Effectiveness of remotely-delivered Psychologically-Informed Physical Therapy (PIPT) for people with chronic pain: a systematic review with meta-analysis.

OBJECTIVE

To evaluate the effectiveness of remotely-delivered Psychologically-Informed Physical Therapy (PIPT) for individuals with chronic pain (CP) through a systematic review and meta-analysis.

METHODS

Seven databases were searched until May 2025. Randomized controlled trials (RCTs) assessing PIPT effects by physiotherapists for CP people were included. Primary outcomes were pain and disability; secondary outcomes included quality of life, self-efficacy, kinesiophobia, and costs. The risk of bias (RoB) and certainty of evidence (CoE) were assessed using the Cochrane RoB 2.0 tool and GRADE approach, respectively. Random effect meta-analyses were performed.

RESULTS

Four RCTs (n = 911 participants) involving patients with knee osteoarthritis were included. Meta-analyses showed low CoE that remotely-delivered PIPT reduces pain (MD = -0.81 at 6 months; -0.50 at 12 months) and moderate CoE that it can reduce disability (MD = -3.44 at 6 months; -5.71 at 12 months) compared to other remote interventions. Quality of life improvements were also reported but did not exceed the minimal clinically important difference. One study showed improved self-efficacy but no significant effects on kinesiophobia or healthcare costs. The RoB was assessed as ranging from some concerns to high.

CONCLUSION

Compared to other remote intervention, there is low CoE that PIPT can decrease pain,moderate CoE that PIPT can reduce disability and low CoE that PIPT can improve quality of life. Although effect sizes were small, these findings support the integration of psychological principles into telerehabilitation. Further research is warranted to explore its generalizability to other CP conditions and to compare its effectiveness against psychologist-led interventions.