JMIR Publications

ABSTRACT

Background:

The number of mobile health (mHealth) apps released for musculoskeletal (MSK) injury treatment and self-management of home-exercise programmes (HEPs) has risen rapidly in recent years as digital health interventions are explored and researched in more detail. As this number grows, it is becoming increasingly difficult for users to navigate the market and select the most appropriate app for their use-case. It is also unclear as to what features developers of these apps are harnessing to support patient self-management, and how they fit into clinical care pathways.

Objective:

The objective of this study was to scope the current market of mHealth apps for MSK rehabilitation and to report on the app features, claims, evidence-base and functionalities.

Methods:

A cross-sectional study of apps for MSK rehabilitation was performed across both major app stores: iOS App Store and Google Play Store. Four search terms were used; physiotherapy rehabilitation, physical therapy rehabilitation, rehabilitation exercise and therapeutic exercise, to identify apps which were then cross-referenced against set selection criteria by four reviewers. Each reviewer, where possible, downloaded the app and accessed supplementary literature available on the product to assist in data extraction.

Results:

A total of 1322 apps were identified. After application of the inclusion/exclusion criteria and removal of duplicates, 144 apps were included in the study. Over half of the included apps (56.3%) had been released within the past three years. Three quarters (74.3%) of the apps made no reference to evidence supporting the design or efficacy of the app, with only 11.1% providing direct citations to research. The majority of apps did utilise exercise pictures (95.8%) or videos (67.4%), however comparatively few harnessed additional features to encourage engagement and support self-management such as an adherence log (45.8%), communication portal (22.2%), patient reported outcome capture (25%), or direct feedback (39.6%). Of note, and somewhat concern, many of these apps prescribed generic exercises (64.6%) in the absence of individualised input to the user, with few providing specific patient education (34%), and safety advice or disclaimers (26.4%).

Conclusions:

The cohort of apps included in this study contained a large heterogeneity of features meaning it is difficult for users to identify the most appropriate or effective app. Many apps are missing the opportunity to offer key features which could promote exercise adherence and encourage self-management in musculoskeletal rehabilitation. Furthermore, very few developers currently offering products on the market are providing evidence to support the design and efficacy of their technologies.