Evaluating the effectiveness and implementation of digital health interventions for patients with spinal cord injury: a systematic review and meta-analysis.
Yu Jiang, Zhili Ding, Bowen Deng et al.
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In 30 seconds
This systematic review and meta-analysis assessed digital health interventions (DHIs) versus control groups in patients with spinal cord injury, drawing on 26 randomised controlled trials. DHIs were associated with improvements in several outcomes, including pain, independence, mood, lower-limb function, balance, and some quality-of-life domains; upper-limb function did not improve significantly. The largest reported functional result was a 10.69-point higher Functional Independence Measure score (MD = 10.69, 95% CI 9.33-12.04, P < 0.00001). Evidence certainty ranged from very low to moderate, and most included trials were rated at high risk of bias.
Key findings
- Functional Independence Measure scores improved with DHIs (MD = 10.69, 95% CI 9.33-12.04, P < 0.00001).
- Pain decreased (SMD = -0.19, 95% CI -0.38 to -0.00, P = 0.05); depressive and anxiety symptoms also improved.
- Lower-limb function and balance improved, while no significant improvement was found in upper-limb function.
- Reach ranged from 14.05% to 100%, feasibility from 58.33% to 100%, and adherence from 51.05% to 100%.
Why it matters
Digital interventions may extend or complement rehabilitation for people with spinal cord injury and could support functional, psychological, and quality-of-life outcomes. However, the findings span diverse outcomes and implementation measures, and the review reports limited certainty. Clinicians and services should therefore interpret the apparent benefits alongside the high risk of bias in most included trials.
What to keep in mind
Nineteen of 26 trials were rated overall at high risk of bias, and evidence certainty ranged from very low to moderate. Implementation measures varied widely across studies.