Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 23, 2021
Date Accepted: Mar 22, 2022
Evaluation of the Effect of Patient Education and Strengthening Exercise Therapy Using Mobile Messaging Application on Work Productivity in Japanese Patients with Chronic Low Back Pain: Open-Label, Randomized, Parallel-Group Trial
ABSTRACT
Background:
Artificial intelligence-assisted interactive health promotion systems are useful tools for the management of musculoskeletal conditions
Objective:
This study aims to explore the effects of online video patient education and strengthening exercise therapy using a mobile messaging application (app) on work productivity and pain in patients with chronic low back pain (CLBP) receiving pharmacological treatment.
Methods:
Patients with CLBP were randomly allocated to either the exercise group, who received education and exercise therapy using a mobile messaging app, or the conventional group. For patient education, an online video program was used to provide evidence-based thinking about the importance of a cognitive-behavioral approach for CLBP. The exercise therapy was developed in accordance with the recommendations for alignment, core muscles, and endogenous activation, including "improvement of posture and mobility for proper alignment," "stimulation/strengthening of deep muscles for spinal stability," and "operation of intrinsic pain" for the "activation of endogenous substances by aerobic exercise." Both groups continued to receive the usual medical care with pharmacological treatment. The endpoints were changes in work productivity, pain intensity, quality of life (QoL), fear of movement, and depression. The observation period for this study was 12 weeks. An analysis adjusted for baseline values, age at the time of consent acquisition, sex, and willingness to strengthen exercise therapy was performed.
Results:
Results:
The exercise and conventional groups included 48 and 51 patients with a mean age of 47.9 years (56.3% male) and 46.9 years (54.9% male) in the full analysis set, respectively. The exercise group showed consistently better trends for other endpoints than the conventional group. Compared to the conventional group, the exercise group showed a significant improvement in the symptoms of low back pain (LBP) (P=.04), shoulder stiffness (P=.004), QoL (EQ-5D-5L: P=.03), and fear of movement at Week 12 (P=.04). However, no significant impact of these interventions on work productivity was observed in the exercise group compared to the conventional group.
Conclusions:
This study suggests that patient education and strengthening exercise therapy using a mobile messaging app would be useful for treating CLBP. This study does not reveal the effect of therapeutic interventions on CLBP on work productivity. Thus, further research is needed to assess work productivity with therapeutic interventions. Clinical Trial: The study was registered with the UMIN Clinical Trials Registry [UMIN000041037].
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.