Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Mar 23, 2022
Date Accepted: Jun 15, 2022
Clinical outcomes after a digital musculoskeletal (MSK) program for acute and subacute pain: an observational, longitudinal study with comparison group
ABSTRACT
Background:
Telerehabilitation for musculoskeletal (MSK) conditions may produce similar or even better pain, functional, and health related quality of life outcomes as usual care, but most telerehabilitation studies address only chronic or post-surgical pain.
Objective:
Our primary objective was to examine pain and function at 3 weeks, 6 weeks, and 12 weeks for persons with acute and subacute MSK pain who took part in a digital MSK program versus a nonparticipant comparison group.
Methods:
The intervention group had video visits with physical therapists who recommended exercise therapies and education articles delivered via an app. Nonparticipants registered, but were unable to participate since benefit coverage had not yet begun. We collected pain and function outcomes through surveys delivered at 3 week, 6 week, and 12 week and follow up. We conducted descriptive analyses, unadjusted, and adjusted mixed effects regression, adjusting for baseline characteristics, time as fixed effects, and a time*group interaction term.
Results:
Compared to baseline, the intervention group showed significantly more pain improvement at 3 weeks, 6 weeks, and 12 weeks versus nonparticipants after adjusting for baseline factors. The intervention group’s pain scores decreased by 55.8% at 3 weeks versus baseline, 69.1% at 6 weeks, and 73.0% at 12 weeks. In contrast, nonparticipants’ pain scores decreased by 30.8% at 3 weeks versus baseline, 45.8% at 6 weeks, and 46.7% at 12 weeks. After adjustments, the percent reporting pain was better or much better at follow up was significantly higher by: 40.6 percentage points at 3 weeks, 31.4 percentage points at 6 weeks, and 31.2 percentage points at 12 weeks for intervention group members versus nonparticipants. After adjustments, the percent with meaningful functional improvement at follow up was significantly higher by: 15.2 percentage points at 3 weeks and 24.6 percentage points at 12 weeks for intervention group members versus nonparticipants.
Conclusions:
A digital MSK program may help to improve pain and function in the short term among those with acute and subacute MSK pain.
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