Digitally Delivered Exercise and Education Treatment Program for Low Back Pain: Longitudinal Observational Cohort Study.
Helena Hörder, Håkan Nero, Majda Misini Ignjatovic and 4 others
PMID 35727622WHAT IT FOUND
After 3 months in a digital back-pain program, pain fell by 1.7 points, and 58.50% reached a meaningful improvement.
No control group means the program cannot be proven to cause this.
Key findings
01At 3 months, mean back-pain score fell by 1.7 points, and 58.50% reached a clinically important change.
02Reaching a clinically important pain change was associated with higher baseline pain (OR 1.9), high adherence (OR 1.5), and high motivation (OR 1.2).
0330.35% changed from no to yes on a question about whether their back state was acceptable, and adherence was not associated with that change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no control group, so the study cannot separate the program's effect from natural recovery, placebo effects, or other changes over time. 26.34% did not reach the 3-month follow-up, and those who dropped out were more often working age, reported more depression or anxiety, had lower physical activity, and less often used peer support. Participants were self-selected app users and often highly educated, so results may not apply to people who prefer face-to-face care or have lower digital access. Follow-up was only 3 months, so sustained benefit is unknown. Several authors were employed by or founded Joint Academy, the company that provides the program.
Declared interests
Several authors were employed by Joint Academy, including part-time employment, founder and chief medical officer, vice president of clinical strategy, and data analyst; one reviewer received no compensation.
The easy way to misread this
Do not attribute the 58.50% improvement to exercise alone. Participants also received education with quizzes, peer chat, physiotherapist chat supervision, and scheduled consultations, and the study had no control group.