Digital Therapeutics in the Management of Chronic Pain

Park

et al. 2023

Preprint

Background: Temporomandibular disorder (TMD) is a common condition that affects the temporomandibular joint (TMJ) and the muscles of the jaw, resulting in pain and dysfunction. TMD is affected by both behavioral and psychological factors. However, the effectiveness of conservative treatments varies among patients. Digital therapeutics (DTx) is a new treatment approach where a software based medical device is used such as smartphone application. DTx can expect therapeutic effects by controlling behavioral factors through delivery of appropriate intervention and cognitive behavioral therapy. DTx have emerged as a promising alternative treatment option for various chronic conditions, but the development of DTx and the efficacy for TMD have not been fully evaluated. Objective: The aim of this study is to evaluate the efficacy of a DTx for TMD called ‘Clickless®’, which is the first DTx using a smartphone application for TMD. Methods: We recruited 40 participants diagnosed with TMD who visited the Bundang Seoul National University Hospital from March to May 2022. Participants were randomly divided into an intervention test group (DTx use) and a control group. The intervention group received the usual treatment process for TMD in addition to the use of the DTx. The control group received the usual treatments only. The patients were followed up in 3-4 weeks for both groups, and the outcome data were collected and analyzed. Result: The intervention group showed a significant reduction in pain score as measured by the numeral rating scale (NRS) (mean difference 0.82, p = 0.038). Additionally, the intervention test group showed a statistically significant increase in maximal mouth opening compared to the control group. (mean difference 1.38(mm), p = 0.040] However, there was no significant difference of improvement in jaw functional limitation scale, oral behavior checklist, and patient health questionnaire-4 between the two groups. Conclusion: DTx is an effective treatment option for TMD patients when it applied with the conventional treatments, however further research is necessary to confirm its efficacy and wider application.

Section: Discussionmentioning

confidence: 99%

Open label randomized controlled trial of a digital therapeutics in temporomandibular disorder (TMD) patients: A preliminary study

Park

et al. 2023

Preprint

“…Repeated movement is the method by which the pain radiating from the spine is sequentially eliminated distally to proximally in response to a specific therapeutic exercise. 55 Digital application physical therapy comprises a thorough clinical history followed by a physical examination, where symptomatic, mechanical, and functional baselines are assessed, and the response to repeated end-range movements, posture, and core stability is determined. Such customized, repetitive, and accurate movement training helps restore activity limitations such as squatting, lunging, and climbing stairs.…”

Section: Discussionmentioning

confidence: 99%

Long-term effects of deep-learning digital therapeutics on pain, movement control, and preliminary cost-effectiveness in low back pain: A randomized controlled trial

Park,

Yi,

Choi

et al. 2023

DIGITAL HEALTH

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.

“…Virtual reality (VR) technologies may offer several clinical benefits: improving treatment efficacy, decreasing treatment time and decreasing overall cost ( 103 ). A combination of VR and telemedicine can also set the foundation for novel clinical practice in the future.…”

Section: Integration Of Digital Health Technologies and Future Applications With Neuromodulationmentioning

confidence: 99%

“…Specifically, behavioral exercises tailored to patients' needs can effectively engage them in their therapy and increase compliance. Further, game-like features of these tasks and realistic environments add to a heightened sense of experience ( 103 ).…”

Section: Integration Of Digital Health Technologies and Future Applications With Neuromodulationmentioning

confidence: 99%

Digital Health Integration With Neuromodulation Therapies: The Future of Patient-Centric Innovation in Neuromodulation

Pathak

Greenleaf

Metman

et al. 2021

Front. Digit. Health

Self Cite

Digital health can drive patient-centric innovation in neuromodulation by leveraging current tools to identify response predictors and digital biomarkers. Iterative technological evolution has led us to an ideal point to integrate digital health with neuromodulation. Here, we provide an overview of the digital health building-blocks, the status of advanced neuromodulation technologies, and future applications for neuromodulation with digital health integration.