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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Apr 24, 2019
Open Peer Review Period: Apr 29, 2019 - May 28, 2019
Date Accepted: Jul 21, 2019
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial

Kryger MA, Crytzer TM, Fairman A, Quinby EJ, Karavolis M, Pramana G, Setiawan IMA, McKernan GP, Parmanto B, Dicianno BE

The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial

J Med Internet Res 2019;21(8):e14305

DOI: 10.2196/14305

PMID: 31464189

PMCID: 6737885

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial

  • Michael Alan Kryger; 
  • Theresa M Crytzer; 
  • Andrea Fairman; 
  • Eleanor J Quinby; 
  • Meredith Karavolis; 
  • Gede Pramana; 
  • I Made Agus Setiawan; 
  • Gina Pugliano McKernan; 
  • Bambang Parmanto; 
  • Brad E Dicianno

Background:

Individuals with spinal cord injury (SCI) are at risk for secondary medical complications, such as urinary tract infections (UTIs) and pressure injuries, that could potentially be mitigated through improved self-management techniques. The Interactive Mobile Health and Rehabilitation (iMHere) mobile health (mHealth) system was developed to support self-management for individuals with disabilities.

Objective:

The main objective of this study was to determine if the use of iMHere would be associated with improved health outcomes over a 9-month period. A secondary objective was to determine if the use of iMHere would be associated with improved psychosocial outcomes. Phone usage, app usage, and training time data were also collected to analyze trends in iMHere use.

Methods:

Overall, 38 participants with SCI were randomized into either the intervention group who used the iMHere system and received standard care or the control group who received standard care without any technology intervention. Health outcomes were recorded for the year before entry into the study and during the 9 months of the study. Participants completed surveys at baseline and every 3 months to measure psychosocial outcomes.

Results:

The intervention group had a statistically significant reduction in UTIs (0.47 events per person; P=.03; number needed to treat=2.11). Although no psychosocial outcomes changed significantly, there was a nonsignificant trend toward a reduction in mood symptoms in the intervention group compared with the control group meeting the threshold for clinical significance. Approximately 34 min per participant per month were needed on average to manage the system and provide technical support through this mHealth system.

Conclusions:

The use of the iMHere mHealth system may be a valuable tool in the prevention of UTIs or reductions in depressive symptoms. Given these findings, iMHere has potential scalability for larger populations.

ClinicalTrial:

ClinicalTrials.gov NCT02592291; https://clinicaltrials.gov/ct2/show/NCT02592291.


 Citation

Please cite as:

Kryger MA, Crytzer TM, Fairman A, Quinby EJ, Karavolis M, Pramana G, Setiawan IMA, McKernan GP, Parmanto B, Dicianno BE

The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial

J Med Internet Res 2019;21(8):e14305

DOI: 10.2196/14305

PMID: 31464189

PMCID: 6737885

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