PTCohortJMIR rehabilitation and assistive technologies2022

Clinical Outcomes After a Digital Musculoskeletal Program for Acute and Subacute Pain: Observational, Longitudinal Study With Comparison Group.

Grace Wang, Manshu Yang, Mindy Hong and 2 others

PMID 35759317

WHAT IT FOUND

People with recent back, neck, hip, knee, or shoulder pain who used a digital physical therapy program combining video visits, app exercises, and education reported lower pain and more functional improvement than nonparticipants at follow-up.

This was observational, so it shows association, not proof.

Key findings

01After adjustment, pain scores were lower in the intervention group than in nonparticipants at 3, 6, and 12 weeks: 19.3 versus 30.3, 13.5 versus 23.7, and 11.8 versus 23.3 on a 0 to 100 scale.

02After adjustment, 77.5% of intervention participants reported pain was better or much better at 12 weeks, compared with 46.3% of nonparticipants.

03After adjustment, 77.8% of intervention participants reported functional improvement at 12 weeks, compared with 53.2% of nonparticipants, with significance reported at 3 and 12 weeks.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Because the study was observational, it cannot show that the digital program caused the better outcomes. Participants had already applied for a digital program, so motivation or expectations may explain part of the difference. Nonparticipants were people who applied but were declined because their employers did not offer the program, not a usual-care randomised control group. The paper did not document which medications participants took, and it did not record exercises completed outside the app. Outcomes were combined across back, neck, hip, knee, and shoulder pain, so it is unclear whether results were the same for each region. Follow-up numbers were smaller than baseline, and the analysis used available data rather than all 937 participants at every time point.

Declared interests

GW, MH, and JK are employees of Hinge Health, Inc and have equity interest in Hinge Health, Inc. The paper does not state a separate funding source.

The easy way to misread this

Do not conclude that the app alone caused better pain and function. The intervention included physical therapist video visits, a published care plan, app-based exercises, and education, and the study was observational, so it shows association rather than proof of benefit.

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The study

Participants
937 at baseline (675 nonparticipants, 262 intervention participants); follow-up sample sizes were 196, 130, and 123 for nonparticipants and 150, 115, and 121 for intervention at 3, 6, and 12 weeks.
Certainty of evidence
Low

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Cite

Grace Wang, Manshu Yang, Mindy Hong, et al. Clinical Outcomes After a Digital Musculoskeletal Program for Acute and Subacute Pain: Observational, Longitudinal Study With Comparison Group. JMIR rehabilitation and assistive technologies. 2022.

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