Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study

BMC Musculoskeletal Disorders

Gerard E. Francisco¹  Jorge Lains²  Dora Janela³  Fabíola Costa³  Maria Molinos³  Virgílio Bento³  Fernando Dias Correia⁴ 

[1] Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center McGovern Medical School, and TIRR Memorial Hermann, Houston, TX, USA;Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal;Faculty of Medicine, Coimbra University, Coimbra, Portugal;SWORD Health Technologies, Inc, Draper, UT, USA;SWORD Health Technologies, Inc, Draper, UT, USA;Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal;

关键词: Musculoskeletal pain;    Home-based digital rehabilitation;    Digital therapy;    Physical therapy;    eHealth;    Rehabilitation;   

DOI  :  10.1186/s12891-021-04891-5

来源: Springer

【 摘 要 】

BackgroundAcute musculoskeletal (MSK) pain is very common and associated with impaired productivity and high economic burden. Access to timely and personalized, evidence-based care is key to improve outcomes while reducing healthcare expenditure. Digital interventions can facilitate access and ensure care scalability.ObjectivePresent the feasibility and results of a fully remote digital care program (DCP) for acute MSK conditions affecting several body areas.MethodsInterventional single-arm study of individuals applying for digital care programs for acute MSK pain. Primary outcome was the mean change between baseline and end-of-program in self-reported Numerical Pain Rating Scale (NPRS) score and secondary outcomes were change in analgesic consumption, intention to undergo surgery, anxiety (GAD-7), depression (PHQ-9), fear-avoidance beliefs (FABQ-PA), work productivity (WPAI-GH) and engagement.ResultsThree hundred forty-three patients started the program, of which 300 (87.5%) completed the program. Latent growth curve analysis (LGCA) revealed that changes in NPRS between baseline and end-of-program were both statistically (p < 0.001) and clinically significant: 64.3% reduction (mean − 2.9 points). Marked improvements were also noted in all secondary outcomes: 82% reduction in medication intake, 63% reduction in surgery intent, 40% in fear-avoidance beliefs, 54% in anxiety, 58% in depression and 79% recovery in overall productivity. All outcomes had steeper improvements in the first 4 weeks, which paralleled higher engagement in this period (3.6 vs 3.2 overall weekly sessions, p < 0.001). Mean patient satisfaction score was 8.7/10 (SD 1.26).Strengths and limitationsThis is the first longitudinal study demonstrating the feasibility of a DCP for patients with acute MSK conditions involving several body areas. Major strengths of this study are the large sample size, the wide range of MSK conditions studied, the breadth of outcomes measured, and the very high retention rate and adherence level. The major limitation regards to the absence of a control group.ConclusionsWe observed very high completion and engagement rates, as well as clinically relevant changes in all health-related outcomes and productivity recovery. We believe this DCP holds great potential in the delivery of effective and scalable MSK care.Trial registrationNCT, NCT04092946. Registered 17/09/2019;

【 授权许可】

CC BY