The Clinical journal of pain · 2026
The Effect of Behavioural Interventions that Include Goal Setting on Pain, Disability, and Physical Activity in People With Chronic Musculoskeletal Pain: A Systematic Review and Meta-analysis.
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Natoli Andrew R, Gibbs Mitchell T, Mishra Isha, Devonshire Jack, O'Brien-Smith Jade, McAuley James H, Cashin Aidan G, Jones Matthew D
Аннотация
OBJECTIVES: This systematic review and meta-analysis aimed to assess the effect of behavioural interventions that include goal setting on pain, disability, and physical activity in people with chronic musculoskeletal pain.
METHODS: Five electronic databases (PubMed, CENTRAL (Cochrane Library), PEDro, PsycINFO, CINAHL) and three clinical trial registers (ClinicalTrials.gov, ANZCTR, ISRCTN) were searched from inception to August 2025 for randomised controlled trials of behavioural interventions with goal setting compared to matched comparators without goal setting, usual care, or wait-list. Screening, data extraction, risk of bias (RoB2), and certainty of evidence assessments (GRADE) were conducted in duplicate. We performed random-effects meta-analyses to estimate effects on pain, disability, and physical activity.
RESULTS: Thirty-six trials involving 7,275 participants (mean age 57.29.2 y; 61.6% female) were included. Compared to matched comparators at post-intervention, behavioural interventions that include goal setting may reduce pain (SMD -0.32, 95%CI: -0.58 to -0.06, very low certainty) and disability (SMD -0.52, 95% CI: -0.90 to -0.15; low certainty) and increase physical activity (SMD 0.88, 95% CI: -0.32 to 2.07), but the effect is imprecise and very uncertain. Usual care and wait-list comparisons found varied effects on outcomes post-intervention, based on moderate to very low certainty evidence.
DISCUSSION: Behavioural interventions that include goal setting may produce small improvements in pain and disability in adults with chronic musculoskeletal pain, but effects on physical activity are unclear. If clinicians choose to include goal setting within a behavioural intervention, they should consider how it could be best implemented to guide behaviour change and support evidenced-based management.
METHODS: Five electronic databases (PubMed, CENTRAL (Cochrane Library), PEDro, PsycINFO, CINAHL) and three clinical trial registers (ClinicalTrials.gov, ANZCTR, ISRCTN) were searched from inception to August 2025 for randomised controlled trials of behavioural interventions with goal setting compared to matched comparators without goal setting, usual care, or wait-list. Screening, data extraction, risk of bias (RoB2), and certainty of evidence assessments (GRADE) were conducted in duplicate. We performed random-effects meta-analyses to estimate effects on pain, disability, and physical activity.
RESULTS: Thirty-six trials involving 7,275 participants (mean age 57.29.2 y; 61.6% female) were included. Compared to matched comparators at post-intervention, behavioural interventions that include goal setting may reduce pain (SMD -0.32, 95%CI: -0.58 to -0.06, very low certainty) and disability (SMD -0.52, 95% CI: -0.90 to -0.15; low certainty) and increase physical activity (SMD 0.88, 95% CI: -0.32 to 2.07), but the effect is imprecise and very uncertain. Usual care and wait-list comparisons found varied effects on outcomes post-intervention, based on moderate to very low certainty evidence.
DISCUSSION: Behavioural interventions that include goal setting may produce small improvements in pain and disability in adults with chronic musculoskeletal pain, but effects on physical activity are unclear. If clinicians choose to include goal setting within a behavioural intervention, they should consider how it could be best implemented to guide behaviour change and support evidenced-based management.