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Shi JLH, Sit RWS. Impact of 25 Years of Mobile Health Tools for Pain Management in Patients With Chronic Musculoskeletal Pain: Systematic Review. J Med Internet Res 2024; 26:e59358. [PMID: 39150748 DOI: 10.2196/59358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/18/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Mobile technologies are increasingly being used in health care and public health practice for patient communication, monitoring, and education. Mobile health (mHealth) tools have also been used to facilitate adherence to chronic musculoskeletal pain (CMP) management, which is critical to achieving improved pain outcomes, quality of life, and cost-effective health care. OBJECTIVE The aim of this systematic review was to evaluate the 25-year trend of the literature on the adherence, usability, feasibility, and acceptability of mHealth interventions in CMP management among patients and health care providers. METHODS We searched the PubMed, Cochrane CENTRAL, MEDLINE, EMBASE, and Web of Science databases for studies assessing the role of mHealth in CMP management from January 1999 to December 2023. Outcomes of interest included the effect of mHealth interventions on patient adherence; pain-specific clinical outcomes after the intervention; and the usability, feasibility, and acceptability of mHealth tools and platforms in chronic pain management among target end users. RESULTS A total of 89 articles (26,429 participants) were included in the systematic review. Mobile apps were the most commonly used mHealth tools (78/89, 88%) among the included studies, followed by mobile app plus monitor (5/89, 6%), mobile app plus wearable sensor (4/89, 4%), and web-based mobile app plus monitor (1/89, 1%). Usability, feasibility, and acceptability or patient preferences for mHealth interventions were assessed in 26% (23/89) of the studies and observed to be generally high. Overall, 30% (27/89) of the studies used a randomized controlled trial (RCT), cohort, or pilot design to assess the impact of the mHealth intervention on patients' adherence, with significant improvements (all P<.05) observed in 93% (25/27) of these studies. Significant (judged at P<.05) between-group differences were reported in 27 of the 29 (93%) RCTs that measured the effect of mHealth on CMP-specific clinical outcomes. CONCLUSIONS There is great potential for mHealth tools to better facilitate adherence to CMP management, and the current evidence supporting their effectiveness is generally high. Further research should focus on the cost-effectiveness of mHealth interventions for better incorporating these tools into health care practices. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42024524634; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=524634.
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Affiliation(s)
- Jenny Lin-Hong Shi
- Department of Medicine, Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Regina Wing-Shan Sit
- Department of Medicine, Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Cargnin ZA, Schneider DG, de Souza MG, Vargas MADO, Tourinho FSV. Low back pain self-management mobile applications: a systematic review on digital platforms. Rev Esc Enferm USP 2024; 58:e20230326. [PMID: 38875500 PMCID: PMC11210980 DOI: 10.1590/1980-220x-reeusp-2023-0326en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/27/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVE To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults. METHOD A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality. RESULTS Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale. CONCLUSION Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.
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Affiliation(s)
- Zulamar Aguiar Cargnin
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| | - Dulcinéia Ghizoni Schneider
- Universidade Federal de Santa Catarina, Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| | | | | | - Francis Solange Vieira Tourinho
- Universidade Federal de Santa Catarina, Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
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3
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Dobija L, Lechauve JB, Mbony-Irankunda D, Plan-Paquet A, Dupeyron A, Coudeyre E. Smartphone applications are used for self-management, telerehabilitation, evaluation and data collection in low back pain healthcare: a scoping review. F1000Res 2024; 11:1001. [PMID: 38846061 PMCID: PMC11153999 DOI: 10.12688/f1000research.123331.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/09/2024] Open
Abstract
Background Smartphone use has grown in providing healthcare for patients with low back pain (LBP), but the literature lacks an analysis of the use of smartphone apps. This scoping review aimed to identify current areas of smartphone apps use for managing LBP. We also aimed to evaluate the current status of the effectiveness or scientific validity of such use and determine perspectives for their potential development. Methods We searched PubMed, PEDro and Embase for articles published in English up to May 3 rd, 2021 that investigated smartphone use for LBP healthcare and their purpose. All types of study design were accepted. Studies concerning telemedicine or telerehabilitation but without use of a smartphone were not included. The same search strategy was performed by two researchers independently and a third researcher validated the synthesis of the included studies. Results We included 43 articles: randomised controlled trials (RCTs) (n=12), study protocols (n=6), reliability/validity studies (n=6), systematic reviews (n=7), cohort studies (n=4), qualitative studies (n=6), and case series (n=1). The purposes of the smartphone app were for 1) evaluation, 2) telerehabilitation, 3) self-management, and 4) data collection. Self-management was the most-studied use, showing promising results derived from moderate- to good-quality RCTs for patients with chronic LBP and patients after spinal surgery. Promising results exist regarding evaluation and data collection use and contradictory results regarding measurement use. Conclusions This scoping review revealed a notable interest in the scientific literatures regarding the use of smartphone apps for LBP patients. The identified purposes point to current scientific status and perspectives for further studies including RCTs and systematic reviews targeting specific usage.
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Affiliation(s)
- Lech Dobija
- UNH, INRAE, Université Clermont-Auvergne, Clermont-Ferrand, Puy de Dôme, 63000, France
- Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Cébazat, Puy de Dôme, 63118, France
| | - Jean-Baptiste Lechauve
- Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Cébazat, Puy de Dôme, 63118, France
| | - Didier Mbony-Irankunda
- Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Cébazat, Puy de Dôme, 63118, France
| | - Anne Plan-Paquet
- Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Cébazat, Puy de Dôme, 63118, France
| | - Arnaud Dupeyron
- Université Montpellier, Nimes, 30900, France
- Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire (CHU) de Nimes, Nimes, 30900, France
| | - Emmanuel Coudeyre
- UNH, INRAE, Université Clermont-Auvergne, Clermont-Ferrand, Puy de Dôme, 63000, France
- Service de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire (CHU) de Clermont Ferrand, Cébazat, Puy de Dôme, 63118, France
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Withers HG, Glinsky JV, Chu J, Jennings MD, Starkey I, Parmeter R, Boulos M, Cruwys JJ, Duong K, Jordan I, Wong D, Trang S, Duong M, Liu H, Hayes AJ, Lambert TE, Zadro JR, Sherrington C, Maher C, Lucas BR, Taylor D, Ferreira ML, Harvey LA. Remotely delivered physiotherapy is as effective as face-to-face physiotherapy for musculoskeletal conditions (REFORM): a randomised trial. J Physiother 2024; 70:124-133. [PMID: 38494405 DOI: 10.1016/j.jphys.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
QUESTION Is remotely delivered physiotherapy as good or better than face-to-face physiotherapy for the management of musculoskeletal conditions? DESIGN Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis. PARTICIPANTS A total of 210 adult participants with a musculoskeletal condition who presented for outpatient physiotherapy at five public hospitals in Sydney. INTERVENTION One group received a remotely delivered physiotherapy program for 6 weeks that consisted of one face-to-face physiotherapy session in conjunction with weekly text messages, phone calls at 2 and 4 weeks, and an individualised home exercise program delivered through an app. The other group received usual face-to-face physiotherapy care in an outpatient setting. OUTCOME MEASURES The primary outcome was the Patient Specific Functional Scale at 6 weeks with a pre-specified non-inferiority margin of -15 out of 100 points. Secondary outcomes included: the Patient Specific Functional Scale at 26 weeks; kinesiophobia, pain, function/disability, global impression of change and quality of life at 6 and 26 weeks; and satisfaction with service delivery at 6 weeks. RESULTS The mean between-group difference (95% CI) for the Patient Specific Functional Scale at 6 weeks was 2.7 out of 100 points (-3.5 to 8.8), where a positive score favoured remotely delivered physiotherapy. The lower end of the 95% CI was greater than the non-inferiority margin. Whilst non-inferiority margins were not set for the secondary outcomes, the 95% CI of the mean between-group difference ruled out clinically meaningful differences. CONCLUSION Remotely delivered physiotherapy with support via phone, text and an app is as good as face-to-face physiotherapy for the management of musculoskeletal conditions. TRIAL REGISTRATION ACTRN12619000065190.
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Affiliation(s)
- Hannah G Withers
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Joanne V Glinsky
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jackie Chu
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Ian Starkey
- Physiotherapy Department, Blacktown and Mt Druitt Hospitals, Sydney, Australia
| | - Rachel Parmeter
- Physiotherapy Department, Blacktown and Mt Druitt Hospitals, Sydney, Australia
| | - Max Boulos
- Musculoskeletal and Cancer Outpatients, Orthopaedics, ED, Fracture Clinic, Women's Health, Camden and Campbelltown Hospital, Sydney, Australia
| | - Jackson J Cruwys
- Physiotherapy Department, Camden and Campbelltown Hospital, Sydney, Australia
| | - Kitty Duong
- Physiotherapy Department, Camden and Campbelltown Hospital, Sydney, Australia
| | - Ian Jordan
- Physiotherapy Department, Hornsby-Ku-Ring-Gai Hospital, Sydney, Australia
| | - David Wong
- Physiotherapy Department, Liverpool Hospital, Sydney, Australia
| | - San Trang
- Physiotherapy Department, Bankstown-Lidcombe Hospital, Sydney, Australia
| | - Maggie Duong
- Physiotherapy Department, Bankstown-Lidcombe Hospital, Sydney, Australia
| | - Hueiming Liu
- The George Institute for Global Health, Sydney, Australia
| | - Alison J Hayes
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tara E Lambert
- Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia
| | - Joshua R Zadro
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, Australia
| | | | - Christopher Maher
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, Australia
| | - Barbara R Lucas
- Sydney Musculoskeletal Health, School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Deborah Taylor
- Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia
| | - Manuela L Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
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Shah N, Shetty GM, Kanna R, Thakur H. Efficacy of telerehabilitation for spine pain during the Coronavirus pandemic lockdown: a retrospective propensity score-matched analysis. Disabil Rehabil Assist Technol 2024; 19:558-565. [PMID: 35930451 DOI: 10.1080/17483107.2022.2107718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 05/20/2022] [Accepted: 07/19/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Despite increased usage of telemedicine to deliver treatment during the coronavirus disease 2019 (COVID-19) pandemic, the efficacy of telerehabilitation for spine pain is unknown. This study aimed to investigate the effect of telerehabilitation on pain and disability in patients with spine pain treated during the COVID-19 pandemic and compare the results to in-clinic rehabilitation. MATERIALS & METHODS In this propensity score-matched analysis, 428 patients with spine pain who underwent telerehabilitation during the 6 months of COVID-19 pandemic lockdown and 428 patients who underwent in-clinic multimodal rehabilitation treatment during the 6-month period prior to lockdown were compared. Propensity score matching was done based on gender, age, pre-treatment pain, and disability. Post-treatment numerical pain rating scale (NPRS), Oswestry or Neck disability index (ODI or NDI), and minimal clinical important difference (MCID) achieved for NPRS and ODI/NDI scores were compared between the 2 groups. RESULTS Post-treatment, the mean NPRS (mean difference - 1, p < 0.0001) and ODI/NDI (mean difference - 5.8, p < 0.0001) scores, were significantly lower in the telerehabilitation group when compared to control group. Similarly, the percentage of patients who achieved MCID of ≥ 2 for NPRS (mean difference - 6%, p = 0.0007) and MCID of ≥ 10 for ODI/NDI (mean difference - 7.5%, p = 0.005) scores were significantly higher in the telerehabilitation group. CONCLUSIONS Telerehabilitation achieved significant reduction in pain and disability among patients with spine pain, better than in-clinic rehabilitation. These encouraging results during the COVID-19 pandemic indicate the need to further explore and test the efficacy and wider application of telerehabilitation for treating spine pain.IMPLICATIONS FOR REHABILITATIONTelerehabilitation can help achieve significant reduction in pain and disability among patients with spine pain.These encouraging results indicate the need to further explore a wider application of telerehabilitation for treating patients with spine pain during non-pandemic times.
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Affiliation(s)
- Nidhi Shah
- National Clinical Expert & Senior Spine Physiotherapist, QI Spine Clinic, Mumbai, India
| | - Gautam M Shetty
- Consultant Orthopaedic Surgeon and Head of Reseach, QI Spine Clinic, Mumbai, India
| | - Raj Kanna
- Department of Orthopaedics, Madha Medical College and Research Institute, Chennai, India
| | - Harshad Thakur
- National Institute of Health and Family Welfare (NIHFW), New Delhi, India
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Molina-Garcia P, Mora-Traverso M, Prieto-Moreno R, Díaz-Vásquez A, Antony B, Ariza-Vega P. Effectiveness and cost-effectiveness of telerehabilitation for musculoskeletal disorders: A systematic review and meta-analysis. Ann Phys Rehabil Med 2024; 67:101791. [PMID: 38128150 DOI: 10.1016/j.rehab.2023.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/25/2023] [Accepted: 08/21/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Internet-based telerehabilitation could be a valuable option for the treatment of musculoskeletal disorders, with the advantage of providing rehabilitation from anywhere. However, there is no solid and updated evidence demonstrating its effectiveness on relevant clinical and cost outcomes. OBJECTIVE This systematic review aims to determine the clinical and cost-effectiveness of internet-based telerehabilitation during the recovery of musculoskeletal disorders. METHODS Medline, Web of Science, Scopus and Cochrane databases were systematically searched from inception to June 2023. Trials investigating the effects of internet-based telerehabilitation in any musculoskeletal disorder were selected. Nonoriginal articles and grey literature were excluded. Two independent reviewers conducted the study selection and data extraction. Random effect meta-analyses (standardized mean difference) and further sensitivity analyses were performed. RESULTS We selected 37 clinical trials (33 randomized and 4 non-randomized) and 5 health economics studies, which included a total of 4,288 participants. Telerehabilitation was more favourable than control treatments in improving all studied clinical outcomes, although the effectiveness varied depending on the type of musculoskeletal disorder. The standard mean differences (SMD) ranged from 0.24 to 0.91. For physical function, the primary outcome, superior effectiveness was found only in people with hip fractures (SMD, 0.87; 95 % CI, 0.34 to 1.41). The effects for joint replacement, osteoarthritis, and spine pain were similar to those of control treatments. However, the favourable outcomes for telerehabilitation became insignificant when compared specifically to face-to-face rehabilitation. Some results displayed publication bias and a lack of robustness, necessitating cautious interpretation. In terms of health economics studies, telerehabilitation was 89.55$ (95 % CI 4.6 to 174.5) cheaper per individual than conventional treatments. CONCLUSIONS Telerehabilitation should be considered in the recovery process of musculoskeletal disorders when optimal face-to-face rehabilitation is not feasible. Moreover, telerehabilitation reduces costs and time. PROSPERO NUMBER CRD42022322425.
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Affiliation(s)
| | - Marta Mora-Traverso
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Rafael Prieto-Moreno
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain; Biomedical Research Unit, Torrecárdenas University Hospital, 04009 Almería, Spain; Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024) and CERNEP Research Center, University of Almería, Almería, Spain
| | | | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania 7000, Australia
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria ibs.GRANDA, Granada, Spain; PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain; Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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Özlü A, Ünver G, Tuna Hİ, Erdoğan A. Effects of Interactive Telerehabilitation Practices in Office Workers with Chronic Nonspecific Neck Pain: Randomized Controlled Study. Telemed J E Health 2024; 30:438-447. [PMID: 37498517 DOI: 10.1089/tmj.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Aim: Aim of this study is to investigate the effects of interactive telerehabilitation exercises in office workers with chronic nonspecific neck pain. Methods: Office workers (n = 120) were randomly divided into three groups between February and July 2022, taking into account the inclusion and exclusion criteria, and office ergonomics training was given to all of the participants. Group 1 participants were given an interactive telerehabilitation program (strengthening, motor control, and posture correction exercises) for 45 min per day, 3 days a week, for a total of 6 weeks. Group 2 participants were trained to do the home exercise program on their own for 45 min per day, 3 days a week, for a total of 6 weeks. Only office ergonomics training was given to Group 3 patients. Results: Statistically significant improvement in pain (p < 0.001), range of motion (ROM) (p < 0.001), neck disability status (p < 0.001), functional status (p < 0.001), and quality of life (p < 0.001) of 6-week interactive telerehabilitation application in office workers was found. Discussion: In addition to office ergonomics training, interactive telerehabilitation program is the most effective method on pain, ROM, and neck disability compared with home exercise program and office ergonomics training alone, and studies are needed on the long-term effectiveness of telerehabilitation applications and telerehabilitation treatment diversity.
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Affiliation(s)
- Aysun Özlü
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Services University, Kutahya Turkey
| | - Gamze Ünver
- Internal Medicine, Nursing Faculty of Health Sciences, Kutahya Health Services University, Kutahya Turkey
| | | | - Ahmet Erdoğan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Turkey
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López-Marcos JJ, Díaz-Arribas MJ, Valera-Calero JA, Navarro-Santana MJ, Izquierdo-García J, Ortiz-Gutiérrez RM, Plaza-Manzano G. The Added Value of Face-to-Face Supervision to a Therapeutic Exercise-Based App in the Management of Patients with Chronic Low Back Pain: A Randomized Clinical Trial. SENSORS (BASEL, SWITZERLAND) 2024; 24:567. [PMID: 38257659 PMCID: PMC10819225 DOI: 10.3390/s24020567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
Low back pain (LBP) is a significant global health challenge due to its high prevalence, and chronicity and recurrence rates, with projections suggesting an increase in the next years due to population growth and aging. The chronic and recurrent nature of LBP, responsible for a significant percentage of years lived with disability, underscores the need for effective management strategies, including self-management strategies advocated by current guidelines, to empower patients and potentially improve healthcare efficiency and clinical outcomes. Therefore, the aim of this study was to analyze the added value of face-to-face visits in patients with chronic LBP undergoing a self-management program based on therapeutic exercises on pain intensity, disability, quality of life and treatment adherence and satisfaction. A randomized clinical trial was conducted, allocating 49 patients into a experimental group with a mobile health (mHealth) app usage and face-to-face sessions and 49 patients into an active control group without face-to-face sessions. Pain intensity, disability and quality of life were assessed at baseline, 4 weeks postintervention and 12 weeks postintervention. Patients' satisfaction and adherence were assessed at the end of the study. The multivariate general model revealed no statistically significant time × group interaction for any outcome (p > 0.0068) but mental quality of life (p = 0.006). Within-group differences revealed significant improvements for all the clinical indicators (all, p < 0.001). Patients allocated to the experimental group reported greater satisfaction and adherence (both, p < 0.001) compared to the control group. The use of mHealth apps such as Healthy Back® as part of digital health initiatives may serve as a beneficial approach to enhance the management of LBP.
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Affiliation(s)
- José Javier López-Marcos
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
- Faculty of Life and Natural Sciences, Nebrija University, 28015 Madrid, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Juan Izquierdo-García
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
- Multidisciplinary Cardiac Rehabilitation Unit, University Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Rosa María Ortiz-Gutiérrez
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (J.J.L.-M.); (J.A.V.-C.); (M.J.N.-S.); (J.I.-G.); (R.M.O.-G.); (G.P.-M.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Khruakhorn S, Jirasakulsuk N, Saengpromma P. Effectiveness of Telerehabilitation for Correcting Posture in Elderly with Thoracic Kyphosis in Urban Thailand. Int J Telerehabil 2023; 15:e6566. [PMID: 38162942 PMCID: PMC10754235 DOI: 10.5195/ijt.2023.6566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Introduction Thoracic kyphosis (TK) is an abnormal thoracic spine. Telerehabilitation and conventional physical therapy were compared for correct posture in the thoracic angle, forward head posture, back muscle strength, and cost-effectiveness. Method Twenty-two Thai women 60 years of age and over, with thoracic angles over 45 degrees, participated in this study. Participants were randomly allocated into a telerehabilitation group (TG) or a control group (CG). TG and CG underwent a thoracic corrective exercise program for 1 hour each session, three times per week for 8 weeks. Result Thoracic angle, forward head posture, and back muscle strength improved (P < .05) in both groups. Furthermore, cost-effectiveness showed the cost of intervention in TG lower than CG, approximately 133.78 US$. Conclusion Our study showed no difference in telepractice program efficacy and effectiveness compared to in-person treatment in the clinic. Thus, telerehabilitation may be an alternative treatment for the elderly who cannot travel to the hospital.
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Affiliation(s)
- Santhanee Khruakhorn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Thailand
| | - Nathaphon Jirasakulsuk
- Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Thailand
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Mitchaï PM, Mapinduzi J, Verbrugghe J, Michiels S, Janssens L, Kossi O, Bonnechère B, Timmermans A. Mobile technologies for rehabilitation in non-specific spinal disorders: a systematic review of the efficacy and potential for implementation in low- and middle-income countries. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4077-4100. [PMID: 37794182 DOI: 10.1007/s00586-023-07964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 05/22/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE The aim of this systematic review was primarily to identify the types of mHealth technologies for the rehabilitation of non-specific spinal disorders, second to evaluate their efficacy, and finally to determine their applicability in LMICs. METHODS Three databases (Scopus, PubMed, and Web of Science) were searched for randomized controlled trials and clinical trials from January 2012 until December 2022. Studies were found eligible when using mHealth technologies for the rehabilitation of non-specific spinal disorders. To evaluate efficacy, the primary outcome was pain intensity, and the secondary outcomes were disability and quality of life. To evaluate the applicability in LMICs, information about financial and geographical accessibility, offline usability, and languages was extracted. RESULTS Fifteen studies were included comprising 1828 participants who suffer from non-specific low back pain (86.05%) and non-specific neck pain (13.95%). Fourteen distinct smartphone-based interventions and two sensor system interventions were found, with a duration ranging from four weeks to six months. All mHealth interventions demonstrated efficacy for the improvement of pain, disability and quality of life in non-specific spinal disorders, particularly low back pain. Five of the evaluated smartphone applications were free of charge accessible and had language features that could be adapted for use in LMICs. CONCLUSION mHealth interventions can be used and integrated into the conventional treatment of non-specific spinal disorders in rehabilitation. They have demonstrated efficacy and could be implemented in LMICs with minor adaptations to overcome language barriers and the absolute necessity of the internet.
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Affiliation(s)
- Pénielle Mahutchegnon Mitchaï
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, 03 BP 10, Parakou, Benin
| | - Jean Mapinduzi
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- Department of Physiotherapy, National Institute of Public Health, University of Bujumbura, Bujumbura, Burundi
| | - Jonas Verbrugghe
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Sarah Michiels
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Lotte Janssens
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Oyéné Kossi
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, 03 BP 10, Parakou, Benin.
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin.
| | - Bruno Bonnechère
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Annick Timmermans
- REVAL, Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
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Feng Y, Wu Y, Liu H, Bao T, Wang C, Wang Z, Huang J, Jiang Y, He C, Zhu S. Effect of the telemedicine-supported multicomponent exercise therapy in patients with knee osteoarthritis: study protocol for a randomized controlled trial. Trials 2023; 24:729. [PMID: 37964273 PMCID: PMC10647045 DOI: 10.1186/s13063-023-07749-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION The rising prevalence of knee osteoarthritis is placing a considerable strain on the global healthcare system. To address this issue, telemedicine-supported multicomponent exercise therapy has emerged as a promising approach. This therapy combines exercise, patient education, and health coaching to empower knee osteoarthritis patients to manage their condition from the comfort of their homes. Nevertheless, there are some existing limitations in the current research on this approach, including challenges related to patient compliance and the absence of objective evaluation methods. METHODS AND ANALYSIS Patients diagnosed with knee osteoarthritis, who have not undergone knee surgery in the past year, will be recruited for a randomized controlled trial. The trial will include an intervention group and a control group. The intervention group will receive an mHealth app-based multicomponent exercise therapy, consisting of exercise therapy, patient education, and health coaching. Meanwhile, the control group will receive usual care, involving drug therapy and patient education. The primary outcome of the trial will be the measurement of pain intensity, assessed using a visual analog scale at baseline and at 4, 8, and 12 weeks of the post-intervention. To analyze the data, a two-factor, four-level repeated measures ANOVA will be used if the assumptions of homogeneity of variance and sphericity are met. If not, a mixed effects model will be employed. DISCUSSION The aim of the study is to evaluate the effectiveness of multicomponent exercise therapy aimed at enhancing pain self-management for knee osteoarthritis patients in the comfort of their own homes. The intervention incorporate wearable devices equipped with advanced deep learning systems to monitor patients' adherence to the prescribed at-home exercise regimen, as well as to track changes in outcomes before and after the exercise sessions. The findings from this trial have the potential to enhance both the accessibility and quality of care provided to knee osteoarthritis patients, offering valuable insights for future improvements in their treatment and management. TRIAL REGISTRATION Chinese Clinical Trials Registry, ChiCTR2300073688. Registered on 19 July 2023, https://www.chictr.org.cn/bin/project/edit?pid=199707 . World Health Organization International Clinical Trials Registry Platform, https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2300073688 .
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Affiliation(s)
- Yuan Feng
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China
| | - Yan Wu
- Department of Postgraduate Students, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- College of Marxism, Sichuan University, Chengdu, China
| | - Huizhen Liu
- Centre for Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, China
| | - Tianjie Bao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Chongyang Wang
- Department of Computer Science and Technology, Tsinghua University, No. 30, Shuangqing Road, Beijing, Haidian District, China
| | - Zezhang Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China
| | - Jielei Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China
| | - Yiwei Jiang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China.
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
| | - Siyi Zhu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
- Department of Rehabilitation Medicine, West China Clinical Medical College, Sichuan University, Chengdu, China.
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
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12
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Mehendale P, Iyenagar M, Bhatt GD, Kothary K. Telerehabilitation for a Non-specific Low Back Pain: A Case Report. Cureus 2023; 15:e47854. [PMID: 38021986 PMCID: PMC10680045 DOI: 10.7759/cureus.47854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
One of the most common conditions that affect activities of daily living and make them significantly more difficult to perform is low back pain (LBP). As a result, it is essential to treat LBP at an early stage. Particularly in geographically remote areas where there is a shortage of medical professionals and a lack of rehabilitation services, telerehabilitation is considered a potential alternative. Hence, this case report represents the impact of telerehabilitation on LBP in a 32-year-old female corporate worker who presented to the out-patient department of physiotherapy with the chief complaints of LBP for the last three months with difficulty in performing activities, and being unable to sit for prolonged period of time. The physiotherapeutic rehabilitation was virtually administered through online sessions through the cloud-based application as the patient was not able to visit the outpatient department on a regular basis. Post-intervention results demonstrated increased range of motion and flexibility, reduced pain, increased muscle strength, reduced disability and kinesiophobia, and improved quality of life. Hence, it can be concluded that telerehabilitation offers a novel solution to increase access to rehabilitation services.
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Affiliation(s)
- Priti Mehendale
- Department of Musculoskeletal Physiotherapy, K J Somaiya College of Physiotherapy, Mumbai, IND
- Department of Physiotherapy, Parul University, Vadodara, IND
| | - Madhavan Iyenagar
- Department of Surgery, Parul Sevashram Hospital, Parul Institute of Medical Sciences and Research, Vadodara, IND
| | - Geeta D Bhatt
- Department of Neurophysiotherapy, K J Somaiya College of Physiotherapy, Mumbai, IND
| | - Khyati Kothary
- Department of Cardiorespiratory Physiotherapy, K J Somaiya College of Physiotherapy, Mumbai, IND
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13
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Mehendale P, Iyenagar M, Bhatt G, Manwadkar S. Virtually Administered Intervention Through Telerehabilitation for Chronic Non-specific Low Back Pain: A Review of Literature. Cureus 2023; 15:e42942. [PMID: 37667713 PMCID: PMC10475325 DOI: 10.7759/cureus.42942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
The most frequent reason for individuals to seek medical attention in both primary care settings and immediate care centers is low back pain (LBP). Over a duration of time, the disability caused by lower back pain has risen enough, particularly in countries with low or moderate incomes. In the coming years, there may be an increase in LBP-related impairment and expenses in countries with low or medium incomes, particularly when fragile medical systems are unable to handle this growing load. Hence, this review focuses on the effectiveness of telerehabilitation (TR) on LBP. The significant advantages of TR may include greater interaction and remote accessibility to medical treatments. The exchange of knowledge and health information is made possible through a more effective interaction, which benefits patients, families, carers, physicians, and researchers. People who live in distant places now have the opportunity to get medical attention assisting families in caring for patients with poor responsiveness. In addition, it provides the potential for prompt detection, the beginning of treatment in the midst of an emergency, a shorter stay in the hospital, ongoing monitoring of those at risk, and overall time and expense savings. Therefore, this study supports the application of TR in conditions of LBP for early management and relief of pain for patients in low-resource areas.
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Affiliation(s)
- Priti Mehendale
- Department of Physiotherapy, Parul Institute of Doctoral Studies, Parul University, Vadodara, IND
| | - Madhavan Iyenagar
- Department of Surgery, Parul Institute of Doctoral Studies, Parul University, Vadodara, IND
| | - Geeta Bhatt
- Department of Neurophysiotherapy, K.J. Somaiya College of Physiotherapy, Mumbai, IND
| | - Shweta Manwadkar
- Department of Cardiorespiratory Physiotherapy, K.J. Somaiya College of Physiotherapy, Mumbai, IND
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Cui D, Janela D, Costa F, Molinos M, Areias AC, Moulder RG, Scheer JK, Bento V, Cohen SP, Yanamadala V, Correia FD. Randomized-controlled trial assessing a digital care program versus conventional physiotherapy for chronic low back pain. NPJ Digit Med 2023; 6:121. [PMID: 37420107 DOI: 10.1038/s41746-023-00870-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023] Open
Abstract
Low back pain (LBP) is the world's leading cause of years lived with disability. Digital exercise-based interventions have shown great potential in the management of musculoskeletal conditions, promoting access and easing the economic burden. However, evidence of their effectiveness for chronic LBP (CLBP) management compared to in-person physiotherapy has yet to be unequivocally established. This randomized controlled trial (RCT) aims to compare the clinical outcomes of patients with CLBP following a digital intervention versus evidence-based in-person physiotherapy. Our results demonstrate that patient satisfaction and adherence were high and similar between groups, although a significantly lower dropout rate is observed in the digital group (11/70, 15.7% versus 24/70, 34.3% in the conventional group; P = 0.019). Both groups experience significant improvements in disability (primary outcome), with no differences between groups in change from baseline (median difference: -0.55, 95% CI: -2.42 to 5.81, P = 0.412) or program-end scores (-1.05, 95% CI: -4.14 to 6.37; P = 0.671). Likewise, no significant differences between groups are found for secondary outcomes (namely pain, anxiety, depression, and overall productivity impairment). This RCT demonstrates that a remote digital intervention for CLBP can promote the same levels of recovery as evidence-based in-person physiotherapy, being a potential avenue to ease the burden of CLBP.
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Affiliation(s)
- Di Cui
- Physical and Rehabilitation Medicine, Emory University, Atlanta, GA, Georgia
| | | | | | | | | | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Justin K Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | | | - Steven P Cohen
- Departments of Anesthesiology & Critical Care Medicine, Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Departments of Anesthesiology and Physical Medicine and Rehabilitation and Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Vijay Yanamadala
- Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA
- Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
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15
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Villatoro-Luque FJ, Rodríguez-Almagro D, Aibar-Almazán A, Fernández-Carnero S, Pecos-Martín D, Ibáñez-Vera AJ, Achalandabaso-Ochoa A. In non-specific low back pain, is an exercise program carried out through telerehabilitation as effective as one carried out in a physiotherapy center? A controlled randomized trial. Musculoskelet Sci Pract 2023; 65:102765. [PMID: 37141771 DOI: 10.1016/j.msksp.2023.102765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND s:The effectiveness of telerehabilitation (TLRH) in patients with non-specific low back pain (NLBP) remains unknown. No study till date has investigated the efficacy of a mobile-based TLRH in patients with NLBP. OBJECTIVES To investigate if a TLRH program is as effective as a clinical exercise programme in improving disability, pain intensity, pain catastrophizing, and hip pain and strength in patients with NLBP. DESIGN Single-blind, two-armed, randomized controlled study. METHOD A total of 71 individuals with NLBP were randomly allocated to either the TLRH home group (TLRH) or clinic group (CG). The TLRH followed exercise videos and read information on pain neurophysiology. The CG performed the same exercises and received on-site pain education. Both groups performed the exercises twice weekly for 8 weeks. Disability, pain intensity, pain catastrophizing, and hip pain and strength were assessed at baseline, at post-treatment, and at three months. RESULTS Statistically significant differences for time-by-group interaction were detected in the strength of left hip flexors (supine [F = 8.356; p = .005]; sitting [F = 9.828; p = .003]), right hip extensors with extended knee [F = 7.461; p = .008], left hip extensors (extended knee [F = 13.175; p = .001]; flexed knee [F = 13.505; p < .001]), pain during flexion of the right [F = 5.133; p = .027] and left [F = 4.731; p = .033] hips in the supine position, disability [F = 4.557; p = .014], and pain catastrophizing [F = 14.132; p < .001]. CONCLUSION A TLRH mobile-based is as effective as clinical treatment in improving disability, pain catastrophizing, and pain and strength of the hip structures in patients with NLBP.
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Affiliation(s)
| | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
| | - Samuel Fernández-Carnero
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
| | - Daniel Pecos-Martín
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
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Scheer J, Areias AC, Molinos M, Janela D, Moulder R, Lains J, Bento V, Yanamadala V, Dias Correia F, Costa F. Engagement and Utilization of a Complete Remote Digital Care Program for Musculoskeletal Pain Management in Urban and Rural Areas Across the United States: Longitudinal Cohort Study. JMIR Mhealth Uhealth 2023; 11:e44316. [PMID: 36735933 PMCID: PMC10132051 DOI: 10.2196/44316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Musculoskeletal (MSK) conditions are the number one cause of disability worldwide. Digital care programs (DCPs) for MSK pain management have arisen as alternative care delivery models to circumvent challenges in accessibility of conventional therapy. Despite the potential of DCPs to reduce inequities in accessing care, the outcomes of such interventions in rural and urban populations have yet to be studied. OBJECTIVE The aim of this study was to assess the impact of urban or rural residency on engagement and clinical outcomes after a multimodal DCP for MSK pain. METHODS This study consists of an ad hoc analysis of a decentralized single-arm investigation into engagement and clinical-related outcomes after a multimodal DCP in patients with MSK conditions. Patients were coded according to their zip codes to a specific rural-urban commuting area code and grouped into rural and urban cohorts. Changes in their engagement and clinical outcomes from baseline to program end were assessed. Latent growth curve analysis was performed to estimate change trajectories adjusting for the following covariates: age, gender, BMI, employment status, and pain acuity. Outcomes included engagement, self-reported pain, and the results of the Generalized Anxiety Disorder 7-item, Patient Health Questionnaire 9-item, and Work Productivity and Activity Impairment scales. A minimum clinically important difference (MCID) of 30% was considered for pain. RESULTS Patients with urban and rural residency across the United States participated in the program (n=9992). A 73.8% (7378/9992) completion rate was observed. Both groups reported high satisfaction scores and similar engagement with exercise sessions, with rural residents showing higher engagement with educational content (P<.001) and higher program completion rates (P=.02). All groups showed a significant improvement in all clinical outcomes, including pain, mental health, and work productivity, without statistically significant intergroup differences. The percentage of patients meeting the MCID was similar in both groups (urban: 67.1%, rural: 68.3%; P=.30). CONCLUSIONS This study advocates for the utility of a DCP in improving access to MSK care in urban and rural areas alike, showcasing its potential to promote health equity. High engagement, satisfaction, and completion rates were noted in both groups, as well as significant improvements in clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04092946; https://clinicaltrials.gov/ct2/show/NCT04092946.
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Affiliation(s)
- Justin Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, United States
| | | | | | | | - Robert Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, United States
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Coimbra, Portugal
- Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | | | - Vijay Yanamadala
- Sword Health Inc, Draper, UT, United States
- Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, United States
- Department of Surgery, Frank H Netter School of Medicine, Quinnipiac University, Hamden, CT, United States
| | - Fernando Dias Correia
- Sword Health Inc, Draper, UT, United States
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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17
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Areias AC, Costa F, Janela D, Molinos M, Moulder RG, Lains J, Scheer JK, Bento V, Yanamadala V, Cohen SP, Correia FD. Impact on productivity impairment of a digital care program for chronic low back pain: A prospective longitudinal cohort study. Musculoskelet Sci Pract 2023; 63:102709. [PMID: 36543719 DOI: 10.1016/j.msksp.2022.102709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Low back pain (LBP) is the leading cause of disability in the United States and the main reason for absenteeism. Successful management of chronic LBP (CLBP) is dependent on multimodal evidence-based interventions. Digital interventions (DI) may ease accessibility to such treatments, increasing adherence, while reducing healthcare-related costs. OBJECTIVES Assess the impact of a completely remote multimodal DI on productivity impairment in a real-work context cohort of patients with CLBP. DESIGN Longitudinal study. METHODS Ad-hoc analysis of an interventional, single-arm study of individuals with CLBP undergoing a DI for 12 weeks. Outcomes included the mean change in work productivity and activity impairment (including overall and non-work related activities), pain, depression, anxiety, fear-avoidance beliefs, analgesic usage, and engagement. Minimal clinically important change (MCIC) was calculated for productivity using anchor- and distribution-based methods. RESULTS From 560 patients at program start, 78.4% completed the DI. A significant improvement in overall productivity (20.21, 95%CI: 16.48-23.94) and in non-work related activities (21.36, 95%CI: 17.49-25.22) was observed, corresponding to a responder rate of 57.1-83.3% and 60.5-79.8%, respectively, and depending on the MCIC method. Significant improvements were reported for pain (2.32 points, 95%CI: 2.02-2.61), anxiety (5.24, 95%CI: 4.18-6.29), depression (6.38, 95%CI: 4.78-7.98) and fear-avoidance beliefs (8.11, 95%CI: 6.20-10.02). Both engagement (sessions per week) and patient satisfaction scores were high, 2.9 (SD 1.0) and 8.8/10 (SD 1.6), respectively. CONCLUSIONS This study demonstrated the utility of a multimodal DI to address productivity impairment. DIs have great potential to ease the burden of CLBP, providing an accessible and cost-effective modality of care. TRIAL REGISTRATION The study was approved by the New England IRB (protocol number 120190313) and prospectively registered in ClinicalTrials.gov, NCT04092946, on September 17th, 2019.
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Affiliation(s)
| | | | | | | | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, 80309, USA.
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, 3064-908, Tocha, Portugal; Faculty of Medicine, Coimbra University, 3004-504, Coimbra, Portugal.
| | - Justin K Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, 94143, USA.
| | | | - Vijay Yanamadala
- Sword Health, Inc, UT, 84043, USA; Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, 06473, USA; Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, 06103, USA.
| | - Steven P Cohen
- Departments of Anesthesiology & Critical Care Medicine, Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 21287, Baltimore, MD, USA; Departments of Anesthesiology and Physical Medicine and Rehabilitation and Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, 20814, MD, USA.
| | - Fernando Dias Correia
- Sword Health, Inc, UT, 84043, USA; Neurology Department, Centro Hospitalar e Universitário do Porto, 4099-001, Porto, Portugal.
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18
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Bise CG, Cupler Z, Mathers S, Turner R, Sundaram M, Catelani MB, Dahler S, Popchak A, Schneider M. Face-to-face telehealth interventions in the treatment of low back pain: A systematic review. Complement Ther Clin Pract 2023; 50:101671. [PMID: 36379145 PMCID: PMC9613794 DOI: 10.1016/j.ctcp.2022.101671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Christopher G Bise
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA; UPMC Health Plan - Department of Health Economics, USA.
| | - Zachary Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, USA
| | - Sean Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Rose Turner
- Department of Medicine, Health Science Library System, University of Pittsburgh, USA
| | - Meenakshi Sundaram
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Maria Beatriz Catelani
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Sarah Dahler
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Adam Popchak
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Michael Schneider
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
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Moon I, An Y, Min S, Park C. Therapeutic Effects of Metaverse Rehabilitation for Cerebral Palsy: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1578. [PMID: 36674332 PMCID: PMC9864535 DOI: 10.3390/ijerph20021578] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Metaverse physical therapy (MPT), an adjuvant technology for the rehabilitation of children with cerebral palsy (CP), has gained notoriety in the clinical field owing to its accessibility and because it provides motivation for rehabilitation. The aim is to compare the gross motor function and cardiopulmonary function, the activities of daily living, quality of life (QOL), and the perceived risk of coronavirus disease (COVID)-19 transmission between MPT and conventional physical therapy (CPT). A convenience sample of 26 children with CP (mean age, 11.23 ± 3.24 years, 14 females) were randomized into either the MPT or CPT group and received therapy three days/week for four weeks. Clinical outcomes included gross-motor-function measure 66 (GMFM-66), heart rate (HR), Borg-rating perceived exertion (BRPE), functional independence measure (FIM), pediatric QOL, and the risk of COVID-19 transmission. An analysis of variance showed that compared with CPT, MPT exerted positive effects on GMFM, HR, and BRPE. An independent t-test showed that compared with CPT, MPT exerted positive effects on the perceived transmission risk of COVID-19 but not on FIM and QOL. Our results provide promising therapeutic evidence that MPT improves gross motor function, cardiopulmonary function, and the risk of COVID-19 in children with CP.
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Affiliation(s)
- Ilyoung Moon
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea
| | - Yeongsang An
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
| | - Seunghwa Min
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
| | - Chanhee Park
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
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Krkoska P, Vlazna D, Sladeckova M, Minarikova J, Barusova T, Batalik L, Dosbaba F, Vohanka S, Adamova B. Adherence and Effect of Home-Based Rehabilitation with Telemonitoring Support in Patients with Chronic Non-Specific Low Back Pain: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1504. [PMID: 36674258 PMCID: PMC9860722 DOI: 10.3390/ijerph20021504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Home-based exercises have been on the rise recently. This pilot study aimed to assess the adherence and effect of a home-based rehabilitation programme using telemonitoring in patients with chronic non-specific low back pain (CNLBP). Twenty-seven patients with CNLBP were enrolled in the study, each of whom underwent a neurological assessment, including patient-oriented measures and a functional assessment-a battery of tests that comprehensively evaluated trunk muscle function. The rehabilitation programme lasted 18 weeks and included daily home-based exercises. A mobile application or an exercise diary was used to monitor compliance. Adherence to the programme was excellent for both the diary and mobile application groups, with 82.3% in the diary group exercising at least once a day and 72.9% twice a day, and 94.8% in the mobile application group exercising at least once a day and 86.6% twice a day. Both patient-oriented and functional outcomes improved significantly; however, the relative changes of the parameters in these two groups did not correlate, which supports the idea that trunk muscle function does not directly relate to patient complaints and that CNLBP is a multifactorial issue. This model of rehabilitation programme should be used in clinical practice, as its adherence and effectiveness seem noticeable.
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Affiliation(s)
- Peter Krkoska
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Daniela Vlazna
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Michaela Sladeckova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jitka Minarikova
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, Second Medical Faculty, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Tamara Barusova
- Institute of Biostatistics and Analysis Ltd., 602 00 Brno, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Stanislav Vohanka
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Blanka Adamova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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21
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Park C, Yi C, Choi WJ, Lim HS, Yoon HU, You S(JH. Long-term effects of deep-learning digital therapeutics on pain, movement control, and preliminary cost-effectiveness in low back pain: A randomized controlled trial. Digit Health 2023; 9:20552076231217817. [PMID: 38053732 PMCID: PMC10695084 DOI: 10.1177/20552076231217817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 11/11/2023] [Indexed: 12/07/2023] Open
Abstract
Objective The present study aimed to compare the effects of a deep learning-based digital application with digital application physical therapy (DPT) and those of conventional physical therapy (CPT) on back pain intensity, limited functional ability, lower extremity weakness, radicular symptoms, limited range of motion (ROM), functional movement, quality of life, cost-effectiveness, and postintervention questionnaires for perceived transmission risk of COVID-19 and satisfaction results in 100 participants with low back pain (LBP). Methods One hundred participants with LBP were randomized into either DPT or CPT groups, three times per week over four weeks. Outcome measures included the (1) Oswestry Disability Index, (2) Quebec Back Pain Disability Scale, (3) Roland-Morris Disability Questionnaire (RMDQ), (4) Numeric Pain Rating Scale, (5) functional movement screen (FMS), (6) short form-12, (7) lower extremity strength, (8) ROM of trunk flexion, extension, and bilateral side bending, (9) questionnaires for perceived transmission risk of COVID-19, (10) preliminary cost-effectiveness, and (11) postintervention satisfaction questionnaire results. The analysis of variance was conducted at p < 0.05. Results Analysis of variance showed that DPT showed superior effects, compared to CPT on RMDQ, hip extensor strength, transmission risk of COVID-19, as well as satisfaction. Both groups showed significant improvement pre- and postintervention, suggesting that DPT is as effective as CPT, and was superior in preliminary cost-effectiveness and transmission risk of COVID-19. Conclusions Our results provide novel, promising clinical evidence that DPT was as effective as CPT in improving structural and functional impairment, activity limitation, and participation restriction. Our results highlight the successful incorporation of DPT intervention for clinical outcome measures, lower extremity strength, trunk mobility, ADL improvement, QOL improvement, and FMS in LBP.
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Affiliation(s)
- Chanhee Park
- Sports(Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
- Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
| | - Chunghwi Yi
- Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
| | | | - Hyo-Sang Lim
- Division of Software, Yonsei University, Wonju, Republic of Korea
| | - Han Ul Yoon
- Division of Computer and Telecommunication Engineering, Yonsei University, Wonju, Republic of Korea
| | - Sung (Joshua) Hyun You
- Sports(Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
- Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
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22
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Lara-Palomo IC, Gil-Martínez E, Ramírez-García JD, Capel-Alcaraz AM, García-López H, Castro-Sánchez AM, Antequera-Soler E. Efficacy of e-Health Interventions in Patients with Chronic Low-Back Pain: A Systematic Review with Meta-Analysis. Telemed J E Health 2022; 28:1734-1752. [PMID: 35532971 DOI: 10.1089/tmj.2021.0599] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction: Low-back pain (LBP) is the leading cause of disability worldwide. Around 75-84% of the world's population will experience LBP at some point, establishing it as a major global health problem. e-Health is the remote delivery of therapeutic services, clinical information, and medical care, and may prove a very useful approach to tackle this pathology. Objectives: To evaluate the efficacy of e-health-based interventions in improving the symptoms of chronic LBP. Methods: A systematic review with meta-analysis was performed in PubMed, Web of Science, and PEDro until January 2022 through the assessment of methodological quality of systematic reviews (AMSTAR). Studies were included in which e-health interventions were used as experimental treatment compared to physical therapy to determine changes in back-specific functional status and pain in patients with chronic LBP. Two reviewers examined the sources individually, calculated the risk of bias, and extracted the data (PROSPERO number CRD42022306130). The effect size was calculated using the standardized mean difference (SMD) and its confidence interval (95% CI). Results: A total of 9 randomized controlled trials with 3,180 participants were included. The results of the findings showed an effect of e-health compared to other physical therapy on short-term (SMD = -0.59, 95% CI: -1.77 to 0.59) and intermediate short-term (SMD = -0.40, 95% CI: -0.91 to 0.11) pain intensity and back-specific functional status in the short term (SMD = -0.20, 95% CI: -0.81 to 0.41) and intermediate short term (SMD = -0.30, 95% CI: -0.74 to 0.14). The effect of e-health compared to minimal intervention on short-term intermediate pain intensity (SMD = -0.64, 95% CI: -1.72 to 0.45) and short-term intermediate back-specific functional status (SMD = -0.39, 95% CI: -0.87 to 0.09). Conclusions: e-Health interventions based on self-maintenance and education are as effective on pain and back-specific functional status as other face-to-face or home-based interventions in patients with chronic LBP, with moderate scientific evidence.
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Affiliation(s)
| | - Esther Gil-Martínez
- Department of Nursing, Physiotherapy and Medicine, Almería University, Almería, Spain
| | | | | | - Héctor García-López
- Department of Nursing, Physiotherapy and Medicine, Almería University, Almería, Spain
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23
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Paolucci T, de Sire A, Ferrillo M, di Fabio D, Molluso A, Patruno A, Pesce M, Lai C, Ciacchella C, Saggino A, Agostini F, Tommasi M. Telerehabilitation proposal of mind-body technique for physical and psychological outcomes in patients with fibromyalgia. Front Physiol 2022; 13:917956. [PMID: 36091366 PMCID: PMC9459112 DOI: 10.3389/fphys.2022.917956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/25/2022] [Indexed: 12/14/2022] Open
Abstract
Fibromyalgia (FM) syndrome is characterized by the close correlation of chronic widespread pain and other non-pain related symptoms. Aim of this study was to investigate whether telerehabilitation that provides physical and psychological support services of the mind-body techniques can affect the clinical profile and pain relief of FM patients. The study included twenty-eight female FM patients, mean aged 56.61 ± 8.56 years. All patients underwent a rehabilitation treatment (8 sessions, 1/week, 1 h/each) through Zoom platform, with the following principles of rehabilitation treatment: Anchoring to a positive emotion; listen and perceive your “own” body; conscious breathing; improve interoceptive awareness; relax. All patients then underwent clinical assessment of the physical distress and fear of movement for the Numeric Rating Scale (NRS); the Fatigue Assessment Scale (FAS); the Fear Avoidance Belief Questionnaire (FABQ); with measures of physical and mental disability for the Fibromyalgia Impact Questionnaire (FIQ); the 12-Items Short Form Survey; the Resilience Scale for Adults and the Coping Strategies Questionnaire-Revised. The evaluations were performed at T0 (baseline), T1 (after 8 weeks of treatment), and T2 (after 1 month of follow-up). The main finding was that telerehabilitation reduced physical and mental distress, fear, and disability (p < 0.001). Resilience and coping ability were less affected by the rehabilitative treatment. Our attempt of mind-body technique telerehabilitation has shown good results in the improvement of painful symptoms and quality of life for the FM patients but showed fewer positive impacts for the resilience and coping abilities aspects.
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Affiliation(s)
- Teresa Paolucci
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, University G. D’Annunzio, Chieti, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Physical and Rehabilitative Medicine Unit, University Hospital “Mater Domini”, Catanzaro, Italy
- *Correspondence: Alessandro de Sire,
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Dania di Fabio
- Italian Association of Fibromyalgia Syndrome (AISF), L’Aquila, Italy
| | - Aurora Molluso
- Department of Oral, Medical and Biotechnological Sciences, Course of Studies in Physiotherapy, University G. D'Annunzio, Chieti, Italy
| | - Antonia Patruno
- Department of Medicine and Aging Sciences, University G. D’Annunzio, Chieti, Italy
| | - Mirko Pesce
- Department of Medicine and Aging Sciences, University G. D’Annunzio, Chieti, Italy
| | - Carlo Lai
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Chiara Ciacchella
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Aristide Saggino
- Department of Medicine and Aging Sciences, University G. D’Annunzio, Chieti, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Marco Tommasi
- Department of Medicine and Aging Sciences, University G. D’Annunzio, Chieti, Italy
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Fatoye F, Akinfala AE, Gebrye T, Fatoye C, Ojelade TF, Oyewole OO, Mbada CE. Translation, Cross-Cultural Adaptation, and Psychometric Testing of Yoruba Version of the EQ-5D Questionnaire in Patients With Musculoskeletal Disorders. Front Public Health 2022; 10:902680. [PMID: 35832283 PMCID: PMC9271675 DOI: 10.3389/fpubh.2022.902680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background The EuroQol-5 Dimension (EQ-5D) is a generic self-administered questionnaire used for the measurement and economic valuation of a wide range of health conditions, which necessitates its existence and adaptation in different languages. Currently, the tool does not exist in any Nigerian language. This study aimed to translate, cross-culturally adapt, and determine the reliability and validity of the Yoruba version of the EQ-5D-5L questionnaire. Methods The International Quality of Life Assessment (IQOLA) project guidelines, involving forward translation, reconciliation and harmonization, backward translation, and reconciliation of problematic items were used in the Yoruba translated version of the EQ-5D-5L (EQ-5D-Yor). A total of 113 and 109 persons with musculoskeletal disorders participated in the validity and 7-day test-retest reliability testing of the EQ-5D-Yor. Convergent and discriminant validity of the EQ-5D-Yor were determined using the Yoruba version of the 12-Item Short-Form Health Survey (SF-12) (SF-12-Y) and Visual Analog Scale (VAS). Data were analyzed using descriptive and inferential statistics of Spearman correlation, Intra-Class Correlation, Cronbach alpha, and multi-trait scaling analysis. Alpha level was set as p < 0.05. Results The construct validity of the EQ-5D-Yor yielded Spearman rho ranging from 0.438 to 1.000, with the EQ-VAS having the highest co-efficient (r = 1.000; p = 0.001). The convergent validity of the EQ-5D-Yor index with scales and domains of the SF-12-Y yielded no significant correlations (p < 0.05), except for the physical functioning scale (r = −0.709, p = 0.001). On the other hand, the divergent validity of the EQ-5D-Yor index with VAS yielded a moderate negative correlation (r = −0.482; p = 0.001). The Intra-class Correlation Coefficient (ICC) and Cronbach's alpha for the test-retest reliability of the EQ-5D-Yor were 1.000 and 0.968. The confirmatory factor analysis showed the factor loadings were poor when including VAS in the model. Conclusion The EQ-5D-Yor has acceptable validity and reliability and can be used as a valid tool among Yoruba speaking population with musculoskeletal disorders.
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
- *Correspondence: Francis Fatoye
| | - Abiodun Emmanuel Akinfala
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Tadesse Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Clara Fatoye
- Department of Health and Social Care, University Campus Oldham, Manchester, United Kingdom
| | - Titilope Faith Ojelade
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Chidozie Emmanuel Mbada
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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25
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Özden F, Sarı Z, Karaman ÖN, Aydoğmuş H. The effect of video exercise-based telerehabilitation on clinical outcomes, expectation, satisfaction, and motivation in patients with chronic low back pain. Ir J Med Sci 2022; 191:1229-1239. [DOI: https:/doi.org/10.1007/s11845-021-02727-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/28/2021] [Indexed: 08/30/2023]
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26
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May S, Aina A. Letter to the editor. Musculoskelet Sci Pract 2022; 59:102459. [PMID: 34556459 DOI: 10.1016/j.msksp.2021.102459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- S May
- Independent Physiotherapy Consultant, U.K.
| | - A Aina
- Physiotherapist, Private Practitioner, Milano, Italy.
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27
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Castro-Sánchez AM, Antequera-Soler E, Matarán-Peñarrocha GA, Hurley DA, Martínez-de la Cal J, García-López H, Capel-Alcaraz AM, Lara-Palomo IC. Comparing an e-Health program vs home rehabilitation program in patients with non-specific low back pain: A study protocol randomized feasibility trial. J Back Musculoskelet Rehabil 2022; 35:239-252. [PMID: 34308900 DOI: 10.3233/bmr-210040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND There is little evidence on the reliability of the web application-based rehabilitation systems to treat chronic low back pain (CLBP). METHODS This protocol describes a double-blind, randomized controlled feasibility trial of an e-Health intervention developed to support the self-management of people with CLBP in primary care physiotherapy. Three Hospitals with primary care for outpatients will be the units of randomisation, in each Hospital the participants will be randomized to one of two groups, a pragmatic control group receiving either the usual home program based on electrostimulation and McKenzie Therapy and e-Health intervention. Patients are followed up at 2 and 6 months. The primary outcomes are (1) acceptability and demand of the intervention by GPs, physiotherapists and patients and (2) feasibility and optimal study design/methods for a definitive trial. Secondary outcomes will include analysis in the clinical outcomes of pain, disability, fear of movement, quality of life, isometric resistance of the trunk flexors, lumbar anteflexion and lumbar segmental range of motion. DISCUSSION The specific e-Health programs to home could increase adherence to treatment, prevent stages of greater pain and disability, and improve the painful symptomatology. CONCLUSIONS The e-Health programs could be an effective healthcare tool that can reach a large number of people living in rural or remote areas.
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Affiliation(s)
| | | | | | - Deirdre A Hurley
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland
| | | | - Héctor García-López
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Spain
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28
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The influence of cognitive factors in relation to the patients' treatment adherence for non-specific chronic low-back pain. A case series. J Bodyw Mov Ther 2022; 29:271-278. [DOI: 10.1016/j.jbmt.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 10/17/2021] [Indexed: 11/20/2022]
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29
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Lara-Palomo IC, Antequera-Soler E, Matarán-Peñarrocha GA, Fernández-Sánchez M, García-López H, Castro-Sánchez AM, Aguilar-Ferrándiz ME. Comparison of the effectiveness of an e-health program versus a home rehabilitation program in patients with chronic low back pain: A double blind randomized controlled trial. Digit Health 2022; 8:20552076221074482. [PMID: 35111332 PMCID: PMC8801654 DOI: 10.1177/20552076221074482] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/03/2022] [Indexed: 12/26/2022] Open
Abstract
OBJETIVE We conducted a randomized double blind clinical trial, to compare the effectiveness of McKenzie exercises and electroanalgesia via an e-Health program versus a home rehabilitation program on functionality, pain, fear of movement and quality of life in patients with non-specific chronic low back pain. METHODS Seventy-four participants with non-specific chronic low back pain were randomized to either the e- Health program group (n = 39) or the home rehabilitation program group (n = 35). The interventions consisted of the e-Health program group performing McKenzie exercises and received transcutaneous electrical nerve stimulation, while the home rehabilitation group attended an information session to explain the exercises, which they then performed at home with printed instructions. Both groups performed 3 weekly sessions for 8 weeks. The following were analyzed main measures: pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline and at 2 months. RESULTS Independent samples Student's t-tests showed that although the patients who followed the e-Health program showed significantly greater improvement than those who followed the home disability rehabilitation program in terms of intensity of pain, lumbar flexion mobility (P < 0.001), and the following dimensions of quality of life (P < 0.005), both groups improved significantly in the immediate post-treatment follow up compared with baseline scores. CONCLUSIONS Patients with chronic low back pain who followed an unsupervised home intervention supported by an individualized video exercise program showed greater post-treatment improvement than those who followed the same program with printed instructions.
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Affiliation(s)
| | - Eduardo Antequera-Soler
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almería, Andalucía, Spain
| | | | - Manuel Fernández-Sánchez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almería, Andalucía, Spain
| | - Héctor García-López
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almería, Andalucía, Spain
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30
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Lewkowicz D, Slosarek T, Wernicke S, Winne A, Wohlbrandt AM, Bottinger E. Digital Therapeutic Care and Decision Support Interventions for People With Low Back Pain: Systematic Review. JMIR Rehabil Assist Technol 2021; 8:e26612. [PMID: 34807837 PMCID: PMC8663573 DOI: 10.2196/26612] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/26/2021] [Accepted: 10/14/2021] [Indexed: 02/06/2023] Open
Abstract
Background Low back pain (LBP) is the leading cause of worldwide years lost because of disability, with a tremendous economic burden for health care systems. Digital therapeutic care (DTC) programs provide a scalable, universally accessible, and low-cost approach to the multidisciplinary treatment of LBP. Moreover, novel decision support interventions such as personalized feedback messages, push notifications, and data-driven activity recommendations amplify DTC by guiding the user through the program while aiming to increase overall engagement and sustainable behavior change. Objective This systematic review aims to synthesize recent scientific literature on the impact of DTC apps for people with LBP and outline the implementation of add-on decision support interventions, including their effect on user retention and attrition rates. Methods We searched bibliographic databases, including MEDLINE, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database, from March 1, 2016, to October 15, 2020, in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted this review based on related previously published systematic reviews. Besides randomized controlled trials (RCTs), we also included study designs with the evidence level of at least a retrospective comparative study. This enables the consideration of real-world user-generated data and provides information regarding the adoption and effectiveness of DTC apps in a real-life setting. For the appraisal of the risk of bias, we used the Risk of Bias 2 Tool and the Risk of Bias in Non-Randomized Studies of Interventions Tool for the RCTs and nonrandomized trials, respectively. The included studies were narratively synthesized regarding primary and secondary outcome measures, DTC components, applied decision support interventions, user retention, and attrition rates. Results We retrieved 1388 citations, of which 12 studies are included in this review. Of the 12 studies, 6 (50%) were RCTs and 6 (50%) were nonrandomized trials. In all included studies, lower pain levels and increased functionality compared with baseline values were observed in the DTC intervention group. A between-group comparison revealed significant improvements in pain and functionality levels in 67% (4/6) of the RCTs. The study population was mostly homogeneous, with predominantly female, young to middle-aged participants of normal to moderate weight. The methodological quality assessment revealed moderate to high risks of biases, especially in the nonrandomized trials. Conclusions This systematic review demonstrates the benefits of DTC for people with LBP. There is also evidence that decision support interventions benefit overall engagement with the app and increase participants’ ability to self-manage their recovery process. Finally, including retrospective evaluation studies of real-world user-generated data in future systematic reviews of digital health intervention trials can reveal new insights into the benefits, challenges, and real-life adoption of DTC programs.
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Affiliation(s)
- Daniel Lewkowicz
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Tamara Slosarek
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Sarah Wernicke
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Antonia Winne
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Attila M Wohlbrandt
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Erwin Bottinger
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
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Abstract
BACKGROUND Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. OBJECTIVES The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic non-specific low back pain compared to no treatment, usual care, placebo and other conservative treatments. SEARCH METHODS We searched CENTRAL (which includes the Cochrane Back and Neck trials register), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, SPORTDiscus, and trials registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform), and conducted citation searching of relevant systematic reviews to identify additional studies. The review includes data for trials identified in searches up to 27 April 2018. All eligible trials have been identified through searches to 7 December 2020, but have not yet been extracted; these trials will be integrated in the next update. SELECTION CRITERIA We included randomised controlled trials that assessed exercise treatment compared to no treatment, usual care, placebo or other conservative treatment on the outcomes of pain or functional limitations for a population of adult participants with chronic non-specific low back pain of more than 12 weeks' duration. DATA COLLECTION AND ANALYSIS Two authors screened and assessed studies independently, with consensus. We extracted outcome data using electronic databases; pain and functional limitations outcomes were re-scaled to 0 to 100 points for meta-analyses where 0 is no pain or functional limitations. We assessed risk of bias using the Cochrane risk of bias (RoB) tool and used GRADE to evaluate the overall certainty of the evidence. When required, we contacted study authors to obtain missing data. To interpret meta-analysis results, we considered a 15-point difference in pain and a 10-point difference in functional limitations outcomes to be clinically important for the primary comparison of exercise versus no treatment, usual care or placebo. MAIN RESULTS We included 249 trials of exercise treatment, including studies conducted in Europe (122 studies), Asia (38 studies), North America (33 studies), and the Middle East (24 studies). Sixty-one per cent of studies (151 trials) examined the effectiveness of two or more different types of exercise treatment, and 57% (142 trials) compared exercise treatment to a non-exercise comparison treatment. Study participants had a mean age of 43.7 years and, on average, 59% of study populations were female. Most of the trials were judged to be at risk of bias, including 79% at risk of performance bias due to difficulty blinding exercise treatments. We found moderate-certainty evidence that exercise treatment is more effective for treatment of chronic low back pain compared to no treatment, usual care or placebo comparisons for pain outcomes at earliest follow-up (MD -15.2, 95% CI -18.3 to -12.2), a clinically important difference. Certainty of evidence was downgraded mainly due to heterogeneity. For the same comparison, there was moderate-certainty evidence for functional limitations outcomes (MD -6.8 (95% CI -8.3 to -5.3); this finding did not meet our prespecified threshold for minimal clinically important difference. Certainty of evidence was downgraded mainly due to some evidence of publication bias. Compared to all other investigated conservative treatments, exercise treatment was found to have improved pain (MD -9.1, 95% CI -12.6 to -5.6) and functional limitations outcomes (MD -4.1, 95% CI -6.0 to -2.2). These effects did not meet our prespecified threshold for clinically important difference. Subgroup analysis of pain outcomes suggested that exercise treatment is probably more effective than education alone (MD -12.2, 95% CI -19.4 to -5.0) or non-exercise physical therapy (MD -10.4, 95% CI -15.2 to -5.6), but with no differences observed for manual therapy (MD 1.0, 95% CI -3.1 to 5.1). In studies that reported adverse effects (86 studies), one or more adverse effects were reported in 37 of 112 exercise groups (33%) and 12 of 42 comparison groups (29%). Twelve included studies reported measuring adverse effects in a systematic way, with a median of 0.14 (IQR 0.01 to 0.57) per participant in the exercise groups (mostly minor harms, e.g. muscle soreness), and 0.12 (IQR 0.02 to 0.32) in comparison groups. AUTHORS' CONCLUSIONS We found moderate-certainty evidence that exercise is probably effective for treatment of chronic low back pain compared to no treatment, usual care or placebo for pain. The observed treatment effect for the exercise compared to no treatment, usual care or placebo comparisons is small for functional limitations, not meeting our threshold for minimal clinically important difference. We also found exercise to have improved pain (low-certainty evidence) and functional limitations outcomes (moderate-certainty evidence) compared to other conservative treatments; however, these effects were small and not clinically important when considering all comparisons together. Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments.
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Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jenna Ellis
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Antti Malmivaara
- Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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Bordeleau M, Stamenkovic A, Tardif PA, Thomas J. The Use of Virtual Reality in Back Pain Rehabilitation: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2021; 23:175-195. [PMID: 34425250 DOI: 10.1016/j.jpain.2021.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/08/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022]
Abstract
This systematic review aimed to synthesize the existing evidence of extended reality (XR) on pain and motor function outcomes in patients with back pain. Following the Cochrane guidelines, relevant articles of any language were selected by 2 independent reviewers from CINAHL, Cochrane, Embase, Medline and Web of Knowledge databases. Of 2,050 unique citations, 24 articles were included in our review. These studies included a total of 900 back pain patients. Despite broader XR search, all interventions were virtual reality (VR) based and involved physical exercises (n = 17, 71%), hippotherapy (n = 4, 17%), motor imagery (n = 1, 4%), distraction (n = 1, 4%), and cognitive-behavior therapy (n = 1, 4%). Sixteen controlled studies were included in a meta-analysis which suggested that VR provides a significant improvement in terms of back pain intensity over control interventions (Mean Difference: -0.67; 95% CI: -1.12 to -0.23; I2 = 85%). Almost all included studies presented high risk of bias, highlighting the need to improve methodology in the examination of VR interventions. While the specific set of studies showed high heterogeneity across several methodological factors, a tentative conclusion could be drawn that VR was effective improving back pain intensity and tends to have a positive effect on improving other pain outcomes and motion function. PERSPECTIVE: Extended reality technologies have appeared as interesting nonpharmacological options for the treatment of back pain, with the potential to minimise the need for opioid medications. Our systematic review summarised existing applications of extended reality for back pain and proposed a few recommendations to direct further studies in the field.
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Affiliation(s)
- Martine Bordeleau
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), Sherbrooke, Quebec, Canada.
| | - Alexander Stamenkovic
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
| | - Pier-Alexandre Tardif
- Population Health and Optimal Health Practices Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec-Université Laval Research Center, Université Laval, Quebec City, Quebec, Canada
| | - James Thomas
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
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Özden F, Sarı Z, Karaman ÖN, Aydoğmuş H. The effect of video exercise-based telerehabilitation on clinical outcomes, expectation, satisfaction, and motivation in patients with chronic low back pain. Ir J Med Sci 2021; 191:1229-1239. [PMID: 34357527 DOI: 10.1007/s11845-021-02727-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The efficacy of exercise-based telerehabilitation in chronic low back pain (CLBP) has not been well studied. To our knowledge, no other studies have investigated the efficacy of video exercise-based telerehabilitation software in the remote management of home exercises in patients with CLBP. AIMS The purpose of the study was to investigate the effect of the video-based exercise software on pain, function, quality-of-life, expectation, satisfaction, and motivation in individuals with CLBP. METHODS A double-blind, two-armed randomized controlled trial was carried out with 50 individuals with CLBP. Participants were randomly allocated to either the telerehabilitation group (n = 25) or the conventional rehabilitation group (n = 25). The telerehabilitation group was followed up with a video exercise-based telerehabilitation software called Fizyoweb. The clinician was able to communicate with the patients through the software. The conventional rehabilitation group was given the same home exercises as the paper-based exercise instruction form. Pain, function, quality-of-life, and kinesiophobia were evaluated at baseline and after 8 weeks of intervention. In addition, patient expectations were questioned at the initial evaluation; afterward, patient satisfaction and motivation were questioned at the eighth week. RESULTS After 8 weeks of treatment, the telerehabilitation group achieved significant improvement in pain, function, quality-of-life, kinesiophobia, satisfaction, and motivation (p < 0.05). In addition, the telerehabilitation group reported more significant gains in all parameters compared with the conventional rehabilitation group (p < 0.05). CONCLUSIONS The video exercise-based telerehabilitation software positively affects clinical parameters and adherence to rehabilitation in patients with CLBP.
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Affiliation(s)
- Fatih Özden
- Köyceğiz Vocational School of Health Services, Department of Health Care Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Zübeyir Sarı
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, İstanbul, Turkey
| | - Özgür N Karaman
- Physical Therapy Unit, Muğla Sıtkı Koçman University, Training and Research Hospital, Muğla, Turkey
| | - Hüseyin Aydoğmuş
- Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
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Raiszadeh K, Tapicer J, Taitano L, Wu J, Shahidi B. In-Clinic Versus Web-Based Multidisciplinary Exercise-Based Rehabilitation for Treatment of Low Back Pain: Prospective Clinical Trial in an Integrated Practice Unit Model. J Med Internet Res 2021; 23:e22548. [PMID: 33734088 PMCID: PMC8074858 DOI: 10.2196/22548] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/02/2020] [Accepted: 01/31/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The recent onset of the COVID-19 pandemic has highlighted the need to reduce barriers to access physical therapy and associated care through the use of web-based programs and telehealth for those seeking treatment for low back pain (LBP). Despite this need, few studies have compared the effectiveness of clinic-based versus web-based or telehealth services. OBJECTIVE This study aims to compare the clinical outcomes of clinic-based multidisciplinary therapy in an integrated practice unit (C-IPU) model with online integrated multidisciplinary therapy (O-IPU) in individuals undergoing conservative care for LBP. METHODS A total of 1090 participants were prospectively recruited to participate in a clinical trial registry (NCT04081896) through the SpineZone rehabilitation IPU program. All participants provided informed consent. Participants were allocated to the C-IPU (N=988) or O-IPU (N=102) groups based on their personal preferences. The C-IPU program consisted of a high-intensity machine-based core muscle resistance training program, whereas the O-IPU program consisted of therapist-directed home core strengthening exercises through a web-based platform. Changes in LBP symptom severity (Numeric Pain Rating Scale), disability (Oswestry Disability Index), goal achievement (Patient-Specific Functional Scale), and frequency of opioid use were compared between the C-IPU and O-IPU groups using multivariate linear regression modeling adjusted for age, gender, treatment number, program duration, and baseline pain and disability. RESULTS Approximately 93.03% (1014/1090) of the participants completed their recommended programs, with no group differences in dropout rates (P=.78). The C-IPU group showed greater pain relief (P<.001) and reductions in disability (P=.002) than the O-IPU group, whereas the O-IPU group reported greater improvements in goal achievement (P<.001). Both programs resulted in reduced opioid use frequency, with 19.0% (188/988) and 21.5% (22/102) of participants reporting cessation of opioid use for C-IPU and O-IPU programs, respectively, leaving only 5.59% (61/1090) of participants reporting opioid use at the end of their treatment. CONCLUSIONS Both in-clinic and web-based multidisciplinary programs are beneficial in reducing pain, disability, and opioid use and in improving goal achievement. The differences between these self-selected groups shed light on patient characteristics, which require further investigation and could help clinicians optimize these programs. TRIAL REGISTRATION ClinicalTrials.gov NCT04081896; https://clinicaltrials.gov/ct2/show/NCT04081896.
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Affiliation(s)
| | | | - Lissa Taitano
- Spinezone Medical Fitness, San Diego, CA, United States
| | - Jonathan Wu
- Spinezone Medical Fitness, San Diego, CA, United States
| | - Bahar Shahidi
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, United States
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Phuphanich ME, Sinha KR, Truong M, Pham QG. Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation. Phys Med Rehabil Clin N Am 2021; 32:319-353. [PMID: 33814061 DOI: 10.1016/j.pmr.2020.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Telehealth visits result in high-quality care, with high patient and provider satisfaction. Strong evidence suggests that virtual physical therapy is noninferior to conventional face-to-face physical therapy for a variety of musculoskeletal disorders. Postoperative telerehabilitation has a strong positive effect on clinical outcomes, and the increased intensity telerehabilitation programs offer is a promising option for patients. Studies demonstrate effective virtual postoperative management. The novel coronavirus disease 2019 pandemic has led to improved reimbursement for telehealth visits and accelerated widespread implementation of telemedicine. This article establishes experience and evidence-based practice guidelines for conducting telemedicine visits, with emphasis on the virtual physical examination.
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Affiliation(s)
- Melissa E Phuphanich
- Department of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Kunal R Sinha
- Department of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Michael Truong
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Quynh Giao Pham
- Pain Medicine Fellowship Training Program, Department of Medicine, Division of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, David Geffen School of Medicine at UCLA, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
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Dadarkhah A, Rezaimoghadam F, Najafi S, Mohebi B, Azarakhsh A, Rezasoltani Z. Remote Versus in-Person Exercise Instruction for Chronic Nonspecific Low Back Pain Lasting 12 Weeks or Longer: A Randomized Clinical Trial. J Natl Med Assoc 2020; 113:278-284. [PMID: 33349469 DOI: 10.1016/j.jnma.2020.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/22/2020] [Accepted: 11/29/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Low back pain is a common health problem. We compared the effects of a remote exercise instruction with in-person exercise instruction on the pain and disability of people with nonspecific low back pain for more than 12 weeks. MATERIAL AND METHODS We carried out a randomized clinical trial with two study arms in an outpatient clinic at a University Hospital. A total of 56 patients were included and randomly allocated to each study arm. The primary outcome was the intensity of the low back pain. The secondary outcome was the Oswestry Disability Questionnaire score. We measured the outcomes before the intervention and in one and three months after completion of the program. The program consisted of core stability exercises and included flexibility and strengthening for all patients. Participants in the remote exercise group carried out the exercises at home two times a day for four weeks. They were followed by telephone calls. Patients in the in-person exercise group received the same exercises at the clinic, three times a week for four weeks. RESULTS Between-group comparisons indicated that there were no significant differences between the two approaches in changing pain (p = 0.93) and disability scores (p = 0.74) from the baseline to three months postintervention values. CONCLUSIONS There was no measurable difference between an exercise program delivered remotely compared to in-person.
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Affiliation(s)
- Afsaneh Dadarkhah
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Farid Rezaimoghadam
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Sharif Najafi
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Bahare Mohebi
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Arezoo Azarakhsh
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Zahra Rezasoltani
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran.
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Odetunde MO, Binuyo OT, Maruf FA, Ayenowowon SO, Okonji AM, Odetunde NA, Mbada CE. Development and Feasibility Testing of Video Home Based Telerehabilitation for Stroke Survivors in Resource Limited Settings. Int J Telerehabil 2020; 12:125-136. [PMID: 33520100 PMCID: PMC7757645 DOI: 10.5195/ijt.2020.6321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Tele-physiotherapy has been shown to be valuable to improve clinical outcomes after stroke. Yet, home-based interventions for stroke survivors (SSVs) who speak indigenous African languages are sparse. This study developed a video-based home exercise programme (VHEP) for SSV speakers of Yoruba. A qualitative descriptive pilot study was conducted in two phases: development and feasibility testing. VHEP development followed the American Stroke Association's recommendations to include demonstrations of task-specific mobility-task and postural training; trunk exercises, and overground walking. The exercise instructions were presented in the Yoruba language. Each exercise was demonstrated for five minutes on video for a total of 30 minutes. The feasibility testing involved ten consenting chronic SSVs. Each imitated the VHEP twice per week for two weeks and thereafter completed a feasibility questionnaire. Criteria for feasibility were: cost of using VHEP, recruitment rate, retention of participants, adherence to the exercises, and intervention delivery. The ten SSVs were recruited within one week, had prior home access to a video player at no-cost, adhered to the exercises as recorded, completed the 30 minute-duration for two weeks, and confirmed intervention delivery of VHEP. Most participants liked the novel use of Yoruba as the language of instruction on VHEP. The VHEP was feasible and acceptable among the studied sample of SSVs. Video based home telerehabilitation for SSVs therefore has the potential to meet the growing need for tele-physiotherapy in resource limited settings.
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Affiliation(s)
- Marufat O Odetunde
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Overcomer T Binuyo
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Fatai A Maruf
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
| | - Sunday O Ayenowowon
- Department of Physiotherapy, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Adaobi M Okonji
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Nurain A Odetunde
- General Out-Patient Department, General Hospital, Gusau, Zamfara State, Nigeria
| | - Chidozie E Mbada
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Vaish H. Letter to the Editor: Tele-rehabilitation of Back Pain Patients in Coronavirus Disease 2019 Pandemic. Asian Spine J 2020; 14:590-591. [PMID: 32791770 PMCID: PMC7435308 DOI: 10.31616/asj.2020.0358.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hina Vaish
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, India
- Corresponding author: Hina Vaish Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, 133207, India Tel: +91-9450124758, E-mail: ;
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Green BN, Pence TV, Kwan L, Rokicki-Parashar J. Rapid Deployment of Chiropractic Telehealth at 2 Worksite Health Centers in Response to the COVID-19 Pandemic: Observations from the Field. J Manipulative Physiol Ther 2020; 43:404.e1-404.e10. [PMID: 32534739 PMCID: PMC7286829 DOI: 10.1016/j.jmpt.2020.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of this paper is to describe the rapid deployment of telehealth, particularly real time video conference, for chiropractic services as a response to COVID-19. METHODS Two health centers at 2 campuses of a large California corporation have chiropractic care integrated into physical medicine services. Care was suspended beginning on March 17, 2020 to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among patients and staff. On March 19, the Governor of California issued a stay at home order. With musculoskeletal problems being common in the employee patient population, telehealth services were quickly developed to continue chiropractic care for patients. Using existing infrastructure, several members of the health center team developed chiropractic telehealth operations within 2 days. RESULTS Musculoskeletal telehealth services included examinations, risk assessment, advice, and rehabilitative exercises. These telehealth visits facilitated care that would have otherwise been unavailable to employees. Patients reported that the appointments were helpful, addressed their concerns, and provided a safe method to see their doctor. Regular interprofessional teamwork and relations between the clinic operator and client company were key contributors to operationalizing this service in our integrated healthcare environment. CONCLUSION We were able to quickly implement real time video conferencing and other forms of telehealth for chiropractic services at 2 worksite health centers. This paper includes information and insights to providers about setting up similar telehealth systems so they may also provide this benefit for patients in their communities during pandemics or disasters.
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Affiliation(s)
- Bart N Green
- Employer Based Integrated Primary Care Health Centers, Stanford Health Care; National University of Health Sciences, San Diego, CA, USA.
| | - Ti V Pence
- Employer Based Integrated Primary Care Health Centers, Stanford Health Care, San Jose, CA, USA
| | - Lawrence Kwan
- Section Chief - Employer Based Integrated Primary Care Health Centers, Stanford Health Care, Stanford Health Care; Clinical Assistant Professor Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jesse Rokicki-Parashar
- Medical Director - Employer Based Integrated Primary Care Health Centers, Stanford Health Care; Clinical Assistant Professor, Stanford University School of Medicine, Palo Alto, CA, USA
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Azhari A, Parsa A. Covid-19 Outbreak Highlights: Importance of Home-Based Rehabilitation in Orthopedic Surgery. THE ARCHIVES OF BONE AND JOINT SURGERY 2020; 8:317-318. [PMID: 32607403 PMCID: PMC7296596 DOI: 10.22038/abjs.2020.47777.2350] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Amin Azhari
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Parsa
- Orthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
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