title: A systematic review of interventions aimed at increasing physical activity in adults with chronic musculoskeletal pain--protocol.
abstract: BACKGROUND
  Chronic musculoskeletal pain is highly prevalent, affecting around one in five people across Europe. Osteoarthritis, low back pain, neck pain and other musculoskeletal disorders are leading causes of disability worldwide and the most common source of chronic pain. Exercise and/or physical activity interventions have the potential to address not only the pain and disability associated with chronic pain but also the increased risk of morbidity and mortality seen in this population. Although exercise and/or physical activity is widely recommended, there is currently a paucity of research that offers an evidence base upon which the development or optimisation of interventions can be based. This systematic review will investigate the components of interventions associated with changes in physical activity levels in adults with chronic musculoskeletal pain.
  
  
  METHODS
  This systematic review will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidance. Randomised and quasi-randomised controlled trials of interventions aimed at increasing physical activity in adults with chronic musculoskeletal pain will be included. Articles will be identified through a comprehensive search of the following databases: CENTRAL in the Cochrane Library, the Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Embase, CINAHL, PsycINFO and AMED. Two review authors will independently screen articles retrieved from the search for eligibility, extract relevant data on methodological issues and code interventions according to the behaviour change technique taxonomy (v1) of 93 hierarchically clustered techniques. As complex healthcare interventions can be modified by a wide variety of factors, data will be summarised statistically when the data are available, are sufficiently similar and are of sufficient quality. A narrative synthesis will be completed if there is insufficient data to permit a formal meta-analysis.
  
  
  CONCLUSIONS
  This review will be of value to clinicians working in chronic pain services and to researchers involved in designing and evaluating interventions.
  
  
  BACKGROUND
  PROSPERO reference: CRD42014010640.
authors.forename: Joanne
authors.initials: J
authors.lastname: Marley
authors.forename: Mark A
authors.initials: MA
authors.lastname: Tully
authors.forename: Alison
authors.initials: A
authors.lastname: Porter-Armstrong
authors.forename: Brendan
authors.initials: B
authors.lastname: Bunting
authors.forename: John
authors.initials: J
authors.lastname: O'Hanlon
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, University of Ulster, Shore Road, Newtownabbey, Co Antrim BT37 0QB, UK. s.mcdonough@ulster.ac.uk.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: McDonough
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D015444:Exercise; D005081:Exercise Therapy; D015438:Health Behavior; D006801:Humans; D017116:Low Back Pain / Q000628:therapy; D059352:Musculoskeletal Pain / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D000078202:Systematic Reviews as Topic