (n = 6), ‘work’ (n = 6), ‘sleep’ (n = 4) and ‘additional measures of osteoarthritis’ (n = 4). Table 3 – Summary of study outcome measures Overarching Domain Subdomain Number of measures/tools Frequency Pain and pain related measures Self-reported intensity/severity/duration 22 57 Objective intensity/severity/duration 4 5 Subscale of an outcome-measure 2 6 Pain related psychological 12 40 Pain related medication 3 8 Domain totals 43 116 Mental/psychological health measures Self–reported depression 9 28 Self-reported Anxiety 5 8 Multicomponent 8 30 Coping/strategies 7 10 General health/wellbeing/distress 8 9 Domain totals 37 85 Progress and agency Self-reported 18 31 Domain totals 18 31 Quality of life Self-reported 12 30 Domain totals 12 30 Disability Self-reported 13 27 Domain totals 13 27 Measures of function Self-reported 11 28 Objective 2 2 Domain totals 13 30 Sleep Self-reported 4 4 Physical activity/performance & exercise related measures Self-reported ROM/flexibility/stiffness 1 1 Self-reported physical activity 8 10 Objective strength/endurance 8 8 Objective ROM/flexibility 3 3 Objective aerobic capacity 5 5 Objective physical capacity 1 4 Domain totals 26 31 Additional measures of osteoarthritis Self-reported 4 7 Domain totals 4 7 Economic 6 12 Domain totals 6 12 Work Self-reported 6 8 Domain totals 6 8 Trial/intervention evaluation 12 18 Domain totals 12 18 Miscellaneous 8 8 Domain totals 8 8 [Insert Table 3 Summary of the outcome measures] Baseline and follow-up assessments Baseline and follow-up assessments highlight significant diversity in the length of follow-ups across the studies. Studies most commonly incorporated baseline, post intervention and 1 x follow-up [ 34 , 39 – 41 , 45 , 46 , 54 , 61 , 63 , 71 , 78 , 81 ], baseline and 2 x follow-ups [ 32 , 38 , 44 , 51 , 64 , 66 , 67 , 75 , 77 , 87 ], baseline and post intervention (pre-post) [ 37 , 43 , 52 , 57 , 62 , 65 , 70 , 84 ], baseline and 1 x follow-up [ 31 , 35 , 69 , 73 , 74 , 84 ] and baseline, post intervention and 2 x follow-ups [ 33 , 47 , 55 , 68 , 80 , 83 ] respectively. Additionally, two studies had baseline, post intervention and 3 x follow-ups [ 49 , 82 ], six had variable follow-ups [ 36 , 42 , 48 , 53 , 58 , 59 , 72 , 76 , 79 , 85 – 87 ] and one did not report the length of follow-up [ 56 ]. Economic evaluation Only 10 studies (18%) reported on the economic impact of the interventions, although the type of evaluation conducted was variable across the studies. Most studies evaluated healthcare service utilisation [ 36 , 61 , 75 , 38 , 77 , 68 , 78 ] followed by the Trimbos/iMAT questionnaire for costs associated with psychiatric illness [ 82 , 54 ]. Less common evaluations involved the Client Services Receipt Inventory (CSRI) [ 41 ], staff cost estimation for the intervention arm [ 61 ] and the number of consulted specialist groups [ 68 ]. Discussion This systematic scoping review comprehensively maps out and presents the breadth and range of non-pharmacological interventions available for people with long-term MSK conditions and co-existing mental distress, achieving the overall aim of the review. Most interventions evaluated over the past 22 years involved an ‘in-person multi-disciplinary and interdisciplinary’ approach, with all interventions involving an exercise therapy/physical activity component, and nearly two thirds integrating psychologically-orientated strategies. Physiotherapists played a key role most interventions, although the majority were delivered by multidisciplinary teams, involving various healthcare professionals, including physiotherapists and psychologists reflecting an integrated, collaborative approach to care. Despite the high number of RCTs identified, substantial heterogeneity in study design, key interventions and outcome measurement limits the generalisability of the findings. Multiple cross-cultural contexts and settings The studies span multiple continents, cultural contexts and settings, suggesting global interest on the topic, which is especially relevant given the rising global prevalence of MSK conditions and mental distress [ 88 ]. A substantial number of studies were conducted within high-income countries, within primary and tertiary care settings [ 89 ]. This trend highlights potential knowledge gaps within community-based and low-income settings and raises concerns about the generalisability of the findings. People experiencing healthcare inequalities are disproportionality affected by MSK conditions and mental distress, underscoring importance for interventions that are responsive to their more complex needs [ 90 ]. Such interventions should not only address clinical outcomes, but also actively promote equitable access to care. Current evidence points to significant barriers to accessing specialist services among these populations [ 91 ] reinforcing the necessity of targeted, contextually appropriate interventions, particularly within community-based settings, where such interventions remain notably underdeveloped. Internet, digital and telephone interventions were identified as the second largest major approach in the current review, highlighting the growing interest in digital healthcare approaches. This trend might be largely driven by technological advancements and strategic policy initiatives. For example, the NHS Long Term Plan outlines clear ambitions to expand the use of digital health tools and services, citing benefits, such as cost savings and improved access to care [ 92 ]. However, while digital interventions may enhance access and outcomes for some, they may also deepen existing health inequalities. This is particularly true for people without internet access, digital literacy, and smart devices, as well as for people with disabilities, which are not accommodated within the digital platforms [ 93 , 94 ]. Reporting for an international audience The inclusion of studies from diverse global regions provides a valuable international perspective, enhancing the relevance of the findings for a worldwide audience. However, the review highlights considerable variation in how international studies report interventions, particularly concerning study setting and psychological strategies. This was compounded by the frequent lack of clarity around the type of psychological strategy and settings reported, since a large proportion of these were undefined [ 95 ]. Additionally, a wide range of outcome measures were employed, many of which are difficult to synthesise into a core, standardise outcome set, partly due to validation and translation across languages. These challenges are further exacerbated by cultural differences, such as varying terminologies/languages used within outcome measures, which cannot be transferred to all contexts. While inadequate reporting is a recognised issue stemming from the diversity of global healthcare systems [ 96 ], the reporting of interventions and outcomes remains an area of improvement requiring researchers to report studies in sufficient detail for an international audience. Integrated psychologically-orientated strategies This review identified a diverse range of psychologically-orientated strategies embedded within the broader interventions. Most interventions combined at least one psychologically-orientated strategy with exercise therapy and/or physical activity. Among studies specifying a psychological approach, CBT was the most frequently employed, which is recognised as the most widely used and extensively studied psychological strategy [ 97 ]. Unlike many other psychological therapies, CBT can be operationalised, making it particularly suitable for evaluation in RCTs [ 98 ]. Furthermore, CBT underpins a range of other psychological therapies, such as ‘third wave therapies’, like mindfulness based cognitive therapy (MBCT) [ 99 ] and Acceptance & Commitment Therapy (ACT) [ 100 ], both of which have demonstrated effectiveness amongst people with physical health conditions. CBT may therefore play a critical role in the ongoing management and rehabilitation of people with MSK conditions. However, further research is needed to determine the most effective methods to broaden access and integration of CBT-based strategies into current MSK pathways. Physiotherapists’ role in psychologically-orientated care Although MDT care is regarded the gold standard, offering co-ordinated and patient-centred management though collaboration across healthcare professionals, practical limitations mean that MSK MDTs in particular often lack psychologists. In the review, most of interventions were delivered by MDTs, although five studies featured physiotherapists as the sole providers of the psychological strategies. Many strategies core to physiotherapists’ practice are considered psychologically oriented, incorporating Behaviour Change Techniques (BCTs), such as goal setting, motivation, feedback and setting outcome expectancies [ 101 , 102 ]. The potential for physiotherapists to deliver some psychologically-orientated strategies has received increasing attention in recent years, particularly in response to the growing prevalence of mental distress and limited access to psychological services. Evidence suggests that some psychologically-orientated strategies delivered by physiotherapists may be effective for improving psychological outcomes amongst people with MSK conditions [ 103 ]. Physiotherapists have expressed positive attitudes towards a variety of psychological interventions, such as promoting behaviour change techniques, motivational talk, cognitive behavioural therapy strategies and offering social support, but barriers to implementation exist, including lack of knowledge, role clarity and time constraints [ 104 ]. Although this remains an underdeveloped area of research, there is a need for greater acknowledgement of physiotherapists’ use of BCTs and to further explore their ability to upskill in the use for some psychologically-orientated strategies, particularly in contexts where access to psychologist-delivered care is limited. Recommendations for future research Based on the gaps identified, this review provides some recommendations for future research. Firstly as discussed, there is a demonstrable need for clearer reporting of interventions and outcomes; to provide sufficient information intended for an international audience to facilitate replication and enable more accurate interpretation of the findings. Moreover, further research is required to assess the effectiveness of these interventions across diverse population groups, with a particular focus on those experiencing health inequalities and community-based settings, as well as developing more inclusive designs, particularly for digital interventions. The review identified a limited number of studies incorporating economic evaluations, which are needed to understand cost-effectiveness and to determine whether the interventions offer value for money, including standardised follow-up times. This becomes even more relevant amongst populations experiencing health inequalities, where cost effectiveness can help reach more people and promote greater access to care, hence economic evaluations should also be incorporated in the future. Finally, there is a need for better recognition of the skillset of physiotherapists for promoting behaviour change in addition to exploring their scope as psychologically-orientated intervention providers particularly when access to MDT care involving psychologists remains limited. Strengths and limitations To the best of our knowledge, this is the first review to comprehensively identify, map, and explore the breadth and range of non-pharmacological management and rehabilitation interventions for people living with long-term MSK conditions and mental distress. The methodological process remained transparent and rigorous through prospective registration of the protocol, strict adherence to a methodological framework [ 15 ] and standardised reporting according to the PRISMA-ScR checklist (Additional file 5). The search strategy was iteratively developed with input from the full team and librarians, thereby strengthening the comprehensiveness of the review searches. Furthermore, the diverse professional skillset of the research team enhanced the contextual underpinning of the findings, particularly as three members have first-hand experience in managing this patient population. Despite the stated strengths, the review also had limitations. Similar to other reviews including peer-reviewed studies, there is a potential for the findings to be influenced by publication bias, leading to inaccurate conclusions, since studies reporting positive findings have a greater representation in the literature [ 105 ]. Due to limited resources, the review identified but did not include studies published in languages other than English, leading to the potential exclusion of relevant studies in other languages. Although the review identified a large group of studies conducted within primary or tertiary care settings, it was not possible to categorise the study setting according to these organisational definitions for more than half of the studies. This finding demonstrates global differences in healthcare terminology, which make it challenging to identify the breadth and range of study settings. Conclusions The review highlights growing global interest in non-pharmacological rehabilitation and management interventions for people with chronic MSK conditions and mental distress over the past 22 years, with notable attention to internet, digital and telephone interventions. Physical activity/exercise remained core to all interventions, with over two thirds also incorporating a psychological strategy. However, poor reporting of interventions and limited representation from low-income countries constrains global relevance of the findings. Physiotherapists played a key role in a substantial proportion of interventions, even though the majority were delivered by MDTs. Resource constraints with MDT-delivered care in the MSK settings indicate that physiotherapists might be well-positioned to deliver some psychologically-orientated strategies when access to MDT care is limited, but this remains an underdeveloped area. Future research is required to report interventions with sufficient detail intended for an international audience, evaluate cost effectiveness, explore the role of physiotherapists in delivering some psychologically-orientated strategies and prioritise studies in community-based and low-income countries. Declarations A bbreviatures Please see additional file 6. Ethics approval and consent to participate Not applicable Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests Funding This systematic scoping review was funded by the Royal National Orthopaedic Hospital NHS Trust and the University of Hertfordshire. Authors' contributions CML, RT, JT, AJ, AA and PR conceived the study aims/objectives and developed the protocol and search strategy. AA and JT performed the electronic databases searches with the support of librarians. RT, AA, JT and CML all contributed to screening and RT, JT and AM extracted the data. RT and JT charted the data and drafted the manuscript, with all members contributing to the interpretation of finings and editing of the manuscript. Acknowledgements The authors would like to thank the Librarians for their support to develop the search strategy and conducted the electronic searches, as well as Amman Merchant, for contributing to the screening of articles and extracting data. References WHO. Musculoskeletal health. [Internet]. 2022 [accessed 2023 Mar 23]. 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1","display":"","copyAsset":false,"role":"figure","size":105721,"visible":true,"origin":"","legend":"\u003cp\u003ePrismaScR flowchart\u003c/p\u003e","description":"","filename":"Figure1PRISMAFlowdiagram.png","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/dd4c019e52475fb478a4fb5a.png"},{"id":91714967,"identity":"6441f274-3290-4c94-8eb6-c46557ae15b2","added_by":"auto","created_at":"2025-09-19 13:09:13","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":76153,"visible":true,"origin":"","legend":"\u003cp\u003ea. study design b. year of publication c. setting d. condition of interest and Number of studies and total number of participants\u003c/p\u003e","description":"","filename":"Figure2Designyearsettingandcondition.png","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/fff91308eb0404cb2858e0e5.png"},{"id":91713702,"identity":"1970e0e1-a8c3-41e6-8268-4e27132d5a68","added_by":"auto","created_at":"2025-09-19 13:01:13","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":215990,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eGlobal Map of Included Studies\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure3Globalmap.png","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/a6cfc69a78a15476db010186.png"},{"id":91717222,"identity":"666e0373-2d35-4aa3-8439-8b8525191633","added_by":"auto","created_at":"2025-09-19 13:33:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":6661525,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/bc24d95e-bfef-4a40-b24f-ebd023ecb447.pdf"},{"id":91713714,"identity":"9f2acfda-1637-44b3-bd7b-e87c6c663522","added_by":"auto","created_at":"2025-09-19 13:01:14","extension":"docx","order_by":8,"title":"","display":"","copyAsset":false,"role":"supplement","size":18322,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile1Feasibilitysearches.docx","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/be2a51ef8d7c8e895f0d4bbd.docx"},{"id":91714969,"identity":"d2fd5647-ba20-40a8-b22b-1d17e26a9c77","added_by":"auto","created_at":"2025-09-19 13:09:13","extension":"docx","order_by":9,"title":"","display":"","copyAsset":false,"role":"supplement","size":19082,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile2InitialsearchstrategyOVID.docx","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/c29e62b0f1608edc56ba1c27.docx"},{"id":91715619,"identity":"21248cf7-2675-43b2-bcd4-a846f9fe668f","added_by":"auto","created_at":"2025-09-19 13:17:14","extension":"doc","order_by":10,"title":"","display":"","copyAsset":false,"role":"supplement","size":110080,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile3Fullelectronicsearchstrategy.doc","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/fb5aa54257e6c2f2fb5a2928.doc"},{"id":91713700,"identity":"68ed1274-f311-4bc7-ac98-9f653a471338","added_by":"auto","created_at":"2025-09-19 13:01:13","extension":"docx","order_by":11,"title":"","display":"","copyAsset":false,"role":"supplement","size":32310,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile4SummaryofSystematicReviews.docx","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/5112d9cd9a651982a7090cb6.docx"},{"id":91714971,"identity":"007dfac4-2f99-4517-b55b-01f0ecb332e0","added_by":"auto","created_at":"2025-09-19 13:09:14","extension":"docx","order_by":12,"title":"","display":"","copyAsset":false,"role":"supplement","size":108852,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile5PRISMAScRChecklist.docx","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/d9875ef2abf0daf859f961f1.docx"},{"id":91713709,"identity":"31b61ce6-2364-4dfb-aefb-25598d054890","added_by":"auto","created_at":"2025-09-19 13:01:14","extension":"docx","order_by":13,"title":"","display":"","copyAsset":false,"role":"supplement","size":16154,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile6Listofabbreviations.docx","url":"https://assets-eu.researchsquare.com/files/rs-6776204/v1/b47950d8ef1c260f520a7adc.docx"}],"financialInterests":"","formattedTitle":"\u003cp\u003eRehabilitation and Management Interventions for People with Chronic Musculoskeletal Condition/S And Mental Distress: A Systematic Scoping Review\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eMusculoskeletal (MSK) conditions pose significant global challenges for healthcare, affecting 1.71\u0026nbsp;billion people worldwide [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and accounting for the leading cause of Years Lived with Disability (YLD) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In the United Kingdom (UK), MSK conditions affect approximately one third of the population, with prevalence rates ranging between 26.9% and 30.1% across all age groups [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. MSK-related issues account for 20% of all General Practitioner (GP) consultations in the UK every year. These conditions account for the third-largest area of expenditure within the National Health Service (NHS), costing approximately \u0026pound;5\u0026nbsp;billion annually [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], and are also among the primary cause of work-related absenteeism, contributing to 23.4\u0026nbsp;million working days lost in 2022 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. MSK conditions including osteoarthritis, back and neck pain are characterised by a range of acute and chronic presentations. Common symptoms include pain, stiffness, fatigue, and reduced mobility, which have substantial impacts on quality of life, independence, and wellbeing [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePeople with chronic MSK conditions are also more likely to experience mental health conditions, or mental distress (encompassing non-specific symptoms of stress, depression and anxiety, indicating impaired mental health), compared to those without [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], and around 30% \u0026minus;\u0026thinsp;60% of people with chronic MSK conditions are reported to be living with both [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. MSK conditions and mental distress influence each other through a bidirectional relationship. Chronic pain and impaired mobility can lead to anxiety, depression or stress, while mental distress can heighten the perception of pain and reduce motivation for physical activity, increasing the risk of exacerbating MSK conditions [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Due to this complex interaction of factors, people with MSK conditions and mental distress are at higher risk of poor clinical outcomes [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], posing challenges for rehabilitation. Currently within the NHS, a gap remains between physical rehabilitation and psychologically-orientated care, as physical and psychological health are often managed separately [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Integrative rehabilitation and management interventions, involving physiotherapists, psychologists and other specialist are therefore increasingly important, and there has been rising interest towards developing and evaluating integrative interventions for people with long terms MSK conditions and mental distress.\u003c/p\u003e\u003cp\u003eThis systematic scoping review aimed to comprehensively map out the breath and range of published literature on non-pharmacological rehabilitation and management interventions for people with chronic/long-term MSK condition(s) and mental distress in terms of: 1) year and location of publication, 2) condition(s) of interest, 3) intervention setting, 4) key interventions and components, 5) intervention provider(s), 6) mode of delivery, 7) study outcome measures 8) dosage, 9) baseline and follow-up assessment time points and 10) economic evaluation. During this mapping process, comparator interventions where available were mapped out. Outcome measures associated with the identified interventions were mapped out including those related to function and disability according to the World Health Organisation (WHO) dimensions [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], quality of life, economic or financial impact, and symptoms such as pain, fatigue, stiffness, and mental health symptoms e.g. anxiety and depression. Knowledge gaps and recommendations for future research were identified by the team.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis scoping review adhered to the methods outlined by Arksey and O\u0026rsquo;Malley\u0026rsquo;s methodological framework [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] (Additional file 5). A multidisciplinary team including clinical, research, and academic physiotherapists, a psychiatrist, nurse, psychology researcher developed the protocol and conducted the review. Two expert librarians provided support to develop the search strategy and conduct the electronic database searches.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eEligibility Criteria\u003c/h2\u003e\u003cp\u003eThe inclusion and exclusion criteria (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) were developed from preliminary feasibility searches conducted in accordance with the Joanna Briggs Institute (JBI\u0026rsquo;s) guidance [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] (Additional file 1). Inclusion criteria were developed using a PC(ICO)C approach, which combines the Population, Concept, Context (PCC) approach recommended by JBI\u0026rsquo;s methodological guidance for scoping reviews [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] and the Population, Intervention, Comparison, Outcomes (PICO) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] approach [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eInclusion and Exclusion Criteria\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInclusion Criteria\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eExclusion Criteria\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePopulation/Participants\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAdults with long-term/ chronic musculoskeletal conditions, pain and mental distress\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePaediatric population (\u0026lt;\u0026thinsp;18 yrs old)\u003c/p\u003e\u003cp\u003ePatients with cancer-related or other non-musculoskeletal conditions\u003c/p\u003e\u003cp\u003ePatients with acute (and not long-term) conditions or trauma\u003c/p\u003e\u003cp\u003ePatients suffering only from migraine\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eConcept\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInterventions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRehabilitation, Physiotherapy/physical therapy, Self-management, supported self-management, multi-modal and/or multidisciplinary interventions, Physical activity, Biopsychosocial approach, Pain management programmes, Psychological therapies (e.g. CBT), CFT, Psychologically informed physiotherapy, Internet-based programmes, Motivational Interviewing, Pain neuroscience education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePharmacological interventions (e.g. opioids, cannabinoids, other pain management medication)\u003c/p\u003e\u003cp\u003eSurgical interventions\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eComparators\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eCollect at literature search/review stage to inform future trials\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutcomes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFunction, Disability according to WHO three dimensions \u0026ndash; impairment, activity limitation, participation restrictions in normal daily activities; Economic/financial impact, Quality of Life, return/modify/adapt to work, cost effectiveness, Symptoms (such as pain, fatigue, stiffness), Mental distress/psychological outcomes (depression, anxiety, fear)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStudies which do not report interventions or outcomes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eContext\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePhysical health setting, Global context\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMental health setting\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eStudy design\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSystematic reviews of systematic reviews/meta-analyses, systematic reviews, RCTs, CCTs, observational, cohort studies, surveys, qualitative studies.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCase studies/series, editorials, commentaries, literature reviews, expert opinion pieces, theoretical approaches, animal trials\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e[Insert Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eInformation sources\u003c/h3\u003e\n\u003cp\u003eAn iterative and extensive search was conducted to ensure breadth and comprehensiveness of coverage [\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Three electronic databases were searched to identify studies published between 1st April 2003 and 31st May 2023 to capture a broad and meaningful span of literature sufficient to identify trends. Searches were initially conducted between May 2023 and June 2023 by (AA) and a librarian, in four databases: CINAHL, Cochrane Library, PsychInfo and MEDLINE. The search was updates by a second librarian (MK) in May 2024 to ensure that recently published articles were not missed. The reference lists of all included studies were screened to identify any further studies meeting the eligibility criteria that were not identified from the initial searches [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Grey literature were not searched as the review aimed to map out published research.\u003c/p\u003e\n\u003ch3\u003eSearch\u003c/h3\u003e\n\u003cp\u003eAn initial search strategy was developed (AA, CML), which was reviewed by the team and refined in consultation with an expert librarian. This search strategy was initially developed for Ovid MEDLINE using MeSH (Medical Subject Headings) and keywords (Additional file 2). Terms included: \u0026ldquo;Chronic NEAR Pain\u0026rdquo;, \u0026ldquo;Musculoskeletal Condition*\u0026rdquo;, \u0026ldquo;Persistent NEAR Pain\u0026rdquo;, \u0026ldquo;Widespread NEAR Pain\u0026rdquo;, \u0026ldquo;Psychological Distress\u0026rdquo;, \u0026ldquo;Emotional Distress\u0026rdquo;, \u0026ldquo;Emotional Stress\u0026rdquo;, \u0026ldquo;Depress*\u0026rdquo;, \u0026ldquo;Anxiety\u0026rdquo;, \u0026ldquo;Anxiousness\u0026rdquo;, \u0026ldquo;Depressive Disorder\u0026rdquo;, \u0026ldquo;Pain Management\u0026rdquo;, \u0026ldquo;Rehabilitation\u0026rdquo;, \u0026ldquo;Intervention*\u0026rdquo;, \u0026ldquo;Physical therap*\u0026rdquo;, \u0026ldquo;Physiotherap*\u0026rdquo;, \u0026ldquo;Quality of Life\u0026rdquo;, \u0026ldquo;Fatigue\u0026rdquo;, \u0026ldquo;Disabilit*\u0026rdquo;, \u0026ldquo;Impairment\u0026rdquo;, \u0026ldquo;Activity Limitation\u0026rdquo;, \u0026ldquo;Financ*\u0026rdquo;, \u0026ldquo;Activities of daily living\u0026rdquo;. The full electronic search strategy for all databases can be found in Additional file 3. To eliminate irrelevant results, search limitations were imposed based on type (i.e., journal article, government report), methodology (i.e., clinical trials, clinical studies, comparative studies, randomised controlled trials, meta-analyses, systematic reviews), and population (i.e., humans).\u003c/p\u003e\n\u003ch3\u003eSelection of sources of evidence\u003c/h3\u003e\n\u003cp\u003eAfter the initial searches, two reviewers (AA, MT) manually screened all articles and sources to remove duplicates. Three reviewers (AA, CML, and MT) independently screened the titles and abstracts of the first 100 articles and discussed any discrepancies until consensus. Once the findings were consistent, the remaining articles were divided between three reviewers (AA, RT and MT) and one other member of the team (CML) provided expertise when there were doubts. Any further uncertainties regarding eligibility were resolved through discussion and consensus with the wider team. Full text articles were subsequently obtained for potentially eligible studies and were independently screened by three reviewers (AM, MT, RT). Any discrepancies were resolved through discussion and consensus among the review team.\u003c/p\u003e\n\u003ch3\u003eData Charting Process and Data Items\u003c/h3\u003e\n\u003cp\u003eA data extraction template was developed in MS Excel (AA, CML) and reviewed by the team to ensure it was fit for purpose. This bespoke proforma was piloted before with three studies (AA and CML) and compared for accuracy between reviewers. The extracted data items included; a) date of publication, b) location of research, c) study design, d) condition(s) of interest, e) intervention setting, f) key interventions, g) intervention provider, h) mode of delivery, i) dosage, j) study outcome measure, k) assessment and follow-ups and l) economic evaluation. Once the pilot phase was complete and inter-agreement was determined for 20% of the articles by two reviewers (AM, MT), the remaining data were extracted by three reviewers (AM, MT, RT), then checked for accuracy by a second reviewer. As with the screening, any uncertainty regarding eligibility was resolved though discussion and consensus with all authors. Upon completion of data extraction for all included articles, two senior authors (RT and MT) proceeded to chart the data.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eSynthesis of results\u003c/h2\u003e\u003cp\u003eUnlike systematic reviews, which aim to synthesise findings to answer specific research questions, scoping reviews focus on summarising the findings of included studies to provide a comprehensive overview of the topic, mapping the breadth and scope of the existing literature. Data were therefore synthesised narratively and performed as per protocol by two authors (MT and RT), with discussions and review by CML, AJ, PR and AA. Data were synthesised in line with the published protocol and the results were presented and charted using tables, graphs and thematic maps to illustrate key patterns, trends and gaps in the literature.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eFollowing deduplication, a total of 7,480 unique records were identified from the searches and screened by the titles and abstract, of which 99 were included for full-text. Fifty-eight articles were included after this screening round, and an additional seven articles were found eligible from the bibliographies of the included articles that were retrieved manually, resulting in 65 articles included. The selection process was charted using PRISMA flow diagram in Fig.\u0026nbsp;1 [\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e] and a summary of the included studies are presented within Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. To avoid duplication, data from systematic reviews (n\u0026thinsp;=\u0026thinsp;8) [\u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e30\u003c/span\u003e] were extracted but excluded from the data synthesis, as some primary studies included within those reviews were also identified in the database search. The data synthesis therefore presented from here onwards includes the 57 primary studies, however a summary of the systematic reviews has been compiled in Additional File 4 to ensure a comprehensive overview. This approach ensured the accuracy and distinctiveness of the data analysed, while the summary of systematic reviews offers an additional resource for contextual understanding.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u0026ndash; Summary of included studies\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eIn-Person Multidisciplinary and Interdisciplinary Approach\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAuthor, Year, Country\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDesign \u0026amp; Aim (s)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePrimary Condition (s) \u0026amp; Participants\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eIntervention (s) Description, Dosage \u0026amp; Evaluation points\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMode of Delivery, Setting \u0026amp; Intervention Provider\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eKey Outcome Measure Domains\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eReported Conclusions\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAmris K \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003cp\u003eDenmark [\u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the functional and psychological outcomes of a multicomponent treatment course compared with a waiting list control.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic Widespread Pain\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;191\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;96 CG n\u0026thinsp;=\u0026thinsp;95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: multicomponent treatment non-residential course involving medication, cognitive behavioural therapy, patient education, and exercise.\u003c/p\u003e\n \u003cp\u003eCG: Waiting list\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: daily programme for 2 weeks (35 hours total).\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluations points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post Intervention \u0026amp; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Rheumatology service\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: rheumatologist, psychologist, nurse, physiotherapist and occupational therapist.\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe 2-week multicomponent treatment course resulted in observable improvement of functional ability in a subgroup of patients at 6-month follow-up.\u003c/p\u003e\n \u003cp\u003eThis improvement, however, was not reflected in secondary patient reported outcomes, including scores of self-reported functional abilities on standardised questionnaires.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBorys C \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo examine the effectiveness of an intensive inpatient multimodal therapy (MMT) programme.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;155\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;89\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: individually-adjusted treatment including: medical treatment (modification of analgesic medication), behavioural management (education, biofeedback and cognitive-behavioural therapy), physiotherapy and active training sessions (Nordic walking).\u003c/p\u003e\n \u003cp\u003eCG: waiting list\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: \u003cem\u003e8 hours per day, 6 days a week for 3 weeks (144h total)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eCG: n/a\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e: Recruitment, Begin and End of intervention, 3 \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: In-patient pain centre\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: pain physicians, psychotherapists, physiotherapists, and pain nurses.\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ Psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMultimodal therapy may be effective with regards to improvements in pain intensity, depression, anxiety, and well-being.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBrendbekken R \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003cp\u003eNorway [\u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare the effects of a Multidisciplinary Intervention (MI) and a Brief Intervention (BI), on mental and physical health complaints, functioning ability and coping in patients on long-term sick leave due to MSK complaints.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic MSK Pain\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;284\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;141\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET) to graphically visualise social and physical problems. ISIVET used to decide ways to go forward, and agreement on actions written down to form rehabilitation plan, typically related to cognitive assessment of health, fear avoidance and catastrophic thinking etc.\u003c/p\u003e\n \u003cp\u003eCG: two consultations based on \u0026apos;non-injury model\u0026apos; to reduce fear and concern through a medical examination, with education about the physiological model on MSK pain.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 3 sessions (ranging 1-3.5h) over 3 months\u003c/p\u003e\n \u003cp\u003eCG: 2 sessions (ranging 1-2.5h) over 2 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline, 3 and 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F and phone\u003c/p\u003e\n \u003cp\u003eCG: Treatment manuals and video taped\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Specialist outpatient clinic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026ndash; 4 physicians, 2 social workers and 4 physiotherapists\u003c/p\u003e\n \u003cp\u003eCG - a physician and physiotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMI may represent an important supplement in the treatment of musculoskeletal pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHamnes B \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2012 [\u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e]\u003c/p\u003e\n \u003cp\u003eNorway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the effects of a multidisciplinary inpatient self-management programme (SMP) on psychological distress, skills as a consumer of health services, self-efficacy, and functional and symptomatic consequences of fibromyalgia.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;150\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: SMP based on a cognitive behavioural approach and focus on enhancing self-efficacy and coping with the disease and daily life. Participants receive individual consultations with the multidisciplinary team if needed.\u003c/p\u003e\n \u003cp\u003eCG: Waiting list\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG:23.5 hours over 1 week\u003c/p\u003e\n \u003cp\u003eCG: No reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBefore randomisation \u0026amp; 3 weeks before intervention \u0026amp;\u003c/p\u003e\n \u003cp\u003e3 weeks after intervention \u0026amp; 6 months (planned, but not collected)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Inpatient Rheumatology service\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: OT, dietician, nurse, physiotherapist, representatives\u003c/p\u003e\n \u003cp\u003efrom patient organisations, rheumatologist, social worker\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Mental /psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSMP had no effect on psychological distress, functional\u003c/p\u003e\n \u003cp\u003eand symptomatic consequences and self-efficacy, except for a small short-term effect on skills and behaviour that are important for managing and participating in health care.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHampel P \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eCluster-block\u003c/p\u003e\n \u003cp\u003eTo analyse the long-term effects of the modified combined cognitive-behavioural pain competence and depression prevention training in a different rehabilitation setting.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;1306\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;637\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;669\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Combined pain competence training, plus four modules of depression prevention training. All 8 modules consisted of group interventions guided by a psychotherapist and group workshop without a psychotherapist.\u003c/p\u003e\n \u003cp\u003eCG: Pain competence training\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 3\u0026ndash;4 weeks, plus 75-min group interventions and 25-minutes group workshop.\u003c/p\u003e\n \u003cp\u003eCG: 3\u0026ndash;4 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp;12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG - F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Inpatient rehabilitation clinic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: physiotherapist, psychotherapist and other members not described.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Work\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePatients with high levels of depressive symptoms showed improvements in depressive symptoms and self-efficacy. However, the beneficial long-term effects of rehabilitation on work ability and pain-related sick leave among the IG support implementation of combined pain competence and depression prevention training.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHaugmark T \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eNorway [\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo study the effects of a community-based multicomponent rehabilitation programme comprising the Vitality Training Programme (VTP) followed by 12 weeks of physical activity (PA) counselling in patients with recently diagnosed Fibromyalgia.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;170\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;85\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: A mindfulness and acceptance-based group programme followed by physical activity counselling. Included patient education, mindfulness \u0026amp; meditation, in addition to individual and group physical activity counselling to set goals/ identify barriers to physical activity.\u003c/p\u003e\n \u003cp\u003eCG: Usual treatment.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 10 weekly 4-hour sessions, with a booster session 6 months after the initial sessions\u003c/p\u003e\n \u003cp\u003eCG: Unorganised intervention\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 3 months for IG \u0026amp; 12 months for IG and CG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG - F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG - Rural and urban community\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Nurses and physiotherapists\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Progress and Agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003cp\u003e\u0026bull; Work\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA multicomponent rehabilitation\u003c/p\u003e\n \u003cp\u003eprogramme combining patient education with a mindfulness-based\u003c/p\u003e\n \u003cp\u003eand acceptance-based\u003c/p\u003e\n \u003cp\u003egroup programme followed by physical activity counselling was not more effective than patient education and treatment as usual for patients with recently diagnosed fibromyalgia at 12-month follow-up.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKaapa E \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2006\u003c/p\u003e\n \u003cp\u003eFinland [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the effectiveness of low-cost semi-intensive outpatient multidisciplinary rehabilitation (MR) compared with individual physiotherapy (IP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;120\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;64\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Physical training, workplace interventions, back school education, relaxation training, and cognitive-behavioural stress management methods.\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapy\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 70 hours over 8 weeks\u003c/p\u003e\n \u003cp\u003eCG1:10 hours over 6 to 8 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; two middle treatment (6 \u0026amp; 12 months) \u0026amp; post treatment (24 months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Outpatient rehabilitation centre\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: A physiotherapist, two occupational physiotherapists, a psychologist, and a physician\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Work\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSemi-intensive outpatient multidisciplinary rehabilitation programme for female chronic low back pain patients does not offer incremental benefits when compared with rehabilitation performed by a physiotherapist having a cognitive-behavioural way of administering the treatment.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLemstra M \u0026amp; Olszynski W\u003c/p\u003e\n \u003cp\u003e2005\u003c/p\u003e\n \u003cp\u003eCanada [\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo assess the effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia in comparison to standard medical care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;79\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;46\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: 18 group supervised exercise therapy sessions, 2 group pain and stress management lectures, 1 group education lecture, 1 group dietary lecture and 2 massage therapy sessions.\u003c/p\u003e\n \u003cp\u003eCG: medical specialist referral (8%), referral to treatment (53%), education (3%), medication (22%), further diagnostics (3%), and nothing at all (11%).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG 25 sessions over 6 weeks (more than 14 hours not all hours reported)\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 15 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Community-based, non-clinical\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Dietitian, massage therapist physical therapist, psychologist and rheumatologist\u003c/p\u003e\n \u003cp\u003eCG: Patients\u0026rsquo; family physician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePositive health-related outcomes can be obtained with a low-cost, group multidisciplinary intervention in a community-based, nonclinical setting.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLera S \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare the ability of two Multidisciplinary Treatments (MTs), with and without Cognitive Behaviour Therapy (CBT), to reduce Fibromyalgia symptoms and increase quality of life.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;83\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;40\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: MT combined with CBT. CBT sessions focused on coping with stress, modifying lifestyles, changing pain behaviours, and improving mental health.\u003c/p\u003e\n \u003cp\u003eCG: MT, which included medical intervention, physical training, education, and discussion about the condition.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG 1: 15 weeks, with sessions held once a week for a duration of 1 hour each.\u003c/p\u003e\n \u003cp\u003eCG: sessions were 90 minutes long and occurred before each multidisciplinary treatment session, except for the first one.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Tertiary hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: a rheumatologist, a rehabilitation practitioner, a physiotherapist, and a clinical psychologist trained in CBT techniques.\u003c/p\u003e\n \u003cp\u003eCG: a rheumatologist, a rehabilitation practitioner, a physiotherapist.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMT improves functional capability and reduces symptom impact. CBT increases mildly the effect of MT in patients with fatigue.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMangels M \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate whether additional psychologic interventions in the context of multidisciplinary inpatient pain treatment increase treatment efficacy compared with normal orthopaedic rehabilitation.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic back pain (CBP)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;363\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG1 n\u0026thinsp;=\u0026thinsp;113\u003c/p\u003e\n \u003cp\u003eIG2 n\u0026thinsp;=\u0026thinsp;119\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG 1: A behavioural-medical inpatient rehabilitation programme with a multidisciplinary treatment approach: group session for pain management; muscle relaxation training; and additional psychologic interventions - individual and in group.\u003c/p\u003e\n \u003cp\u003eIG 2: An additional booster session by telephone within 12 months after discharge for the patients who participated in the behavioural-medical rehabilitation treatment\u003c/p\u003e\n \u003cp\u003eCG: Normal orthopaedic rehabilitation\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG 1: for 4 weeks \u0026minus;\u0026thinsp;9 group sessions of 90 minutes each and weekly individual sessions with the psychotherapist or in a group size of 10 to 12 patients.\u003c/p\u003e\n \u003cp\u003eIG 2: as peer intervention 1 with an additional 7 booster sessions, 12 months after discharge with the duration of 20 minutes each\u003c/p\u003e\n \u003cp\u003eCG: for 4 weeks \u0026minus;\u0026thinsp;9 group sessions of 90 minutes each\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; post-treatment \u0026amp; 1-year follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003eIG2: F2F and phone\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2 \u0026amp; CG: Orthopaedic Rehabilitation Hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2: Multidisciplinary team and two trained clinical psychologists\u003c/p\u003e\n \u003cp\u003eCG: Multidisciplinary team\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAll 3 treatment conditions were effective in improving core outcome measures in chronic back pain patients in the short term. However only slight advantages for the behavioural-medical treatment with subsequent booster sessions compared with the condition without a further maintenance.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMartin \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo assess the efficacy of a 6-week interdisciplinary treatment that combined coordinated psychological, medical, educational, and physiotherapeutic components (PSYMEPHY) over time, compared to standard pharmacologic care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;180\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;54\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: PSYMEPHY, combined \u0026amp; coordinated psychological, medical, educational, and physiotherapeutic components.\u003c/p\u003e\n \u003cp\u003eThe programme targeted three domains: cognitive, physiological, and behavioural included on the psychological component focused on CBT interventions.\u003c/p\u003e\n \u003cp\u003eCG: Standard pharmacologic care, which included pharmacological treatment with a tricyclic antidepressant (amitriptyline, an analgesic (paracetamol,), and an opioid central analgesic (tramadol),\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 6 weeks with 12 sessions, with each patient attending twice-weekly group sessions of 105 minutes for 6 weeks\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; The follow-up times were at 6 months for IG and CG \u0026amp; 12 months for IG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Pain management unit an hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: A physician, clinical psychologist, and a physiotherapist\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAn interdisciplinary treatment\u003c/p\u003e\n \u003cp\u003efor Fibromyalgia was associated with improvements\u003c/p\u003e\n \u003cp\u003ein quality of life, pain, physical function, anxiety and depression, and pain coping strategies up to 12 months after the intervention.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNeumann A and Hampel P\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eCluster-block\u003c/p\u003e\n \u003cp\u003eTo examine the effects of a combined pain competence and depression prevention training compared to the pain competence training and as well as the patients\u0026rsquo; stages of pain on the long-term psychosocial rehabilitation programme.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;1036\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;637\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;669\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Treatment as usual plus cognitive-behavioural pain management and depression prevention training, (called Debora), in addition to elements of mindfulness-based interventions. Group workshops without educators were also included.\u003c/p\u003e\n \u003cp\u003eCG: Treatment as usual plus relaxation exercises.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG 3\u0026ndash;4 weeks, 4\u0026ndash;8 group sessions lasting 75 mins each. Group workshops 25 mins each.\u003c/p\u003e\n \u003cp\u003eCG: 3 to 4 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 6 \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Inpatient multidisciplinary rehabilitation clinics.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: physicians, nursing staff, physiotherapists and psychotherapist \u0026amp; CG - physicians, nursing staff and physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMultidisciplinary rehabilitation seems to be appropriate for patients with CLBP in stage of pain I and II.\u003c/p\u003e\n \u003cp\u003eHowever, patients in stage of pain III need more psychological treatments to manage their mental comorbidities\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSaral I \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003cp\u003eTurkey [\u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate the effects of long- and short-term interdisciplinary treatment approaches for reducing symptoms and improving HRQoL and physical functions of patients with fibromyalgia.\u003c/p\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;66\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIntervention Group Long Term (IGLT) n\u0026thinsp;=\u0026thinsp;22\u003c/p\u003e\n \u003cp\u003eIntervention Group Short term (IGST)\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;22\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIGLT \u0026amp; IGST approaches combined CBT, exercise training, and educational programmes related to fibromyalgia.\u003c/p\u003e\n \u003cp\u003eIGLT: CBT focused on enhancing awareness of the relationship between stressful life events, emotions/ thoughts/ behaviours, and symptomatic patterns. It also aimed to develop coping skills for stressful life events and pain, and increase the ability to express emotions and opinions. Participants were given time to practice aerobic, stretching, and strengthening exercises.\u003c/p\u003e\n \u003cp\u003eIGST: Same as IGLT, but shorter duration.\u003c/p\u003e\n \u003cp\u003eCG: advised to continue previous treatments without change.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIGLT: CBT: 3 hours per session, once a week for 10 weeks. Total of 30 hours. One full day of education and practice. Patients were prescribed home exercise programmes, including aerobic exercises (walking) 3 days a week for 20\u0026ndash;30 minutes, and strengthening and stretching exercises twice a day, 5 days a week, with 5 repetitions for each exercise. Education: 1 full day of education about fibromyalgia, its treatment, and the benefits of exercise.\u003c/p\u003e\n \u003cp\u003eIGST: Education: 4 hours. Exercise Training: 4 hours.\u003c/p\u003e\n \u003cp\u003eCBT: Two 3-hour sessions over two consecutive days. Total of 6 hours.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIGLT \u0026amp;IGST: F2F\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIGLT \u0026amp;IGST \u0026amp; CG: Outpatient clinic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIGLT \u0026amp; IGST: A psychologist specialising in clinical psychology and CBT: A physical therapist, and a team of specialists not stated.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBoth, long and short-term interdisciplinary treatments were effective in reducing the severity of some symptoms and disease activity in patients with fibromyalgia.\u003c/p\u003e\n \u003cp\u003eHowever, a long-term program may be beneficial in reducing fatigue and improving physical function to a higher extent.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSchmidt A \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003cp\u003eDenmark [\u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare the effectiveness of an integrated programme with the existing programme in terms of back-specific disability.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;164\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;82\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG a mix of homebased activities and inpatient stay (a total of 15 inpatient days).\u003c/p\u003e\n \u003cp\u003eCG: a four-week inpatient stay and 26-week follow-up.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: three weeks of inpatient stay (8\u0026ndash;10 hours per day) and 12 weeks of home-based activities.\u003c/p\u003e\n \u003cp\u003eCG: four weeks of inpatient stay \u0026amp; 26-week follow-up (a total of 21 inpatient days).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 26-weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Rheumatology inpatient rehabilitation centre\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Multidisciplinary team job titles not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAn integrated rehabilitation programme was no more effective than an existing rehabilitation programme at the 26-week follow-up.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSerrat M \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo analyse the effectiveness of a multicomponent treatment based on Pain Neuroscience Education (PNE), CBT, and mindfulness training, as an add-on to treatment as usual (TAU) to improve functional impact as well as pain, fatigue, kinesiophobia, physical function, anxiety, and depressive symptoms.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;272\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;135\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: The multicomponent treatment included four main components including: (1) PNE, which aimed to change how patients understood pain, (2). Therapeutic Exercise, involving stretching, balance training, posture correction, and low-impact walking, (3) CBT and (4 Mindfulness Training.\u003c/p\u003e\n \u003cp\u003eCG: Treatment as usual.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: groups of 20 patients per session, with a frequency of one 2-hour weekly session for 12 weeks.\u003c/p\u003e\n \u003cp\u003eCG; advised to follow treatment for 3 months/ 12 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline\u0026amp; post-treatment \u0026amp; 6 and 9 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Tertiary care hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physical therapist \u0026amp; a health psychologist\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCompared with usual care, there was evidence of short-term (up to 3 months) positive effects of the multicomponent treatment for fibromyalgia. Some methodological shortcomings (eg, absence of follow-up in the control group and monitoring of treatment adherence, potential research allegiance) preclude robust conclusions regarding the proposed multicomponent program.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTeixeira M \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003cp\u003eUnited Kingdom [\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo determine the feasibility and acceptability of conducting a future RCT evaluating the clinical and cost- effectiveness of the Collaborative Care Model (CCM) for people with MSK and co-existing mental health conditions.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic MSK conditions\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;40\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;20\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: CCM involved a tailored mental and physical healthcare intervention, co-ordinated by a Case Manager. The Case Manager organised tailored mental health support according to individual needs identified during initial screening, in addition to develop personalised care plans, co-ordinating psychological and MSK outpatient appointments, monitoring progress adjusting support and streamlining communication between physical and mental healthcare providers\u003c/p\u003e\n \u003cp\u003eCG: usual care involving physiotherapy and occupational therapy.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: A monthly basis, with weekly contacts sometimes needed monthly basis for 6 months.\u003c/p\u003e\n \u003cp\u003eCG: Not reported.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; post-treatment \u0026amp; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F, phone and video calls\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Tertiary hospital outpatient\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapist \u0026amp; designated case manager, an assistant psychologist\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapists and or occupational therapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Intervention/trial evaluation\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and Agency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe trial and intervention were acceptable to patients and healthcare professionals. While the findings demonstrate the feasibility of trial recruitment, a future trial will require optimised retention strategies to improve adherence and withdrawal rates.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWippert P \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eMulti Centre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo assess the effectiveness of a self-management programme for people with higher pain and to compare it to regular routines.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;660\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG1 n\u0026thinsp;=\u0026thinsp;222\u003c/p\u003e\n \u003cp\u003eIG2 n\u0026thinsp;=\u0026thinsp;222\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG1: Sensorimotor Training (SMT) and Behavioural Training (BT). The SMT involved a motor control exercise programme including 4 different exercises aiming to enhance core stability. The BT included a cognitive distraction task during SMT, a body scan after SMT, and psychoeducation component.\u003c/p\u003e\n \u003cp\u003eIG2: SMT\u003c/p\u003e\n \u003cp\u003eCG: Standard care (not described)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: a 3-week centre-based programme and a 9-week home-based programme. Participants trained three times per week for approximately 30 minutes.\u003c/p\u003e\n \u003cp\u003eIG2: a 3-week centre-based programme and a 9-week home-based programme.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; middle (3 weeks) \u0026amp; post- intervention (12 weeks) \u0026amp; 24 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: F2F and home base self- guide \u0026amp;\u003c/p\u003e\n \u003cp\u003eIG2: F2F\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2 \u0026amp; CG: Orthopaedic outpatient clinics\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2: Experienced sports therapists and physiotherapists\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCompared to regular routines, the self-management multidisciplinary treatment led to a clinically relevant reduction of pain\u0026ndash;disability and significant mental health improvements.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYamada A \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003cp\u003eBrazil [\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo verify whether physiotherapeutic treatment associated with Pain Neuroscience Education (PNE) could contribute to the reduction of functional disability in patients with nonspecific chronic low back pain (CNLBP).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic non-specific lower back pain (CNLBP)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;40\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;20\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Combination of physical therapy treatment and PNE. The physical therapy protocol focused on kinesiotherapy, which was provided for both the IG and the CG. However, the IG also received 3 individual PNE sessions\u003c/p\u003e\n \u003cp\u003eCG: Only the physical therapy component of the IG.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 12 physiotherapy sessions, twice a week for a period of 6 weeks. Each session was 50 minutes long. PNE: 3 educational sessions before the 12 kinesiotherapy sessions, totalling 15 sessions.\u003c/p\u003e\n \u003cp\u003eCG: 12 physiotherapy sessions, twice a week for a period of 6 weeks. Each session was 50 minutes long.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapy clinic\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: physical therapist \u0026amp; education researcher\u003c/p\u003e\n \u003cp\u003eCG: physical therapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe IG showed significant improvement for all variables. The association showed better results compared to only therapeutic exercises to reduce kinesiophobia and change the perception of pain intensity in the lumbar region.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYeldan I \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003cp\u003eTurkey [\u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare the effects of biofeedback sensor and conventional physiotherapist (PT) feedback during core stabilization and activity training in patients with Chronic Non-Specific Low Back pain (CNLBP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCNLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;40\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;20\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCore intervention for both groups included a standard core stabilization and activity training programme.\u003c/p\u003e\n \u003cp\u003eIG: Biofeedback group received auditory and tactile feedback through a validated tilt sensor integrated with an application called Perfect Practice. The application provided feedback when movements exceed a set threshold.\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapist (PT) Feedback group received extensive verbal and tactile feedback from an experienced PT to guide patients to maintain a neutral position.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eCore programme: 12 sessions, spread over 4 weeks, with each session lasting approximately 30 minutes. Core stabilisation and activity training three times a week. The core stabilisation training included progressively graded 9 exercises performed 10 repetitions/3 sets. The activity training programme consisted of 6 daily living activities in each session. All six daily living activities performed for 1\u0026ndash;2 min, 10 min in total for each session.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Department of Orthopaedics and Traumatology, tertiary hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBiofeedback sensor or PT feedback during core stabilization training equally improves pain, disability, muscle activity, depressive symptoms, patient beliefs, and quality of life in patients with CNLBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChatzitheodorou, D \u003cem\u003eet al.\u003c/em\u003e 2007 Greece [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePilot RCT\u003c/p\u003e\n \u003cp\u003eTo investigate the effects of high intensity aerobic exercise on pain, disability, anxiety or depression, and serum cortisol concentrations in people with chronic musculoskeletal lumbar pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;20\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;10 CG n\u0026thinsp;=\u0026thinsp;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: warm-up, followed by aerobic exercises on a treadmill with increasing intensity before session ended with cool down.\u003c/p\u003e\n \u003cp\u003eCG: Passive modalities with no exercise.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 12 weeks \u0026minus;\u0026thinsp;15 minutes warm-up, 3 minute cool down.\u003c/p\u003e\n \u003cp\u003eCG: 12 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapist \u0026amp; Physician\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Miscellaneous/other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRegular high-intensity aerobic exercise alleviated pain, disability, and psychological strain in participants with chronic low back pain, but did not improve serum cortisol concentrations.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOllevier A et al.\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003cp\u003eBelgium [\u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePilot\u003c/p\u003e\n \u003cp\u003eCohort prospective\u003c/p\u003e\n \u003cp\u003eTo evaluate the effect of multicomponent therapy for fibromyalgia and to explore the predictors for dropout.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;64\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe therapy combined physical and psychological components, including exercises using devices and group exercises, relaxation techniques, and workshops.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e12-week multicomponent therapy programme, involving two-hour sessions twice a week, totalling 24 sessions.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (6 weeks) \u0026amp; Post-treatment (2 weeks after)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eF2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eRehabilitation Centre, secondary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDelivered by\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eOTs physiotherapists, and psychologists under the supervision of a rheumatologist.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/Psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003cp\u003etrial/intervention evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA 12-week multicomponent therapy for fibromyalgia, well described and gradually applied, showed improvement in health-related outcomes.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePfeiffer A \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2003\u003c/p\u003e\n \u003cp\u003eUSA [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePilot Quasi experimental\u003c/p\u003e\n \u003cp\u003eTo determine the effect of a multidisciplinary fibromyalgia treatment program on the impact of illness, depression, and life fulfilment.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;100\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA multidisciplinary group treatment programme (Fibromyalgia Treatment Program (FTP)) aimed to increase physical and mental health functioning, provide accurate and research-based information, and create a standardised treatment approach.\u003c/p\u003e\n \u003cp\u003eProgramme content included Introductory session about pain and fibromyalgia, self-management utilising a cognitive behavioural approach, focusing on wellness and lifestyle management, OT focusing on energy conservation; and Physical therapy involving exercises such as stretching, strength and aerobic exercise.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e1.5 day outpatient programme: introductory educational session is 1 hr in length.; 2 self-management sessions lasting 2.5 hr; 1 OT lasting 1 hr; 1 group physical session lasting 1 hour.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 1 month\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eF2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eOutpatient, tertiary medical centre\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eRegistered nurses, rheumatologists, physiatrists, occupational therapists, physical therapists, and ancillary staff.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA 1.5-day multidisciplinary fibromyalgia\u003c/p\u003e\n \u003cp\u003etreatment program does have a significant positive effect on the impact of illness among patients with fibromyalgia with or without concomitant depression and may be a cost-effective model for the treatment of these patients.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMcCormick Z \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eUSA [\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003eTo investigate whether Complex Regional Pain Syndrome (CRPS) can be effectively treated in a comprehensive interdisciplinary pain management programme.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCRPS\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;42\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-management of chronic pain: relaxation training assisted by biofeedback, pain psychology, occupational therapy, physical therapy, pool therapy, medical management and nursing education.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e8 hours per day (8 am to 4 pm) \u0026amp; 5 days a week for 4 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 1 month\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eF2F (individual or group)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eOutpatient urban interdisciplinary pain management programme.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eOccupational therapist, nurse, physiotherapist, but other professionals not reported.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/exercise related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Agency and progress\u003c/p\u003e\n \u003cp\u003e\u0026bull; Work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThis study demonstrates short-term improvements in physical and emotional functioning, pain coping, and medication usage. These findings are consistent with the rehabilitation philosophy of improving functioning and sense of well-being as of equal value and relevance to pain reduction.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCheng S \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003cp\u003eChina [\u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol,\u003c/p\u003e\n \u003cp\u003eRCT Cluster\u003c/p\u003e\n \u003cp\u003eDouble blind, 1:1\u003c/p\u003e\n \u003cp\u003eTo investigate the long-term effects (up to 6 months post-intervention) of a multimodal intervention combining physical exercise and cognitive behavioural techniques on alleviating the intensity of pain in older adults with chronic musculoskeletal pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic MSK pain\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;150\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: physical exercise, cognitive behavioural techniques\u003c/p\u003e\n \u003cp\u003eCG: pain education programme (usual care).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 10 sessions - physical exercises - each of the ten sessions begins with a 45-minute physical exercise programme that includes a 5-minute warmup and 10-minute stretching, 15-minute strengthening, 10-minute balance, and 5-minute cooldown exercises40-minute\u003c/p\u003e\n \u003cp\u003etraining on cognitive behavioural techniques before a 5-minute conclusion.\u003c/p\u003e\n \u003cp\u003eCG: 10 sessions with similar duration to the IG.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; month 2 \u0026amp; month 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F (on group sessions of 6\u0026ndash;12 participants)\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e20 social centres for older people and outpatient geriatric/ pain clinics.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Research assistant with supervision of a psychologist, physiotherapist and a nursing specialist.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOliveira C \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003cp\u003eBrazil [\u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol,\u003c/p\u003e\n \u003cp\u003eRCT, Single-Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate the efficacy of a multimodal physical activity intervention compared to supervised exercises plus sham coaching and sham activity monitor in patients with chronic, nonspecific CLBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;160\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;80\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: multimodal physical activity intervention consisting of supervised exercises, health coaching and provision of an activity monitor on physical activity levels, pain intensity and disability.\u003c/p\u003e\n \u003cp\u003eCG: the same exercise programme as IG, but with sham health coaching and a sham activity monitor.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eSession with up to 10 people, delivered twice a week for 3 months plus a total of 12 health coaching sessions, each session lasting for 30\u0026ndash;60 min, will be provided over a 3-month period \u0026amp; the activity monitor, Fitbit Flex continuous for 3 months during the walking hours.\u003c/p\u003e\n \u003cp\u003eCG: Same exercise programme as IG plus 1 weekly session, each session lasting for 30\u0026ndash;60 min, over a 3-month period.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; post-treatment \u0026amp; 6- and 12-months post-randomisation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F and telephone contacts\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: 2 outpatient physical therapy clinics.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/exercise related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eInternet, Digital and Telephone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlzahrani H \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eAustralia [\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo examine the feasibility and initial efficacy of a wearables-based walking intervention in addition to usual physiotherapy care in people with LBP at risk of chronicity.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;26\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;12\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Usual care plus wearable-based walking intervention\u003c/p\u003e\n \u003cp\u003eCG: Usual physiotherapy care involved a combination of home exercises, manual therapy, education and advice to maintain usual physical activity.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 8 weeks\u003c/p\u003e\n \u003cp\u003eCG: 8 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post- intervention \u0026minus;\u0026thinsp;9 weeks \u0026amp; 26 weeks post-randomisation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F and data collection from remote device\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003ePrivate physiotherapy practices\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapists\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUsual physiotherapy care plus a wearables-based walking intervention program was safe and moderately feasible, and provided significant reduction in pain at 26 weeks as well as increasing the total volume of light- and moderate-intensity physical activity, and daily walking steps immediately post-intervention.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBennell K \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003cp\u003eAustralia [\u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate the hypothesis that an 8-week internet-based Pain Coping Skills Training PCST programme before a physiotherapist instructed home exercise programme would significantly improve walking pain and physical function at 24 weeks compared with the exercise program alone in people with hip OA.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHip OA\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;144\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;73\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Education and pain coping skills training (PCST) and physiotherapy for home exercises prescription.\u003c/p\u003e\n \u003cp\u003eCG: Education and physiotherapy for home exercises prescription.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: First 8 weeks complete the eight 35- to 45-minute modules at a rate of 1 per week and to practice skills daily and on week 8 to 24, physiotherapy 3 times per week, 30 minutes individual sessions (5 sessions).\u003c/p\u003e\n \u003cp\u003eCG: First 8 weeks educational material, 1 sheet per week and on week 8 to 24 physiotherapy 3 times per week, 30 minutes individual sessions (5 sessions).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (8 weeks) \u0026amp; Post-treatment (24 weeks) \u0026amp; 52 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F and Online\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eCommunity-dwelling\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: MSK physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Additional measures of Osteoarthritis\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/ psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOnline PCST immediately improved pain coping and function but did not confer additional benefits to a subsequent exercise program, despite sustained pain coping improvements.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePak S \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003cp\u003eUSA [\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare clinical outcomes between digital physical therapy and conventional in-person physical therapy in patients with CSP.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic shoulder pain (CSP)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;87\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;46\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: The digital intervention consisted of home exercise, education, and CBT, using a device with movement digitalization for biofeedback and asynchronous physical therapist monitoring through a cloud-based portal.\u003c/p\u003e\n \u003cp\u003eCG: Received in-person physical therapy, including exercises, manual therapy, education, and CBT.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 8 weeks - perform three 20-minute exercise sessions per week (total of 24 sessions).\u003c/p\u003e\n \u003cp\u003eCG: 8 weeks - Two 30-minute sessions per week were prescribed (total of 14\u0026ndash;16 sessions).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (week 4) \u0026amp; Post-treatment (week 8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Video- call and smartphone app\u003c/p\u003e\n \u003cp\u003eCG: F2F, telephone and email\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG - Outpatient physical therapy\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: physical therapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFully remote digital programs can be viable care delivery models for CSP given their\u003c/p\u003e\n \u003cp\u003escalability and effectiveness, assessed through comparison with high-dosage in-person rehabilitation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTore N \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003cp\u003eTurkey [\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo examine the effects of simultaneous telerehabilitation with a physiotherapist in patients with Knee OA and to evaluate the quality of the physiotherapy and rehabilitation programme received through telerehabilitation.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKnee OA\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;50\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;25\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSame exercises provided for both groups, including knee strengthening, ROM and stretching exercises.\u003c/p\u003e\n \u003cp\u003eIG: telerehabilitation was delivered using the Zoom Meetings application, via video conference simultaneously, accompanied by a physiotherapist.\u003c/p\u003e\n \u003cp\u003eCG: Provided with brochure with guidance on how to perform exercises.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eG: 8 weeks - Zoom Meetings application used it 24 times in total for telerehabilitation, excluding their evaluations. The duration and repetitions of these exercises\u003c/p\u003e\n \u003cp\u003ewere increased on a weekly basis. Telerehabilitation was carried out 3 days a week, for 45\u0026ndash;60 min a day and for\u003c/p\u003e\n \u003cp\u003e8 weeks,\u003c/p\u003e\n \u003cp\u003eCG: 8 weeks - Participants made their exercises by themselves.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment (only 8 weeks after treatment)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Video call\u003c/p\u003e\n \u003cp\u003eCG: Brochure\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Not clear\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapist\u003c/p\u003e\n \u003cp\u003eCG: self-management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Additional measures of osteoarthritis\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThis study indicated that telerehabilitation is superior to self-management. Moreover, through this innovative and population specific web-based approach for KOA, a vast number of patients who have internet access could be reached.\u003c/p\u003e\n \u003cp\u003eThus, patients with KOA received effective treatment.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSerrat M \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo examine the effectiveness of two video-based multicomponent programmes (FIBROWALK) and the Multicomponent Physiotherapy Program (MPP) for patients with fibromyalgia (FM) compared to treatment-as-usual (TAU) only.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;330\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG1 n\u0026thinsp;=\u0026thinsp;110\u003c/p\u003e\n \u003cp\u003eIG2 n\u0026thinsp;=\u0026thinsp;110\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG1: FIBROWALK is a multicomponent treatment programme with 5ve components, including Pain Neuroscience Education (PNE), therapeutic exercise, self-management patient education, CBT, and mindfulness training in a group-based format \u0026amp; TAU\u003c/p\u003e\n \u003cp\u003eIG2: Multicomponent Physiotherapy Programme (MPP) involving only physiotherapy techniques \u0026amp; TAU\u003c/p\u003e\n \u003cp\u003eCG: TAU including medications, and written advice on PNE and aerobic exercise adapted to individual capabilities.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: 1-hour weekly video for over 12 weeks.\u003c/p\u003e\n \u003cp\u003eIG2: 1 h per week for 12 weeks\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2: Video based\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1, IG2 \u0026amp; CG: Tertiary hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: Physiotherapist, health psychologist and rheumatologist\u003c/p\u003e\n \u003cp\u003eIG2: Physiotherapist\u003c/p\u003e\n \u003cp\u003eCG: Rheumatologist and other professionals which role not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThis RCT supports the short-term effectiveness of the video-based multicomponent programs\u003c/p\u003e\n \u003cp\u003eFIBROWALK and MPP for FM and provides evidence that cognitive-behavioural and mindfulness-based techniques can be clinically useful in the context of physiotherapeutic multicomponent treatment programs.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSerrat M \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the efficacy of a virtual FIBROWALK compared to Treatment-As-Usual (TAU) in patients with fibromyalgia.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;151\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;76\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: FIBROWALK arm underwent a multicomponent strategy based on therapeutic exercise, pain neuroscience education, CBT and mindfulness training and TAU\u003c/p\u003e\n \u003cp\u003eCG: TAU mainly based on medication, individualised advice on aerobic exercise and basic health education about their condition.\u003c/p\u003e\n \u003cp\u003eThe prescribed medications were not modified during the 12week study for both groups.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 60 min video (hosted on a private YouTube channel) was sent by email once a week for 12 weeks.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG: F2F \u0026amp; Video based\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Tertiary hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Therapists\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe results of this proof-of-concept RCT\u003c/p\u003e\n \u003cp\u003epreliminarily support the efficacy of virtual FIBROWALK in patients with FM during the Spanish\u003c/p\u003e\n \u003cp\u003eCOVID-19 lockdown.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eToelle \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate the clinical effects of a multidisciplinary mHealth back pain App (Kaia App).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;101\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;53\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: The mHealth app (Kaia) facilitated an evidence-based Multidisciplinary pain treatment (MPT) programme focusing on physical, psychological, and educational interventions for non-specific LBP in accordance with current international disease management guidelines.\u003c/p\u003e\n \u003cp\u003eCG: Therapy programme consisting of physiotherapy guided exercises plus online back pain education group.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 6 weeks\u003c/p\u003e\n \u003cp\u003eCG: 6 weeks - six individual physiotherapy sessions \u0026amp; high-quality online education\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 12 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Kaia App\u003c/p\u003e\n \u003cp\u003eCG: F2F and online\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Online\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: APP\u003c/p\u003e\n \u003cp\u003eCG: physiotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResults indicate that the Kaia App as a multidisciplinary back pain app is\u003c/p\u003e\n \u003cp\u003ean effective treatment in LBP patients and is superior to physiotherapy in combination with online education\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYang J \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003cp\u003eChina [\u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo assess the additional effect of self-management on physiotherapy through the application smart-phone APPs on management of chronic low back pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;8\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;5\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Self-management - Individualised exercise was prescribed to each participant by their own APP plus physiotherapy.\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapy may consist of manual therapy, electrophysical therapy, and traction as prescribed by the physiotherapist.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: perform exercises 4 times daily for 4 weeks; an hour per day in total.\u003c/p\u003e\n \u003cp\u003eCG: 4-week physiotherapy\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (2 weeks) \u0026amp; Post-treatment (4 weeks after)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: APP \u0026amp; F2F\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Rehabilitation Clinic at University Hospital\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThis pilot study indicated that smartphone APPS-based self-management program appears to bring additional benefits to physiotherapy for patients with CLBP. Self-management is a potential approach for people with CLBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGarreta-Catala I \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFeasibility\u003c/p\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eMulti centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo provide evidence of multidisciplinary group videoconferencing approach (MGVA) feasibility in managing CNSLBP and its impact on clinical practice.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic non-specific low\u003c/p\u003e\n \u003cp\u003eback pain (CNSLBP)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;18\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;9\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Standard care plus 8 group MGVA consisting of integrated sessions for physical rehabilitation/ physiotherapy, psychology, and social work treatments.\u003c/p\u003e\n \u003cp\u003eCG: Standard care consisted of patient referral for follow-up at the discretion of the healthcare providers involved.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: weekly 2-h group videoconference sessions; Physical Rehabilitation/ Physiotherapy (Total of 8 Sessions); Psychology Treatment (Total of 8 Sessions); Social Work Treatment (Total of 8 Sessions)\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F \u0026amp; videoconference\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG - Tertiary and secondary hospitals and one mental hospital.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG: physiatrist/physiotherapist, pain clinic specialist, general practitioner, and/ or spine surgeon, psychologist, and a social worker.\u003c/p\u003e\n \u003cp\u003eCG: physiatrist/physiotherapist, pain clinic specialist, general practitioner, and/ or spine surgeon.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe multidisciplinary group videoconferencing approach to managing chronic non-specific low back pain was feasible, suggesting overall beneficial effects on patients\u0026rsquo; health and could play a role in changing a patient\u0026rsquo;s status from \u0026ldquo;candidate\u0026rdquo; to \u0026ldquo;non-candidate\u0026rdquo; for surgery.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAmirabadi N \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003cp\u003eIran [\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol,\u003c/p\u003e\n \u003cp\u003eRCT, Single centre, (1:1)\u003c/p\u003e\n \u003cp\u003eTo determine whether exercise therapy via telerehabilitation and mHealth is as effective as the same F2F physical therapy programme in reducing pain and improving physical function and quality of life in people with patellofemoral pain syndrome.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeople with Patellofemoral pain syndrome (PwFPS)\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;\u003cem\u003e=\u0026thinsp;60\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Three stages of therapeutic exercises including stretching, strengthening, balance, and functional exercises delivered via smartphone app.\u003c/p\u003e\n \u003cp\u003eCG: Same as IG, but delivered F2F.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 6 weeks \u0026minus;\u0026thinsp;3 sessions per week (18 sessions and each session lasts half an hour).\u003c/p\u003e\n \u003cp\u003eCG: 6 weeks \u0026amp; sessions descriptions not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment (6 weeks and 18 sessions) \u0026amp; 1 month after\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Smartphone app\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Telerehabilitation\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Assigned physical therapist to explain the application (APP).\u003c/p\u003e\n \u003cp\u003eCG: Physical therapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003e\u0026bull; exercise related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Additional measures of osteoarthritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBijker \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003cp\u003eNetherlands [\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol\u003c/p\u003e\n \u003cp\u003eRCT Cluster (1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the effectiveness of an eHealth intervention blended with physiotherapy compared with physiotherapy alone.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeople with non-specific subacute or persistent spinal pain\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSample size not stated\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Physiotherapy blended with eHealth intervention incorporating six modules, with a focus on pain education and behavioural activation. Modules include (1) \u0026lsquo;understanding pain\u0026rsquo;, (2) \u0026lsquo;feeling safe\u0026rsquo;, (3) \u0026lsquo;feeling balanced\u0026rsquo;, (4) \u0026lsquo;your story\u0026rsquo;, (5) \u0026lsquo;feeling motivated\u0026rsquo; and (6) \u0026lsquo;future goals\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003eCG: Usual care physiotherapy according to the Dutch Clinical Practice Guidelines for low back pain.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: over 6 weeks, with a maximum treatment duration of 8 weeks.\u003c/p\u003e\n \u003cp\u003eCG: 6\u0026ndash;9 physiotherapy sessions\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 12 months after baseline.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Online and F2F\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Primary Care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003cp\u003e\u0026bull; Other/miscellaneous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNeves A \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003cp\u003eBrazil [\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol\u003c/p\u003e\n \u003cp\u003eRCT, Multicentre (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate if telerehabilitation is just as effective as the same face-to-face exercise programme in patients with chronic neck pain (CNP) regarding pain, disability, psychological factors and pain self-efficacy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic neck pain (CNP)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;140\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;70\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Home exercises facilitated by pre-recorded videos, which contains guidelines for performing the exercise, rest time, number of sets and repetitions. A weekly scheduled call will be made to ask nine monitoring questions, including adverse events, according to preference.\u003c/p\u003e\n \u003cp\u003eCG: Same exercises as IG under supervision of physical therapist.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eG: 12 sessions of 30\u0026ndash;40 min each for 6 weeks, receive one video every 2 weeks. To perform the exercises twice a week, with at least one day between them.\u003c/p\u003e\n \u003cp\u003eCG: 12 sessions of 30\u0026ndash;40 min each for 6 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle(6 weeks) \u0026amp; Post-treatment (6 months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Telerehabilitation\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Community centres\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Videos \u0026amp; phone calls\u003c/p\u003e\n \u003cp\u003eCG: Physical therapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdditional In-Person Psychological Interventions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBennell K \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003cp\u003eAustralia [\u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eMulticentre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate whether a 12-week physio\u0026ndash;delivered intervention combined pain coping skills training (PCST) and exercise (PCST/exercise) is more effective and cost effective than either treatment alone for knee OA.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKnee OA\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;222\u003c/p\u003e\n \u003cp\u003eIG1 n\u0026thinsp;=\u0026thinsp;73\u003c/p\u003e\n \u003cp\u003eIG2 n\u0026thinsp;=\u0026thinsp;74\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG1: PCST integrated with exercises: Facilitated by using exercise and examples and encouraged to incorporate at home.\u003c/p\u003e\n \u003cp\u003eIG2: 10 physio\u0026ndash;delivered modules, covering pain education and training in cognitive and behavioural pain coping skills (activity-rest cycling, pleasant activity scheduling, problem solving etc).\u003c/p\u003e\n \u003cp\u003eCG: Exercises only (provision of 6 exercises to strengthen quads, hip abductors and hamstrings)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: 10 x 70min sessions over 12 weeks, then 3 x per week exercises and PCST home practice thereafter\u003c/p\u003e\n \u003cp\u003eIG2: 10 X 45min sessions over 12 weeks, then PCST home practice\u003c/p\u003e\n \u003cp\u003eCG: 10 x 25 min sessions over 12 weeks, then exercises 3 x per week the rafter\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 32 and 52 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2 \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2 \u0026amp; CG: University\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2: Physiotherapists, psychologists\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Additional measures of osteoarthritis\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThis model of care could improve access to psychological treatment and augment patient outcomes from exercise in knee OA, although it did not appear to be cost effective.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHelminen E \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003cp\u003eFinland [\u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo assess the effectiveness of a six-week cognitive\u0026ndash;behavioural group intervention in patients with knee OA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKnee OA\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;111\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;55\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Alongside usual General Practitioner (GP) care, group sessions were provided, including introduction, lecture and insight, problem solving, skills training and homework task led by psychologist. Role of physio was to provide relaxation classes, information on pain mechanisms, and advice on exercises.\u003c/p\u003e\n \u003cp\u003eCG: usual care provided by GP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e2 hours per week for 6 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 3 months \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapist and Psychologist\u003c/p\u003e\n \u003cp\u003eCG: GP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThis trial could not confirm the hypothesized advantage of a cognitive\u0026ndash;behavioural training programme over ordinary GP care in knee OA pain patients.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNagasawa Y \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003cp\u003eJapan [\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate the effectiveness of physical therapist-delivered acceptance and commitment therapy (PACT) in older outpatients with knee osteoarthritis and chronic pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKnee OA\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;30\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;15\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: PACT and exercise therapy (strengthening excs). PACT aimed promote pain acceptance and improve maladaptive pain coping strategies and facilitate psychological flexibility. Homework delivered after each session.\u003c/p\u003e\n \u003cp\u003eCG: usual care exercise therapy.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG:1 hour, 1 x per week for 8 weeks\u003c/p\u003e\n \u003cp\u003eCG: 1 x per week for 8 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e4 weeks pre intervention 7 baseline \u0026amp; 4 weeks and 8 weeks post\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Outpatients, secondary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention Provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapist and Psychologist\u003c/p\u003e\n \u003cp\u003eCG: Physiotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Additional measures of osteoarthritis\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhysical therapist-delivered acceptance and commitment therapy did not appear to show significant effects in the present study.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGodfrey E \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003cp\u003eUK [\u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eMulticentre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the efficacy of Physiotherapy informed by Acceptance and Commitment Therapy (PACT) on functioning at the primary end point of 3 months\u0026rsquo; follow-up, compared with standard, usual care physical therapy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;248\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;124\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Brief physical therapy intervention, guided by principles of ACT. Treatment included an initial physical assessment with feedback, identification of value-based goals, individualized physical exercise prescription, addressing barriers and facilitators to self-management, and skills training to promote psychological flexibility.\u003c/p\u003e\n \u003cp\u003eCG: Any treatment considered suitable by the treating physical therapist, including individual physical therapy and/or back rehabilitation classes, dynamic control classes, manual therapy, and hydrotherapy.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: two 60-minute face-to-face sessions 2 weeks apart conducted in a private room, plus one 20-minute telephone call 1 month later\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline, 3 \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapy outpatients\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental health/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Work\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePsychologically informed physical therapy has great potential but there are challenges in implementation. The training and support included in the PACT trial enabled the intervention to be delivered as planned. This successfully reduced disability in the short but not long term.\u003c/p\u003e\n \u003cp\u003eFindings could inform physical therapists\u0026rsquo; treatment of CLBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRedondo \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2004\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo analyse the long-term efficacy of 2 interventions for female fibromyalgia patients: 1) cognitive behavioural therapy (CBT), and 2) a physical exercise (PE)\u0026ndash;based strategy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;40\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;21\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAll patients were offered pharmacologic treatment.\u003c/p\u003e\n \u003cp\u003eIG: Provision of information about: chronic pain, emotional aspects,, relaxation techniques, chronic pain and daily activity coping strategies, s, social abilities, sleep and resting, problem solving, and prevention of relapses.\u003c/p\u003e\n \u003cp\u003eCG: fitness, muscular endurance, and flexibility. Each session included a preliminary warm-up exercise followed by the specific objective proposed in that session. Each week there was 1 session of exercises in a warm-water pool, 2 sessions of flexibility and endurance exercises, and 2 sessions of cardiovascular fitness by means of a cycle ergometer and isokinetic exercises with weights for upper limbs.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 8 consecutive weeks with a once-weekly session of 2.5\u003c/p\u003e\n \u003cp\u003ehours.\u003c/p\u003e\n \u003cp\u003eCG: 45-minute session of PE 5 times weekly for 8 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 6 month and 12 months after treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: not reported\u003c/p\u003e\n \u003cp\u003eCG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Rheumatology Unit, Tertiary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapists \u0026amp; psychologists\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePE and CBT improve clinical manifestations in FM patients only for short periods of time. Improvement in self-efficacy and physical fitness are not associated with improvement in clinical manifestations.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWellburn S \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003cp\u003eUK [\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQuasi-experimental Single Centre\u003c/p\u003e\n \u003cp\u003eTo evaluate the outcomes and explore experiences of patients undergoing a residential Combined Physical and Psychological Programme (CPPP) for chronic\u003c/p\u003e\n \u003cp\u003eLBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;100\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResidential CPPP involved a multidisciplinary biopsychosocial rehabilitation intervention that included physical, psychological and educational components as recommended by the National Institute for Health and Care Excellence (NICE).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e3 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eQuantitative: Baseline \u0026amp; Post-treatment \u0026amp; 6 and 12 months\u003c/p\u003e\n \u003cp\u003eQualitative: 6\u0026ndash;10 weeks post intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eF2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eResidential rehabilitation centre\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eMultidisciplinary: job titles not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003evan Erp R \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003cp\u003eNetherlands [\u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol,\u003c/p\u003e\n \u003cp\u003eRCT, Multicentre cluster (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate the difference in (cost) effectiveness between a biopsychosocial primary care intervention, Back on Track, and primary care physiotherapy as usual in a subgroup of adults with chronic low back pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003eN\u0026thinsp;=\u0026thinsp;86 participants\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;43\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Intervention based on principles used in cognitive behavioural interventions, for example Graded Activity and Graded exposure. Graded Activity involved an operant conditioning approach to gradually, increase activity level. Graded Exposure involved a classical conditioning approach to expose patients to fearful activities stimulating them to recognize the inconsistency between their unrealistic thoughts about fearful activities.\u003c/p\u003e\n \u003cp\u003eCG: Primary care as usual according to their current knowledge and the Dutch profession-specific guideline for LBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eG: 4 individual sessions (30 minutes) and 8 group sessions (60 minutes). In 8 weeks\u003c/p\u003e\n \u003cp\u003eCG: max of 12 sessions (30 minutes) within eight week.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 8 weeks, 3 \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapy outpatients\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental /psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation-Based Interventions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDragesund T \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eNorway [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo investigate if individual Norwegian Psychomotor Physiotherapy (NPMP) improves pain as a primary outcome and physical function, mental health, sleep, and quality of life as secondary outcomes, compared to Cognitive Patient Education in combination with active physiotherapy (COPE-PT).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWidespread MSK Pain\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;128\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;64\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG1: Key elements of NPMP included: readjusted posture, harmonised muscle tension, breathing and movements and body awareness.\u003c/p\u003e\n \u003cp\u003eCG: COPE-PT was an education programme which aimed to reduce fear of pain, improve understanding of pain \u0026amp; exposure to threatening inputs. These sessions were followed by individualised physiotherapy according to pain problems.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 45-60min session, 1 x per week for 3\u0026ndash;6 months.\u003c/p\u003e\n \u003cp\u003eCG: 30 min session, 1x per week for 4 weeks, followed by individualised physiotherapy 1x per week for 3\u0026ndash;6 months.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (3 month) \u0026amp; Post-treatment \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapy clinic\u003c/p\u003e\n \u003cp\u003eIntervention provider:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/Psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Sleep\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCOPE-PT, which is targeted towards pain‐coping and increasing activity, contribute to more improvements than NPMP.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAreso-B\u0026Atilde;veda P \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eSpain [\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQuasi-experimental\u003c/p\u003e\n \u003cp\u003eMulticentre\u003c/p\u003e\n \u003cp\u003eTo explore the efficacy of an intervention based on Pain Neuroscience Education (PNE) and exercise compared to treatment as usual in Primary Care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;64\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;45 CG n\u0026thinsp;=\u0026thinsp;19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Combination of education sessions, including neurophysiology of pain in combination with physiotherapist guided exercises, including graded exposure to movement and relaxation. Patients received a summary of the session and reading materials\u003c/p\u003e\n \u003cp\u003eCG: No additional therapy beyond the treatment they were undergoing (pharmacotherapy), although informed that in the future, they could receive the group intervention if they wished.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 2h weekly sessions for 6 weeks\u003c/p\u003e\n \u003cp\u003eCG: Not applicable\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline, 2, 6 \u0026amp; 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Urban Health Centres, primary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physician, Physiotherapist, Nurse\u003c/p\u003e\n \u003cp\u003eCG: None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental /psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAn intervention based on PNE and exercise in patients with Fibromyalgia is feasible and seems effective in Primary Care.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStanton T \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003cp\u003eAustralia [\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol\u003c/p\u003e\n \u003cp\u003eRCT, Multicentre\u003c/p\u003e\n \u003cp\u003eTo determine the clinical and cost-effectiveness of a Pain Science Education (PSE)-driven individualised walking, strengthening and education program, called EPIPHA-KNEE, in people with painful knee OA, compared to an individualised current practice.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKnee OA\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;198\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;99 CG n\u0026thinsp;=\u0026thinsp;99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: the EPIPHA-KNEE group received contemporary PSE underpinned by principles of self-regulated learning and conceptual change theory in addition to current practice (control).\u003c/p\u003e\n \u003cp\u003eCG: standardised general OA/activity education, graded walking and strengthening components.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG and CG: 4 x 60\u0026ndash;90 min session over 4 weeks, followed by 4 weeks of home activities. Weekly video calls lasting 20mins. In person follow-up with physio at month 5\u0026amp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (1 week) \u0026amp; Post-intervention (12 week) \u0026amp; 6 and 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F \u0026amp; Video call\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Community physiotherapy clinics, primary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Physical activity\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental health/psychological\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003ePredominantly Self-Management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCedraschi C \u003cem\u003eet al.\u003c/em\u003e 2004 Switzerland [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate a multidisciplinary self-management programme on quality of life and satisfaction with treatment for people with Fibromyalgia, compared with a wait list control group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;164\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;84\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Group sessions including swimming, relaxation exercise, and low impact land exercises, sessions on activities of daily living and education-discussion sessions.\u003c/p\u003e\n \u003cp\u003eCG: Waiting list\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 12 90 min sessions, 2 x a week for 6 weeks.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment \u0026amp; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: F2F\u003c/p\u003e\n \u003cp\u003eCG: n/a\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Outpatients, tertiary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: Physiotherapist, Occupational Therapist, Rheumatologist \u0026amp; Psychologist\u003c/p\u003e\n \u003cp\u003eCG : n/a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA 6 week self-management based programme of pool exercises and education can improve the quality of life of patients with FM and their satisfaction with treatment. These improvements are sustained for at least 6 months after programme completion.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGustavsson C et al.\u003c/p\u003e\n \u003cp\u003e2010 [\u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e]\u003c/p\u003e\n \u003cp\u003eSweden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eMulticentre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare treatment effects of (a) a multi-component pain and stress self-management group intervention (PASS) and (b) individually administered physical therapy (IAPT) for patients with persistent musculoskeletal tension-type neck pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNeck pain\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;156\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;77\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG :PASS information and training programme performed with groups of patients. Each session consisted of applied relaxation training, body awareness exercises, lectures and group discussions. Short lectures combined with group discussions on issues related to pain and pain self-management: anatomy, aetiology, physiology and the psychology of pain and stress.\u003c/p\u003e\n \u003cp\u003eCG: Individual physical therapy sessions according to current practice and was not a standardised treatment procedure.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 7 x 1.5 hours (plus homework) over 7 weeks. Booster session at 20 weeks.\u003c/p\u003e\n \u003cp\u003eCG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 10 and 20 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Health Centre\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePASS had a better effect than IAPT in\u003c/p\u003e\n \u003cp\u003ethe treatment of persistent musculoskeletal tension-type neck pain regarding coping with pain, in\u003c/p\u003e\n \u003cp\u003eterms of patients\u0026rsquo; self-reported pain control, self-efficacy, disability and catastrophizing, over the\u003c/p\u003e\n \u003cp\u003e20-week follow-up.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFrih Z \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003cp\u003eTunisia [\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo assess the efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain (CLBP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;107\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;54\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: Home based rehabilitation programme involving group practical supervised rehabilitation of 18 exercises (positioning, strengthening and stretching). Advised to perform daily at home with support of illustrative booklet.\u003c/p\u003e\n \u003cp\u003eCG: The programme included analgesic electrotherapy, flexibility training, pain management, stretching and proprioception exercises and muscle strengthening exercises. All patients received an individual session by the same physiotherapist.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG weekly 2-hour sessions with physio, then daily exercises for 2 months. Participants reviewed after 1 month then given 9 exercises to perform each day for 1 month.\u003c/p\u003e\n \u003cp\u003eCG: 90 mins per day, 3 x per week\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Middle (4 weeks) \u0026amp; Post-treatment (3 months) \u0026amp; 6 and 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physical Medicine Rehabilitation or Rheumatology unit, Tertiary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Trial/intervention evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA home-based rehabilitation programme is as effective as standard physical therapy. However, this type of\u003c/p\u003e\n \u003cp\u003eprogramme requires patient motivation and regular follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJessep S \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003cp\u003eUK [\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo establish the feasibility of Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain) and compare its clinical effectiveness and costs with outpatient physiotherapy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChronic Knee Pain\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;64\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;29\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: The programme aimed to change behaviour by challenging inappropriate beliefs regarding condition and physical activity, encouraging regular exercise and enabling self-management though informal group discussions, information about coping and exercise regimen. After completion, a written, tailored home exercise regimen and information about local community exercise facilities/ self-help groups was provided.\u003c/p\u003e\n \u003cp\u003eCG: Outpatient physiotherapy\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 10 sessions (2 x per week for 5 weeks)\u003c/p\u003e\n \u003cp\u003eCG: 1 x 30\u0026ndash;45 min assessment then up to 10x PT sessions\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-intervention \u0026amp; 12 months.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Outpatient physiotherapy department and community centre, primary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Additional measures of Osteoarthritis\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eValim \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2003\u003c/p\u003e\n \u003cp\u003eBrazil [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT,\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare two exercise modalities, aerobic fitness training and stretching exercises, in patients with Fibromyalgia.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFibromyalgia\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;60\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: walking programme monitored with frequency meters. Each training session was preceded by a warm-up period and cool down upon completion.\u003c/p\u003e\n \u003cp\u003eCG: General exercises involving the face, cervical spine, trunk and extremities, which were chosen to provide overall flexibility.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 3 times a week, of 45 min duration, for 20 weeks.\u003c/p\u003e\n \u003cp\u003eCG; 3 sessions a week of 45 min duration each and included 17 exercises, for 20 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; week 10 and 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Rheumatology outpatient, Tertiary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResults confirm that aerobic exercise is beneficial to patients with Fibromyalgia, but the\u003c/p\u003e\n \u003cp\u003ecardiorespiratory fitness gain is not related to improvement of Fibromyalgia symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTrapp W \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003cp\u003eUK [\u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRCT\u003c/p\u003e\n \u003cp\u003eSingle Centre (1:1)\u003c/p\u003e\n \u003cp\u003eTo examine the effects of a combined intervention that utilises visual feedback, motion and sensory discrimination training in patients with Chronic Low back Pain (LBP).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;30\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;15\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: In addition to standard treatment, the Feedback Group (FG) received 6 feedback sessions where they watched the image of their back during a brief 2-point discrimination training. They were then advised to perform pelvic tilts using isolated lumbar and multifidus muscles.\u003c/p\u003e\n \u003cp\u003eCG: Units of physiotherapy, relaxation training and movement training (walking) - relaxation training, movement therapy, massage, pain education intervention \u0026amp; psychological consultation.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 6h per day (standard treatment) \u0026minus;\u0026thinsp;3 times per week) plus 6 x 20 min sessions over 2 weeks.\u003c/p\u003e\n \u003cp\u003eCG: 6 h per day (standard treatment), plus 6 x 30 min sessions over 2 weeks\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Inpatient rehabilitation ward\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental /psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFindings imply that very simple feedback interventions without major technical requirements could be a valuable supplement to standard treatment in CLBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeonhardt C \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003cp\u003eGermany [\u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePilot\u003c/p\u003e\n \u003cp\u003eQuasi experimental\u003c/p\u003e\n \u003cp\u003eTo develop a standardised graded exposure treatment according to the fear-avoidance model of musculoskeletal pain for older patients with CLBP and to examine its effectiveness and feasibility in the German health care system.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;16\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKey components included determination of functional goals (session 1), establishment of a fear hierarchy (session 2), patient education (sessions 2\u0026ndash;4), graded exposure to activities causing fear (from session 3 to 11), and transfer into everyday life and re-evaluation of the fear hierarchy.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e12 sessions of 45-minutes over 9 weeks.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eF2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eRehabilitation centre, primary care\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003ePhysiotherapists with previous psychological training (form psychologist).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Measures of function\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe treatment appears effective and feasible. In addition to the benefits achieved by the participants, the study provides a basis for designing future studies at a higher level of evidence.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeorge S \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003cp\u003eUSA [\u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQuasi-experimental\u003c/p\u003e\n \u003cp\u003eSingle Centre\u003c/p\u003e\n \u003cp\u003eTo determine whether pain intensity and disability outcomes\u003c/p\u003e\n \u003cp\u003ewere associated with treatment received (graded exercise or graded exposure) and if changes in selected psychological factors were associated with pain and disability\u003c/p\u003e\n \u003cp\u003eoutcomes.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;33\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG n\u0026thinsp;=\u0026thinsp;15\u003c/p\u003e\n \u003cp\u003eCG n\u0026thinsp;=\u0026thinsp;18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAll participants enrolled on to a chronic pain management programme to limit medication use, receive education, relaxation and intensive physical therapy with the interdisciplinary team.\u003c/p\u003e\n \u003cp\u003eIG: (Graded Exercise) included general therapeutic activities, which were progressed with a quota-based system.\u003c/p\u003e\n \u003cp\u003eCG: Graded exposure included specific activities that were feared due to back pain, which were progressed with a hierarchical exposure paradigm.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e7 hours per day/ \u0026amp; 5 days per week.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDuration: 3\u0026ndash;5 weeks depending on participant\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; Post-treatment (3 or 5 weeks)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Not reported\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG 1 \u0026amp; CG: Interdisciplinary team: clinical psychologists, physiotherapists, physicians, nurses, biofeedback therapists and occupational therapists.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhysical therapy supplemented with graded exercise or graded exposure resulted in equivalent clinical outcomes for pain intensity and disability. The overall treatment effects were modest in this setting. Instead of being associated with a specific behavioural intervention, reductions in pain and disability were associated with reductions in depressive symptoms and pain catastrophizing, respectively.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHay E \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2008\u003c/p\u003e\n \u003cp\u003eUK [\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol\u003c/p\u003e\n \u003cp\u003eRCT Multicentre (1:1)\u003c/p\u003e\n \u003cp\u003eTo compare the overall effectiveness of a \u0026quot;subgrouping for targeted treatment STarT\u0026quot; approach with \u0026quot;best current care\u0026quot; (non-targeted) physiotherapy practice, over a 12-month period, for LBP.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLBP\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026thinsp;=\u0026thinsp;800\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: not stated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG: (targeted treatment). The STarT Back tool score is used to identify/address specific concerns. A \u0026apos;Back Book\u0026apos; is given with an information about local services (ie, swimming), plus video to re-enforce message. Patients then triaged according to \u0026apos;low risk\u0026apos; (no further treatment, \u0026apos;medium risk\u0026apos; (physiotherapy approaches) or \u0026apos;high risk\u0026apos; (psychological and physio approach).\u003c/p\u003e\n \u003cp\u003eCG: Best practice usual care - a consultation with an experienced community physiotherapist who is blinded to the results of the STarT Back tool. A management plan is formulated according to normal clinical practice. This may include referral to community physiotherapy.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG: 30 mins plus 15 min video to re-enforce message.\u003c/p\u003e\n \u003cp\u003eCG: 30-minute consultation\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 4 and 12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: F2F\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Primary care centre\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG \u0026amp; CG: Physiotherapists\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Quality of Life\u003c/p\u003e\n \u003cp\u003e\u0026bull; Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHurley M \u003cem\u003eet al.\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2010 [\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e]\u003c/p\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProtocol\u003c/p\u003e\n \u003cp\u003eRCT, Single Centre (1:1:1)\u003c/p\u003e\n \u003cp\u003eTo evaluate the feasibility of an RCT, exploring the effects of three forms of physiotherapy on sleep quality in people with chronic low back pain.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCLBP\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;60\u003c/p\u003e\n \u003cp\u003eIG1, IG2 \u0026amp; CG: not stated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIG1: Supervised exercise class (SEC) group-based format based on the \u0026apos;Back to Fitness\u0026apos; programme underpinned by cognitive behavioural therapy principles, agreement on goals, exercise therapy sessions \u0026amp; promotion of self-management.\u003c/p\u003e\n \u003cp\u003eIG2: Waking programme (WP) to increase physical activity through a graded walking \u0026amp; agreement on goals. Participants to be given education manual and pedometer.\u003c/p\u003e\n \u003cp\u003eCG: Usual Physiotherapy (UP): multimodal approach of education/ advice, manipulative therapy and exercise therapy, plus individualised home exercise programme.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDosage\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG 1: once per week for 8 weeks, group based\u003c/p\u003e\n \u003cp\u003eIG 2: 8 weeks. Participants to encourage minimum of 10 min walk 4 days per week. Aim to progress to 30mins 5 x week.\u003c/p\u003e\n \u003cp\u003eCG: baseline plus 3 F2F sessions and 1 x 6 month follow up\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eEvaluation points\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eBaseline \u0026amp; 3 and 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMode\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: F2F\u003c/p\u003e\n \u003cp\u003eIG2 \u0026amp; CG: F2F \u0026amp; Home\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSetting\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1 \u0026amp; IG2 \u0026amp; CG: Physiotherapy outpatients department\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eIntervention provider\u003c/em\u003e:\u003c/p\u003e\n \u003cp\u003eIG1: Physiotherapist\u003c/p\u003e\n \u003cp\u003eIG2: Self-management\u003c/p\u003e\n \u003cp\u003eCG: Not clear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026bull; Sleep\u003c/p\u003e\n \u003cp\u003e\u0026bull; Disability\u003c/p\u003e\n \u003cp\u003e\u0026bull; Pain and pain related measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Mental/psychological health measures\u003c/p\u003e\n \u003cp\u003e\u0026bull; Progress and agency\u003c/p\u003e\n \u003cp\u003e\u0026bull; work\u003c/p\u003e\n \u003cp\u003e\u0026bull; Physical activity/performance/\u003c/p\u003e\n \u003cp\u003eexercise related measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003en/a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eACT - Acceptance and Commitment Therapy; ASE - Arthritis Self-Efficacy; BI - Brief Intervention; BPS - Biopsychosocial; CBT - Cognitive Behavioural Therapy; CBE - Centre-Based Exercise; CG - Control Group; CLBP - Chronic Low Back Pain; CNSLBP - Chronic Non-Specific Low Back Pain; CPPP - Combined Physical and Psychological Program;\u003c/p\u003e\n \u003cp\u003eFM - Fibromyalgia; F2F - Face-to-Face; FG - Feedback Group; GP - General Practitioner; HBE - Home-Based Exercise; HRQoL - Health-Related Quality of Life; IG - Intervention Group; IAPT - Individually Administered Physical Therapy; IGLT - Intervention Group Long Term; IGST - Intervention Group Short Term; IMPT - Interdisciplinary Multimodal Pain Treatment; IP - Individual Physiotherapy; ISIVET - Interdisciplinary Structured Interview with a Visual Educational Tool; KOA - Knee Osteoarthritis; LBP - Low Back Pain;\u003c/p\u003e\n \u003cp\u003eMBR - Multidisciplinary Biopsychosocial Rehabilitation; MI - Multidisciplinary Intervention; MMT - Multimodal Therapy; MPVA - Multidisciplinary Pain Videoconferencing Approach; MSK - Musculoskeletal; MT - Multidisciplinary Treatment; MPP - Multicomponent Physiotherapy Programme; MR - Multidisciplinary Rehabilitation;\u003c/p\u003e\n \u003cp\u003eMSMP - Multidisciplinary Self-Management Program; NPMP - Norwegian Psychomotor Physiotherapy; OA - Osteoarthritis; OT - Occupational Therapy;\u003c/p\u003e\n \u003cp\u003ePACT - Physiotherapy informed by Acceptance and Commitment Therapy; PASS - Pain and Stress Self-Management; PCST - Pain Coping Skills Training; PE - Physical Exercise;\u003c/p\u003e\n \u003cp\u003ePNE - Pain Neuroscience Education; PSYMEPHY - Psychological, Medical, Educational, and Physiotherapeutic Programme; PT - Physiotherapy; QOL - Quality of Life;\u003c/p\u003e\n \u003cp\u003eRCT - Randomised Controlled Trial; ROM - Range of Motion; SMP - Self-Management Program; SMT - Sensorimotor Training; STarT - Subgrouping for Targeted Treatment;\u003c/p\u003e\n \u003cp\u003eTAU - Treatment As Usual; UP - Usual Physiotherapy; VTP - Vitality Training Program; WOMAC - Western Ontario and McMaster Universities Arthritis Index\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e[Insert Fig.\u0026nbsp;1 PrismaScR flowchart]\u003c/p\u003e\n\u003cp\u003e[Insert Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e\n\u003cp\u003eFigure 2 presents the data by year of publication, study design, setting and MSK conditions of interest.\u003c/p\u003e\n\u003cp\u003e[ Insert Fig.\u0026nbsp;2a. study design b. year of publication c. setting d. condition of interest and Number of studies and total number of participants]\u003c/p\u003e\n\u003ch3\u003eTimeline of Publication\u003c/h3\u003e\n\u003cp\u003eThe annual publication rate shows noticeable fluctuations, indicating variable levels of research activity on the topic across a 22-year period. Between 2003\u0026ndash;2008 [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e], publication rates remained low, with one to two publications per year. In 2009, there was a temporary peak (n\u0026thinsp;=\u0026thinsp;4) [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e], followed by gradual growth until 2019. A more significant rise began in 2020, peaking in 2021 (n\u0026thinsp;=\u0026thinsp;8) [\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e], the highest in the 22-year period. Although output declined slightly after 2021, research activity remained higher, with five articles published in both 2022 [\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e] and 2023 [\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e]. In 2024, the number decreased to three [\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e]. Overall, the data reflects growing interest on the topic since 2003.\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eLocation of research\u003c/h2\u003e\n \u003cp\u003eNearly two thirds of publications (n\u0026thinsp;=\u0026thinsp;37, 65%) originated from Europe, with Spain (n\u0026thinsp;=\u0026thinsp;8), [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e], the UK (n\u0026thinsp;=\u0026thinsp;7) [\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e] and Germany (n\u0026thinsp;=\u0026thinsp;7), [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e], producing 22 publications combined, representing 39% of all articles. Figure\u0026nbsp;3 presents the global distribution of studies in more detail, illustrating a global interest across 20 countries and five continents.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003e[Figure 3 Global Map of Included Studies]\u003c/h2\u003e\n \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\n \u003ch2\u003eStudy design\u003c/h2\u003e\n \u003cp\u003eA range of study designs were employed amongst the primary studies, although most were RCTs (n\u0026thinsp;=\u0026thinsp;40, 70%) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e], five of which had three arms [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e]. Fewer (n\u0026thinsp;=\u0026thinsp;9, 16%) were protocol [\u003cspan class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e], pilot (n\u0026thinsp;=\u0026thinsp;4, 7%) [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e] and quasi-experimental studies (n\u0026thinsp;=\u0026thinsp;3, 5%) [\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e] and one used a cohort design [\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eCondition(s) of Interest\u003c/h2\u003e\n \u003cp\u003eInterventions were targeted towards a wide range (n\u0026thinsp;=\u0026thinsp;10) of MSK conditions. However, over a third of the studies (n\u0026thinsp;=\u0026thinsp;24) involved patients with chronic low back pain (4,561 participants) [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], followed by fibromyalgia (n\u0026thinsp;=\u0026thinsp;15) (1,973 participants) [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e], mild-moderate knee osteoarthritis (n\u0026thinsp;=\u0026thinsp;6) (675 participants) [\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e] and chronic primary musculoskeletal pain (n\u0026thinsp;=\u0026thinsp;5) (575 participants) [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e]. See Fig.\u0026nbsp;2 for less common conditions.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention Setting\u003c/h2\u003e\n \u003cp\u003eThirty seven studies (65%) were single centre [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], while 14 (25%) were multicentre [\u003cspan class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e]. Six studies (10%) did not report the number of sites [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e]. Interventions were delivered across a wide range of predominantly clinical settings, apart from one study that was conducted on a university [\u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e] and another which involved a digital application [\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eAmongst the studies with clearly defined settings, the majority were delivered in the primary (n\u0026thinsp;=\u0026thinsp;10) [\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e] and tertiary care setting (n\u0026thinsp;=\u0026thinsp;9) [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], while two were conducted in secondary care [\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e]. It was not possible to categorise the study setting according to primary, secondary or tertiary care definitions for more than half of all studies (n\u0026thinsp;=\u0026thinsp;34; 60%) due to differences in terminology across the studies. These settings are therefore reported as described by the articles and are presented within Fig.\u0026nbsp;2.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eKey interventions\u003c/h2\u003e\n \u003cp\u003eSixty-two intervention groups were delivered across the 57 primary studies (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). These interventions were categorised according to five major approaches, namely; 1) in-person multidisciplinary and interdisciplinary (n\u0026thinsp;=\u0026thinsp;25) [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], 2) internet, digital and telephone (n\u0026thinsp;=\u0026thinsp;12) [\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], 3) additional in-person psychological programme (n\u0026thinsp;=\u0026thinsp;7) [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e]; 4) Education-based (n\u0026thinsp;=\u0026thinsp;3) [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e] and 5) predominantly self-management (n\u0026thinsp;=\u0026thinsp;2) [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e]. The interventions described in eight studies [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e], did not fit into a clearly defined category and were therefore categorised as \u0026lsquo;other\u0026rsquo;.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eKey intervention components\u003c/h2\u003e\n \u003cp\u003eAll Intervention included at least one or more physical training component, such as exercise therapy and/or physical activity. Sixty-five percent (n\u0026thinsp;=\u0026thinsp;37) incorporated at least one or more psychological strategy or talking therapy, 42% (n\u0026thinsp;=\u0026thinsp;24) of which were clearly defined. The most common, was Cognitive Behavioural Therapy (CBT) (n\u0026thinsp;=\u0026thinsp;13) [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], while there was significant heterogeneity in the remaining strategies, including; Combined pain competence and depression prevention training [\u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e], combined pain education and behavioural activation [\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e], depression prevention training [\u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e], mindfulness and meditation (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e], stress management (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e], cognitive-behavioural pain management and depression prevention training (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e]; CBT or mindfulness (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e], mental health support if required (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e], and behavioural training (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e]. There was a group of undefined psychological interventions (n\u0026thinsp;=\u0026thinsp;13) [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e], 17 studies did not include any psychological strategy [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], and three studies did not report clearly [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eThere was also substantial heterogeneity amongst the studies in terms of the content of the comparator groups. Most (n\u0026thinsp;=\u0026thinsp;21) employed \u0026lsquo;usual care\u0026rsquo; [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e88\u003c/span\u003e], while others comprised of: physiotherapy (n\u0026thinsp;=\u0026thinsp;7) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e]; waiting list (n\u0026thinsp;=\u0026thinsp;4) [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e]; in person exercises (n\u0026thinsp;=\u0026thinsp;3) [\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e] individual physiotherapy sessions (n\u0026thinsp;=\u0026thinsp;2) [\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e]; multidisciplinary team approach (n\u0026thinsp;=\u0026thinsp;2) [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e]; non-injury model (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e]; medication (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e]; treatment as usual with relaxation exercises (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e]; inpatient programme (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e]; physiotherapy with education and CBT (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e]; cognitive patient education with physiotherapy (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e]; brochures with exercises (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e]; education and physiotherapy at home (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e]; graded exposure (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e] passive modalities with no exercise (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e]; pain education programme (n\u0026thinsp;=\u0026thinsp;1) exercise programme with sham health coaching and a sham activity monitor (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e]; in-person exercises (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e]; and physiotherapy and pain education group (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention providers\u003c/h2\u003e\n \u003cp\u003eA diverse range of healthcare professionals delivered interventions. Physiotherapists solely delivered interventions amongst 16 studies, [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e], however most studies employed a combination of healthcare professionals including; Physiotherapists and psychologists (n\u0026thinsp;=\u0026thinsp;6) [\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], physiotherapists and one other non-psychology healthcare professional (n\u0026thinsp;=\u0026thinsp;4) [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e], and physiotherapists and more than two other healthcare professionals (n\u0026thinsp;=\u0026thinsp;21) [\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e]. On one study was delivered by a psychologist and a nurse team [\u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e] and it was unclear who delivered the intervention in another [\u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e] and the other through self-management [\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eAmongst the 37 studies that included a psychological strategy, five were delivered by a physiotherapist [\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e], while it was not clear who delivered the psychological component amongst four of the studies [\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eOver a third of comparator groups (n\u0026thinsp;=\u0026thinsp;25) were exclusively provided by physiotherapists [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], while others were provided by a combination of health care professionals including; A physiotherapist and two or more health care professionals (n\u0026thinsp;=\u0026thinsp;6) [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e], a physiotherapist and another health care professional (n\u0026thinsp;=\u0026thinsp;2) [\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e], GPs (n\u0026thinsp;=\u0026thinsp;2), and one study was self-management [\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e]. It was unclear who provided the comparator groups for 16 studies [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\n \u003ch2\u003eMode of delivery\u003c/h2\u003e\n \u003cp\u003eOver two thirds of studies (n\u0026thinsp;=\u0026thinsp;39) were exclusively delivered in-person [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], while fewer employed a hybrid approach (n\u0026thinsp;=\u0026thinsp;9) [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e]. Interventions were also delivered using various technologies, including digital applications (n\u0026thinsp;=\u0026thinsp;2) [\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e]; telerehabilitation (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e]; videos (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e]; video calls (Zoom) (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e]; videos calls and digital applications (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e] and combination on in-person and digital application (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e]. The mode of delivery was undefined amongst two studies [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eA similar trend was observed for the comparator groups. In-person (n\u0026thinsp;=\u0026thinsp;29) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e] and hybrid approach (n\u0026thinsp;=\u0026thinsp;7) [\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e] were most common, in comparison to video (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e]; and brochures (n\u0026thinsp;=\u0026thinsp;1) [\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e], however 15 comparator groups were not clearly defined [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention duration\u003c/h2\u003e\n \u003cp\u003eIntervention durations were heterogeneous, ranging from less than one week to more than six months. The duration most commonly ranged between four and twelve weeks (26/57 studies) [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], followed by interventions lasting between three and six months (14/57 studies) [ 32, 37, 39, 42, 43, 47, 52, 59, 72, 73, 78, 80, 83, 86]. Eight interventions were shorter, ranging from less than one week to four weeks [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e], while only two lasted more than six months [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e], [\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e]. Seven studies did not clearly specify duration [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eThe majority of comparator groups (n\u0026thinsp;=\u0026thinsp;27) had durations equivalent to those in the intervention groups [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], while six differed [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e]. A large number of comparator groups (n\u0026thinsp;=\u0026thinsp;19) did not specify or clearly report the duration [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\n \u003ch2\u003eNumber of intervention sessions and intensity\u003c/h2\u003e\n \u003cp\u003eThe number of sessions varied substantially. Over a third of studies (n\u0026thinsp;=\u0026thinsp;23) ranged between 1\u0026ndash;12 sessions [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e], followed by 12\u0026ndash;24 sessions (n\u0026thinsp;=\u0026thinsp;13) [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e], and more than 25 sessions (n\u0026thinsp;=\u0026thinsp;5) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e]. The number of sessions was variable amongst three studies [\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e], while 13 either did not clearly report or report the number of sessions [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eThe intensity of the interventions (defined as the total number of hours/minutes) also demonstrated diversity. In one study the shortest intensity was less than one hour [\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e], however the most common intensity range was between 1\u0026ndash;12 hours [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e], 12\u0026ndash;24 hours [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], \u0026gt;\u0026thinsp;48 hours [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e] and 24\u0026ndash;48 hours [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e] respectively. Additionally, eight studies delivered interventions across variable intensities [\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e] and nine did not clearly define or report the intensity of the intervention [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eIn the comparator groups, the number of sessions and intensity were equivalent to the intervention group (n\u0026thinsp;=\u0026thinsp;10) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e]; different from the intervention (n\u0026thinsp;=\u0026thinsp;18) [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e], or not reported/unclear (n\u0026thinsp;=\u0026thinsp;25) [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Outcome measures\u003c/h2\u003e\n \u003cp\u003eThere was substantial heterogeneity amongst the outcome measures used to evaluate the effectiveness of the interventions included within the review as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. A total of 202 outcome measures/assessment tools were identified amongst the 57 primary studies, which were categorised according to 13 overarching domains and 23 sub-domains. The \u0026lsquo;pain and pain related measures\u0026rsquo; domain had the highest number of outcome measures (n\u0026thinsp;=\u0026thinsp;43), where \u0026lsquo;self-reported measures of pain/intensity/duration and \u0026lsquo;pain related psychological measures\u0026rsquo; were the most commonly evaluated. The second largest overarching domain was \u0026lsquo;mental and psychological health measures\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;37), followed by \u0026lsquo;Physical activity/performance/exercise related measures\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;26), and \u0026lsquo;progress and agency\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;18). The overarching domains with the smallest range of outcome measures was \u0026lsquo;economic\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;6), \u0026lsquo;work\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;6), \u0026lsquo;sleep\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;4) and \u0026lsquo;additional measures of osteoarthritis\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;4).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;text-align:justify;line-height:200%;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003eTable 3 \u0026ndash; Summary of study outcome measures\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003ctable style=\"width:733.6pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: 1pt solid windowtext;border-left: 1pt solid windowtext;border-bottom: none;border-right: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eOverarching Domain\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border-right: none;border-bottom: none;border-left: none;border-image: initial;border-top: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSubdomain\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border-right: none;border-bottom: none;border-left: none;border-image: initial;border-top: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eNumber of measures/tools\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: none;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eFrequency\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 12.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003ePain and pain related measures\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 12.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 12.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 12.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported intensity/severity/duration\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e22\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e57\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eObjective intensity/severity/duration\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSubscale of an outcome-measure\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.7pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.7pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003ePain related psychological\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.7pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e12\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.7pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e40\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003ePain related medication\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e43\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e116\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eMental/psychological health measures\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf\u0026ndash;reported depression\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e28\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported Anxiety\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eMulticomponent\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e30\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eCoping/strategies\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e10\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eGeneral health/wellbeing/distress\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e37\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e85\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(231, 230, 230);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eProgress and agency\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(231, 230, 230);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(231, 230, 230);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(231, 230, 230);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eSelf-reported\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e18\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e31\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e18\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e31\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eQuality of life\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e12\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e30\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e12\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e30\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eDisability\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e13\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e27\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e13\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e27\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eMeasures of function\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e28\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eObjective\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e13\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e30\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eSleep\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-left: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003ePhysical activity/performance \u0026amp; exercise related measures\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported ROM/flexibility/stiffness\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eSelf-reported physical activity\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e10\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eObjective strength/endurance\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eObjective ROM/flexibility\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eObjective aerobic capacity\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003eObjective physical capacity\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e26\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e31\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eAdditional measures of osteoarthritis\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eSelf-reported\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e4\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e7\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eEconomic\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e12\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e6\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e12\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eWork\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family: \"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eSelf-reported\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e6\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e8\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family: \"Arial\",sans-serif;color:black;'\u003eTrial/intervention evaluation\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e12\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e18\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e12\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e18\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003eMiscellaneous\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: rgb(242, 242, 242);padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-right: none;border-bottom: none;border-image: initial;border-left: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-bottom: none;border-left: none;border-image: initial;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:black;'\u003e8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 283.25pt;border-top: none;border-left: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-right: none;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003eDomain totals\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 191.35pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:left;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127.55pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e8\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 131.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0in 5.4pt;height: 14.05pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;text-align:center;line-height:normal;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:12px;font-family:\"Arial\",sans-serif;color:red;'\u003e8\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;text-align:justify;line-height:200%;font-size:16px;font-family:\"Calibri\",sans-serif;'\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003e[Insert Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e Summary of the outcome measures]\u003c/p\u003e\n \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e\n \u003ch2\u003eBaseline and follow-up assessments\u003c/h2\u003e\n \u003cp\u003eBaseline and follow-up assessments highlight significant diversity in the length of follow-ups across the studies. Studies most commonly incorporated baseline, post intervention and 1 x follow-up [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e], baseline and 2 x follow-ups [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], baseline and post intervention (pre-post) [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e], baseline and 1 x follow-up [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e] and baseline, post intervention and 2 x follow-ups [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e] respectively. Additionally, two studies had baseline, post intervention and 3 x follow-ups [\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e], six had variable follow-ups [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e79\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e] and one did not report the length of follow-up [\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e].\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\n \u003ch2\u003eEconomic evaluation\u003c/h2\u003e\n \u003cp\u003eOnly 10 studies (18%) reported on the economic impact of the interventions, although the type of evaluation conducted was variable across the studies. Most studies evaluated healthcare service utilisation [\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e] followed by the Trimbos/iMAT questionnaire for costs associated with psychiatric illness [\u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e]. Less common evaluations involved the Client Services Receipt Inventory (CSRI) [\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e], staff cost estimation for the intervention arm [\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e] and the number of consulted specialist groups [\u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis systematic scoping review comprehensively maps out and presents the breadth and range of non-pharmacological interventions available for people with long-term MSK conditions and co-existing mental distress, achieving the overall aim of the review. Most interventions evaluated over the past 22 years involved an \u0026lsquo;in-person multi-disciplinary and interdisciplinary\u0026rsquo; approach, with all interventions involving an exercise therapy/physical activity component, and nearly two thirds integrating psychologically-orientated strategies. Physiotherapists played a key role most interventions, although the majority were delivered by multidisciplinary teams, involving various healthcare professionals, including physiotherapists and psychologists reflecting an integrated, collaborative approach to care. Despite the high number of RCTs identified, substantial heterogeneity in study design, key interventions and outcome measurement limits the generalisability of the findings.\u003c/p\u003e\u003cdiv id=\"Sec26\" class=\"Section2\"\u003e\u003ch2\u003eMultiple cross-cultural contexts and settings\u003c/h2\u003e\u003cp\u003eThe studies span multiple continents, cultural contexts and settings, suggesting global interest on the topic, which is especially relevant given the rising global prevalence of MSK conditions and mental distress [\u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e88\u003c/span\u003e]. A substantial number of studies were conducted within high-income countries, within primary and tertiary care settings [\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e]. This trend highlights potential knowledge gaps within community-based and low-income settings and raises concerns about the generalisability of the findings. People experiencing healthcare inequalities are disproportionality affected by MSK conditions and mental distress, underscoring importance for interventions that are responsive to their more complex needs [\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e]. Such interventions should not only address clinical outcomes, but also actively promote equitable access to care. Current evidence points to significant barriers to accessing specialist services among these populations [\u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e] reinforcing the necessity of targeted, contextually appropriate interventions, particularly within community-based settings, where such interventions remain notably underdeveloped.\u003c/p\u003e\u003cp\u003eInternet, digital and telephone interventions were identified as the second largest major approach in the current review, highlighting the growing interest in digital healthcare approaches. This trend might be largely driven by technological advancements and strategic policy initiatives. For example, the NHS Long Term Plan outlines clear ambitions to expand the use of digital health tools and services, citing benefits, such as cost savings and improved access to care [\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e]. However, while digital interventions may enhance access and outcomes for some, they may also deepen existing health inequalities. This is particularly true for people without internet access, digital literacy, and smart devices, as well as for people with disabilities, which are not accommodated within the digital platforms [\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e, \u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec27\" class=\"Section2\"\u003e\u003ch2\u003eReporting for an international audience\u003c/h2\u003e\u003cp\u003eThe inclusion of studies from diverse global regions provides a valuable international perspective, enhancing the relevance of the findings for a worldwide audience. However, the review highlights considerable variation in how international studies report interventions, particularly concerning study setting and psychological strategies. This was compounded by the frequent lack of clarity around the type of psychological strategy and settings reported, since a large proportion of these were undefined [\u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e95\u003c/span\u003e]. Additionally, a wide range of outcome measures were employed, many of which are difficult to synthesise into a core, standardise outcome set, partly due to validation and translation across languages. These challenges are further exacerbated by cultural differences, such as varying terminologies/languages used within outcome measures, which cannot be transferred to all contexts. While inadequate reporting is a recognised issue stemming from the diversity of global healthcare systems [\u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e96\u003c/span\u003e], the reporting of interventions and outcomes remains an area of improvement requiring researchers to report studies in sufficient detail for an international audience.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\u003ch2\u003eIntegrated psychologically-orientated strategies\u003c/h2\u003e\u003cp\u003eThis review identified a diverse range of psychologically-orientated strategies embedded within the broader interventions. Most interventions combined at least one psychologically-orientated strategy with exercise therapy and/or physical activity. Among studies specifying a psychological approach, CBT was the most frequently employed, which is recognised as the most widely used and extensively studied psychological strategy [\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e]. Unlike many other psychological therapies, CBT can be operationalised, making it particularly suitable for evaluation in RCTs [\u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e98\u003c/span\u003e]. Furthermore, CBT underpins a range of other psychological therapies, such as \u0026lsquo;third wave therapies\u0026rsquo;, like mindfulness based cognitive therapy (MBCT) [\u003cspan citationid=\"CR99\" class=\"CitationRef\"\u003e99\u003c/span\u003e] and Acceptance \u0026amp; Commitment Therapy (ACT) [\u003cspan citationid=\"CR100\" class=\"CitationRef\"\u003e100\u003c/span\u003e], both of which have demonstrated effectiveness amongst people with physical health conditions. CBT may therefore play a critical role in the ongoing management and rehabilitation of people with MSK conditions. However, further research is needed to determine the most effective methods to broaden access and integration of CBT-based strategies into current MSK pathways.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec29\" class=\"Section2\"\u003e\u003ch2\u003ePhysiotherapists\u0026rsquo; role in psychologically-orientated care\u003c/h2\u003e\u003cp\u003eAlthough MDT care is regarded the gold standard, offering co-ordinated and patient-centred management though collaboration across healthcare professionals, practical limitations mean that MSK MDTs in particular often lack psychologists. In the review, most of interventions were delivered by MDTs, although five studies featured physiotherapists as the sole providers of the psychological strategies. Many strategies core to physiotherapists\u0026rsquo; practice are considered psychologically oriented, incorporating Behaviour Change Techniques (BCTs), such as goal setting, motivation, feedback and setting outcome expectancies [\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e, \u003cspan citationid=\"CR102\" class=\"CitationRef\"\u003e102\u003c/span\u003e]. The potential for physiotherapists to deliver some psychologically-orientated strategies has received increasing attention in recent years, particularly in response to the growing prevalence of mental distress and limited access to psychological services. Evidence suggests that some psychologically-orientated strategies delivered by physiotherapists may be effective for improving psychological outcomes amongst people with MSK conditions [\u003cspan citationid=\"CR103\" class=\"CitationRef\"\u003e103\u003c/span\u003e]. Physiotherapists have expressed positive attitudes towards a variety of psychological interventions, such as promoting behaviour change techniques, motivational talk, cognitive behavioural therapy strategies and offering social support, but barriers to implementation exist, including lack of knowledge, role clarity and time constraints [\u003cspan citationid=\"CR104\" class=\"CitationRef\"\u003e104\u003c/span\u003e]. Although this remains an underdeveloped area of research, there is a need for greater acknowledgement of physiotherapists\u0026rsquo; use of BCTs and to further explore their ability to upskill in the use for some psychologically-orientated strategies, particularly in contexts where access to psychologist-delivered care is limited.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eRecommendations for future research\u003c/h3\u003e\n\u003cp\u003e Based on the gaps identified, this review provides some recommendations for future research. Firstly as discussed, there is a demonstrable need for clearer reporting of interventions and outcomes; to provide sufficient information intended for an international audience to facilitate replication and enable more accurate interpretation of the findings. Moreover, further research is required to assess the effectiveness of these interventions across diverse population groups, with a particular focus on those experiencing health inequalities and community-based settings, as well as developing more inclusive designs, particularly for digital interventions. The review identified a limited number of studies incorporating economic evaluations, which are needed to understand cost-effectiveness and to determine whether the interventions offer value for money, including standardised follow-up times. This becomes even more relevant amongst populations experiencing health inequalities, where cost effectiveness can help reach more people and promote greater access to care, hence economic evaluations should also be incorporated in the future. Finally, there is a need for better recognition of the skillset of physiotherapists for promoting behaviour change in addition to exploring their scope as psychologically-orientated intervention providers particularly when access to MDT care involving psychologists remains limited.\u003c/p\u003e\u003cdiv id=\"Sec31\" class=\"Section2\"\u003e\u003ch2\u003eStrengths and limitations\u003c/h2\u003e\u003cp\u003e To the best of our knowledge, this is the first review to comprehensively identify, map, and explore the breadth and range of non-pharmacological management and rehabilitation interventions for people living with long-term MSK conditions and mental distress. The methodological process remained transparent and rigorous through prospective registration of the protocol, strict adherence to a methodological framework [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and standardised reporting according to the PRISMA-ScR checklist (Additional file 5). The search strategy was iteratively developed with input from the full team and librarians, thereby strengthening the comprehensiveness of the review searches. Furthermore, the diverse professional skillset of the research team enhanced the contextual underpinning of the findings, particularly as three members have first-hand experience in managing this patient population.\u003c/p\u003e\u003cp\u003eDespite the stated strengths, the review also had limitations. Similar to other reviews including peer-reviewed studies, there is a potential for the findings to be influenced by publication bias, leading to inaccurate conclusions, since studies reporting positive findings have a greater representation in the literature [\u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e]. Due to limited resources, the review identified but did not include studies published in languages other than English, leading to the potential exclusion of relevant studies in other languages. Although the review identified a large group of studies conducted within primary or tertiary care settings, it was not possible to categorise the study setting according to these organisational definitions for more than half of the studies. This finding demonstrates global differences in healthcare terminology, which make it challenging to identify the breadth and range of study settings.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe review highlights growing global interest in non-pharmacological rehabilitation and management interventions for people with chronic MSK conditions and mental distress over the past 22 years, with notable attention to internet, digital and telephone interventions. Physical activity/exercise remained core to all interventions, with over two thirds also incorporating a psychological strategy. However, poor reporting of interventions and limited representation from low-income countries constrains global relevance of the findings. Physiotherapists played a key role in a substantial proportion of interventions, even though the majority were delivered by MDTs. Resource constraints with MDT-delivered care in the MSK settings indicate that physiotherapists might be well-positioned to deliver some psychologically-orientated strategies when access to MDT care is limited, but this remains an underdeveloped area. Future research is required to report interventions with sufficient detail intended for an international audience, evaluate cost effectiveness, explore the role of physiotherapists in delivering some psychologically-orientated strategies and prioritise studies in community-based and low-income countries.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003cstrong\u003ebbreviatures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePlease see additional file 6.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis systematic scoping review was funded by the Royal National Orthopaedic Hospital NHS Trust and the University of Hertfordshire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCML, RT, JT, AJ, AA and PR conceived the study aims/objectives and developed the protocol and search strategy. AA and JT performed the electronic databases searches with the support of librarians. RT, AA, JT and CML all contributed to screening and RT, JT and AM extracted the data. RT and JT charted the data and drafted the manuscript, with all members contributing to the interpretation of finings and editing of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the Librarians for their support to develop the search strategy and conducted the electronic searches, as well as Amman Merchant, for contributing to the screening of articles and extracting data.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWHO. Musculoskeletal health. [Internet]. 2022 [accessed 2023 Mar 23]. 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Biochem Med. 2017;27(3):030201. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.11613/BM.2017.030201\u003c/span\u003e\u003cspan address=\"10.11613/BM.2017.030201\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Musculoskeletal chronic conditions, Mental distress, Non-pharmacological interventions, Physiotherapist, Rehabilitation, Scoping review","lastPublishedDoi":"10.21203/rs.3.rs-6776204/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6776204/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eMusculoskeletal (MSK) conditions and mental distress present significant challenges for rehabilitation services. Currently, mental and physical healthcare is often segregated despite growing recognition for integrative interventions. This review aimed to map out and provide an overview of non-pharmacological management and rehabilitation interventions for adults with long-term MSK conditions and mental distress, to identify evidence gaps and provide recommendations for future research.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e\u003cp\u003eMEDLINE, CINAHL, PsycInfo, and Cochrane Library were searched for peer-reviewed articles published between 2003 and 2024 for studies involving rehabilitation/ management interventions for adults with long-term MSK conditions and mental distress. Titles and abstracts were divided among three reviewers for screening and full-texts of included articles were screened by two. Data were extracted on year, location, condition, design, key intervention characteristics and outcomes.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFifty-seven primary studies involving 62 interventions were included. Most studies (70%) were Randomised Controlled Trials conducted in Europe (65%), with substantial heterogeneity in the design of the remaining studies. 42% included adults with low back pain and five major intervention approaches were identified: In-person multidisciplinary, Internet, digital and telephone, Additional in-person psychological, Education-based, and Predominantly self-management. Eight studies did not fit a distinct category. Most interventions were conducted in primary or tertiary care, all included a physical activity/exercise component and 65% integrated psychologically-orientated strategies, of which Cognitive Behavioural Therapy was the most common, while 35% were undefined. 54% were delivered by multidisciplinary teams involving physiotherapists. There was substantial heterogeneity in outcome measures, with 202 outcome measures identified spanning 13 domains and 22 subdomains. Only 19% of studies included economic evaluations.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThis review highlights global interest on the topic, with a growing number of studies evaluating internet, digital and telephone interventions, however insufficient intervention reporting and limited representation from community-based and low-income settings reduces global relevance. The findings are broadly discussed in relation to physiotherapists\u0026rsquo; role in psychologically-orientated care when access to psychologists is limited, promoting access to care with a focus on underserved and low-income communities, and reporting for an international audience.\u003c/p\u003e\u003ch2\u003eSystematic Review Registration:\u003c/h2\u003e\u003cp\u003eOpen Science Framework registration (OSF) on the 13th July 2023 \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://osf.io/489fj/\u003c/span\u003e\u003cspan address=\"https://osf.io/489fj/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e","manuscriptTitle":"Rehabilitation and Management Interventions for People with Chronic Musculoskeletal Condition/S And Mental Distress: A Systematic Scoping Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-19 13:01:08","doi":"10.21203/rs.3.rs-6776204/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-09-12T18:09:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-12T03:54:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"Systematic Reviews","date":"2025-05-30T04:55:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ed44f5f6-ee6b-4ef3-abaf-070e13232694","owner":[],"postedDate":"September 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-19T13:01:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-19 13:01:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6776204","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6776204","identity":"rs-6776204","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}