Smartphone-Based Remote Self-Management of Chronic Low Back Pain: A Preliminary Study

Abstract

Objective. To assess the additional effect of self-management on physiotherapy via the use of APPS on management of chronic low back pain. Method. A single-blinded randomized control trial was conducted. 8 participants (male: 4; female: 4) were recruited from the Rehabilitation Clinic of The Hong Kong Polytechnic University. Participants in the treatment group received self-management plus physiotherapy and the control group received physiotherapy only. Assessment was carried out pretreatment, midterm (week 2), and posttreatment (week 4), including Visual Analog Scale (VAS), Pain Self-Efficacy Questionnaire (PSEQ), Roland Morris Disability Questionnaire (RMDQ), and SF36. Results. Compared with the physiotherapy group, the self-management plus physiotherapy group had significance in PSEQ (p=0.035), RMDQ (p=0.035), SF36-Bodily Pain (p=0.008), and SF36-Mental Health (p=0.013). VAS showed a positive trend although there was no significant difference. Conclusion. This pilot study indicated that smartphone APPS-based self-management program appears to bring additional benefits to physiotherapy for patients with CLBP. Self-management is a potential approach for people with CLBP.

Efficacy and safety of treating chronic nonspecific low back pain with radial extracorporeal shock wave therapy (rESWT), rESWT combined with celecoxib and eperisone (C+E) or C+E alone: a prospective, randomized trial

“…The subjects investigated in this study were recruited from the Rehabilitation Clinic of The Hong Kong Polytechnic University and were treated with respectively physiotherapy (Group 1) or physiotherapy + smartphone-based remote selfmanagement (Group 2). The mean PSEQ scores at baseline in [54] (Group 1: 34.3 ± 8.0; Group 2: 38.6 ± 8.5; mean ± SD) were lower than the mean PSEQ score of the subjects investigated in the present study (49.0 ± 10.6). However, there are a number of substantial shortcomings in [54] which renders this study insufficient for contributing to evaluating the mean PSEQ score of subjects with cnsLBP who seek treatment at a department of pain medicine in China: (i) the number of subjects investigated in [54] was very small (Group 1: n=3; Group 2: n=5) and, thus, the total number of subjects investigated in [54] (n=8) was less than 20% of the number of subjects in each group investigated in the present study; and (ii) the only inclusion criteria reported in [54] were nonspecific low back pain due to musculoskeletal origins, access to a mobile phone and the ability to perform a brief exercise during regular working hours; and the only exclusion criterion reported in [54] was history of receiving major surgery.…”

“…Until now the PSEQ score has not been used in any study listed in PubMed on treatment of cnsLBP performed at a department of pain medicine in China. One study on this topic authored by Chinese authors has been listed in PubMed so far [54]. The subjects investigated in this study were recruited from the Rehabilitation Clinic of The Hong Kong Polytechnic University and were treated with respectively physiotherapy (Group 1) or physiotherapy + smartphone-based remote self-management (Group 2).…”

Mobile Application-Based Interventions for Chronic Pain Patients: A Systematic Review and Meta-Analysis of Effectiveness

“…After title and abstract screening, 83 articles were included in the full-text screening; 22 unique studies with a total of 4679 patients met the eligibility criteria (1515 in non-RCT designs, 3164 in RCT designs) ( Figure 1). For the meta-analysis, 12 of these studies were considered as RCTs [36][37][38][39][40][41][42][43][44][45][46][47], while 10 were observational or studies of similar design, which compared baseline measures to post-intervention measures of the same individuals [48][49][50][51][52][53][54][55][56][57]. Studies varied in sample sizes, sex distributions, populations, assessment instruments, and study quality.…”

“…Six studies were aimed at individuals with general chronic pain [40,41,51,52,56,57], nine studies at individuals with chronic lower back pain (LBP) [36,37,39,44,46,47,49,53,54], three studies at individuals with arthritis (e.g., osteoarthritis and rheumatoid arthritis) [43,45,55], and one study each at individuals with menstrual pain [48], frozen shoulder pain [38], chronic neck pain [42], and migraine [50]. Fifteen of the studies recruited patients during clinic visits or through their general practitioners (GP) [36][37][38][40][41][42][43][46][47][48]51,52,[55][56][57] or research institutions, and seven recruited participants from the community via the internet or flyers [39,44,45,49,50,53]. All studies included both sexes, except two which included only women [41,55].…”

“…Of the 12 RCTs, only one compared their app-based intervention with an assessment only group [43]. The other 11 RCTs compared their app-based intervention with active control groups that received either physiotherapy [46,47], educational reading material or other such information [36,40,42,44], recommendations to stay active [37,38], access to a self-help website [41,59], a wearable activity tracker without smartphone application [45], or unspecified treatment as usual with mail reminders to complete assessments [39]. A table with a detailed description of the app content can be found in the Supplementary file (See in Table S2).…”