Abstract
BackgroundEven though modern concepts of disease management of unspecific low back pain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Recently, mobile health solutions have proven to be effective aides to foster self-management of many diseases.ObjectiveThe objective of this paper was to report on the retrospective short-term results of a digital multidisciplinary pain app for the treatment of LBP.MethodsKaia is a mobile app that digitalizes multidisciplinary pain treatment and is in the market as a medical product class I. For the current study, the data of anonymized Kaia users was retrospectively analyzed. User data were evaluated for 12 weeks regarding duration of use and effect on in-app user reported pain levels, using the numerical rating scale (NRS), depending on whether LBP was classified as acute, subacute, or chronic back pain according to current guidelines.ResultsData of 180 users were available. The mean age of the users was 33.9 years (SD 10.9). Pain levels decreased from baseline NRS 4.8 to 3.75 for all users at the end of the observation period. Users who completed 4, 8, or 12 weeks showed an even more pronounced decrease in pain level NRS (baseline 4.9 [SD 1.7] versus 3.6 [SD 1.5] at 4 weeks; baseline 4.7 [SD 1.8] versus 3.2 [SD [2.0] at 8 weeks; baseline 4.6 [SD 2.2] versus 2.6 [SD 2.0] at 12 weeks). In addition, subgroup analysis of acute, subacute, or chronic classification revealed no significant main effect of group (P>.30) on the reduction of pain. Conclusions: This retrospective study showed that in a pre-selected population of app users, an app digitalizing multidisciplinary rehabilitation for the self-management of LBP reduced user-reported pain levels significantly. The observed effect size was clinically relevant. Ongoing prospective randomized controlled trials (RCTs) will adjust for potential bias and selection effects.ConclusionsThis retrospective study showed that in a pre-selected population of app users, an app digitalizing multidisciplinary rehabilitation for the self-management of LBP reduced user-reported pain levels significantly. The observed effect size was clinically relevant. Ongoing prospective RCTs will adjust for potential bias and selection effects.
Highlights
In spite of recent developments in diagnosis and treatment of low back pain (LBP), the burden of disease for patients and health economy remains outstanding
Ongoing prospective randomized controlled trial (RCT) will adjust for potential bias and selection effects. (JMIR Rehabil Assist Technol 2017;4(2):e11) doi:10.2196/rehab
The vast majority of patients are affected by non-specific LBP rather http://rehab.jmir.org/2017/2/e11/
Summary
In spite of recent developments in diagnosis and treatment of low back pain (LBP), the burden of disease for patients and health economy remains outstanding. Treatment paradigms have shifted from a merely somatic disease concept of LBP towards a bio-psycho-social model; a more comprehensive approach that encompasses somatic findings as well as psychological and environmental factors. Multidisciplinary pain treatment (MPT), a combined program comprising educational, physical, and psychological exercises, has been proven to be effective in the treatment of LBP with positive effects on pain level, functionality, and other outcomes parameters including quality of life [3]. Even though modern concepts of disease management of unspecific low back pain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Mobile health solutions have proven to be effective aides to foster self-management of many diseases
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