The Effect of M-Health-Based Core Stability Exercise Combined with Self-Compassion Training for Patients with Nonspecific Chronic Low Back Pain: A Randomized Controlled Pilot Study

Abstract

Introduction: Nonspecific chronic low back pain (NCLBP) is a leading contributor to disease burden worldwide, and the management of NCLBP has always been a problem. This study is designed to explore the feasibility and efficacy of m-health-based core stability exercise (CSE) combined with self-compassion training (SCT) and compare it with m-health-based CSE alone for the management of NCLBP. Methods: This study is a pilot, patient-blinded randomized controlled trial. Participants with NCLBP were randomized into an intervention group and a control group. All the participants received m-health-based CSE, but those in the intervention group also received SCT before CSE.The intervention took place weekly on Saturday or Sunday for 4 weeks in total. Patients selfassessed their outcomes by filling out electronic questionnaires at 4 and 16 weeks after the start of the study. The primary outcome metrics for these questionnaires were back pain disability (based on the Roland-Morris Disability Questionnaire, RMDQ) and Pain intensity (Numeric Rating Scale, NRS; current pain, worst pain, average pain). The secondary outcome metrics were anxiety (GAD-7,7-item Generalized Anxiety Disorder scale), Depression Symptoms (PHQ-9,Patient Health Questionnaire-9), pain catastrophizing (PCS, Pain Catastrophizing Scale) and Self-efficiency (PSEQ, Pain Self-Efficiency Questionnaire). Results: A total of 37 patients comprising 28 (75.7%) females completed the study, with 19 patients in the intervention group and 18 in the control group. The mean (SD) patient age was 35.2 (11.1) years. For all primary outcomes, although there were no significant differences between groups, we found that participants in the intervention group improved function and pain earlier. The RMDQ score changed by -1.771 points (95% CI -3.768 to 0.227) from baseline to 4 weeks in the control group and by -4.822 points (95% CI -6.752 to -2.892) in the intervention group (difference between groups, -3.052 [95% CI -5.836 to -0.267]). Also, the RMDQ score changed by -3.328 points (95% CI -5.252 to -1.403) from baseline to 16 weeks in the control group and by -5.124 points (95% CI -7.014 to -3.233) in Fuming Zheng and Yiyi Zheng are co-first authors.

Impact of an AI app‐based exercise program for people with low back pain compared to standard care: A longitudinal cohort‐study

“…These positive effects were demonstrated by Zheng et al 26 once on pain (NRS) and function (Roland and Morris Disability Questionnaire; RMDQ) using m‐Health‐based core stability exercises after 4 and 16 weeks, with patients who additionally performed self‐compassion training achieving these effects earlier. Two other studies of a mobile app delivering multidisciplinary treatment for pain‐related LBP found the app had a positive effect and a stronger pain reduction on VAS pain compared to the control group after 12 weeks.…”

“…16 Nevertheless, positive effects are attributed to digital exercise treatments, either with educational component 15,17 or without. 25 These positive effects were demonstrated by Zheng et al 26 for pain-related LBP found the app had a positive effect and a stronger pain reduction on VAS pain compared to the control group after 12 weeks. 12,13 In contrast to this study, in which the app group differed significantly from the control group in terms of ODI at 4 and 8 weeks, subjects in the app group were only superior to those in the control group in the study by Priebe et al 13 in functional outcomes.…”

Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial

“…Sample size calculation will be based on the results of our pilot study [34]. We found a mean difference of 5.5 for RMDQ with a standard deviation of 4.7 in the intervention group and a mean difference of 3.1 with a standard deviation of 4.8 in the control group at 16week follow-up.…”

Ultrasonography Comparison of Diaphragm Morphological Structure and Function in Young and Middle-Aged Subjects with and without Non-Specific Chronic Low Back Pain: A Case-Control Study

“…We recruited participants from April 2021 to January 2022 via advertisement posted at the rehabilitation department of the First Afliated Hospital of Sun Yat-Sen University. Te NCLBP group was enrolled based on the following criteria: the participants should meet the medical diagnostic standards for NCLBP [4], aged 18∼59 years with low back pain between the twelfth rib and the gluteus sulcus, pain intensity between 2∼5/10 according to the numerical rating scale (NRS) [13,15,25], and symptoms lasting for at least 3 months. For the healthy control (HC) group, participants were matched with the NCLBP group for demographic data such as sex, educational status, height, weight, age, and so on and with no symptom of low back pain.…”

“…Finally, we excluded participants who had conditions that made them unable to cooperate with the examination (cognitive disorder, psychosis, current self-harm or suicidal ideation, major depression or anxiety, etc.) [25].…”