Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Feb 23, 2018
Open Peer Review Period: Feb 25, 2018 - Jul 22, 2018
Date Accepted: Dec 8, 2018
(closed for review but you can still tweet)
The Effectiveness and Safety of Smartphone for Rehabilitation after Lumbar Spinal Operation: A Multi-center, Prospective, Randomized Controlled Trial
ABSTRACT
Background:
Rehabilitation is very important for postoperative patients with low back pain. However, the promotion of traditional clinic-based program is limited in developing countries like China, due to the maldistribution of medical resources. Smartphones may be a potential substitute for those who have no access to traditional rehabilitation.
Objective:
The aim of this study was to examine the efficacy of a smartphone based rehabilitation system in patients accepted lumbar spinal operation.
Methods:
Postoperative patients with low back pain were recruited and randomized to rehabilitation treatment provide by smartphone based e-health program (EH) or usual care treatment (UC) as control group. Primary outcomes were function and pain status assessed by Oswestry Disability Index (ODI) and visual analogue scale (VAS). Secondary outcomes were general mental health and life status (Likert scales, EQ-5D and SF-36). All the patients were assessed pre-operatively and then at 3, 6, 12 and 24 months post-operatively.
Results:
A total of 168 of the 863 eligible patients were included and randomized in this study. The analysis showed that the improvement of primary outcomes in EH group was superior to UC group at 24 months postoperatively (mean difference [SD]: ODI 7.02 [3.10], P<0.05; VAS 7.59 [3.42], P<0.05). No significant difference of primary outcomes was found at other time points. Subgroup analysis showed that the improvements of the primary outcomes were more significant in those completed 6 or more training each week throughout the trial (the highest compliance group, HC), compared with the UC group at 6 months (mean difference [SD]: ODI 17.94 [5.24], P<0.05; VAS 19.56 [5.27], P<0.05), 12 months (mean difference [SD]: ODI 13.39 [5.32], P<0.05; VAS 14.35 [5.23], P<0.05) and 24 months (mean difference[SD]: ODI 18.80 [5.22], P<0.05; VAS 21.56 [5.28], P<0.05).
Conclusions:
This research demonstrated that e-health, a smartphone based tele-rehabilitation system is effective in self-managed rehabilitation for postoperative patient with low back pain. The effectiveness of e-health was more evident in participants with higher compliance. Future research should focus on improving patient’s compliance. Clinical Trial: Chinese clinical trial registry, ChiCTR-TRC-13003314, http://www.chictr.org.cn/showproj.aspx?proj=6245
Citation
Per the author's request the PDF is not available.
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