Experiences of Older Adults With Mobile Phone Text Messaging as Reminders of Home Exercises After Specialized Manual Therapy for Recurrent Low Back Pain: A Qualitative Study

Abstract

BackgroundClinical experience of manual therapy for musculoskeletal pain is that patients often suffer from recurrent pain and disorders, but that they do not continue to perform their physical home exercises when they are free from symptoms. The chance of positive long-term effects of manual therapy would probably increase if patients were reminded that they are to continue to perform their exercises. Mobile phone text messaging (short messaging service, SMS) is increasingly used as an innovative intervention to remind patient to exercise. However, there are only a few studies on such interventions in the field of low back pain (LBP). Qualitative studies of patients’ experiences of receiving text messages as reminders of home exercises after manual treatment for recurrent LBP have to the best of our knowledge never been published.ObjectivesThe aim of this study was to explore older persons’ common experiences of receiving reminders of home exercises through mobile phone text messaging after specialized manual therapy for recurrent LBP.MethodsA total of 7 men and 8 women (67-86 years), who had sought specialized manual therapy (Naprapathic manual therapy) for recurrent LBP were included in the study. Individual one-way text messages as reminders of home exercises (to be performed on a daily basis) were sent to each patient every third day for 3 weeks, then once a week for another 2 weeks. Semistructured interviews with 2 broad, open-ended questions were held and data were analyzed with systematic text condensation, based on Giorgi’s principles of psychological phenomenological analysis.ResultsThe participants appreciated the messages, which were perceived as timely and usable, and also stimulated memorizing. The messages made the participants reflect on the aim of the exercise, value of being reminded, and on their improvement in pain. During the interviews, the participants created their own routines for continued adherence to the exercises.ConclusionsIt seems plausible that mobile phone text messaging may serve as a useful tool for patient empowerment with regard to recurrent LBP in older persons. Further studies are needed to explore whether future compliance with the exercises will be as large if the participants are not being interviewed.

An mHealth App for Self-Management of Chronic Lower Back Pain (Limbr): Pilot Study

“…The effectiveness of mobile phone-based interventions for measuring and influencing physical activity has been explored in a number of studies, and there is increasing evidence that mHealth interventions that are adaptive to user preference while supplementing standard care with disease monitoring, self-reporting, education, and promoting physical therapy adherence have the potential to improve health outcomes among those living with chronic diseases [ 1 , 10 , 11 ]. Support from a health coach has also been shown to help drive mHealth app use [ 10 , 12 ], and remote health coaching in the form of text messages can effectively improve self-management of symptoms and promote long-term behavior change retention [ 13 , 14 ], including increased compliance with physical therapy [ 15 ]. Ecological momentary assessment, or “experience sampling”—including self-report surveys and sensor-assisted reminders—are effective tools for collecting in situ user data [ 16 , 17 ] and can be used to enhance mHealth interventions for the self-management of CLBP.…”

The Perceived Benefits of an Artificial Intelligence–Embedded Mobile App Implementing Evidence-Based Guidelines for the Self-Management of Chronic Neck and Back Pain: Observational Study (Preprint)

“…Mobile app has been identified as a way to reduce the financial burden of chronic neck and back pain [7]. Use of ICT as part of rehabilitation programme had been suggested to increase adherence to self-management programme [8].…”

Extended dental services to provide oral health promotion text messages for older patients - OHP-TOP study

“…The patients also reported that the text messages promoted a self-consciousness in their rehabilitation and felt empowered when they received the text message after completing the exercises, in which case the text messages felt like a reward (Lilje et al, 2017).…”

“…Additionally, TMIs have been proven to produce an alteration in oral health behaviour habits in as little as one week, however whether these outcomes are sustained is not clear (Hashemian et al, 2015). Studies with a longer intervention time frame, such as 9-12 weeks, were able to collect more baseline data for evaluation post study, permitting greater depth in analysis (Lilje, Olander, Berglund, Skillgate, & Anderberg, 2017;Müller, Khoo, & Morris, 2016;Schluter et al, 2015;Sharma et al, 2011). Previous studies sent as few as two texts per week for longer periods (12 weeks) and multiple daily reminders for week-long studies, making the case for more frequent longer intervention periods.…”