JMIR Publications

ABSTRACT

Background:

Musculoskeletal conditions are among the main contributors to the global burden of disease. For unspecific and degenerative musculoskeletal conditions, international guidelines consider participant education and movement exercise the preferred therapeutic option for this spectrum of conditions. To provide access to and availability of such care, innovative and decentralized therapeutic means are required to meet the increasing therapeutic demand for such conditions.

Objective:

This retrospective observational study of preliminary use and outcome data explores the clinical outcomes of a smartphone-based digital home exercise program (in the following, also referred to as ‘program’) for unspecific and degenerative back, hip, and knee pain before it received regulatory approval for use in the German statutory health insurance system.

Methods:

An incomplete matched block design is employed to assess pain score changes over the intended twelve-week duration of the program. Post-hoc analyses are performed. In addition, a matched comparison of self-reported functional scores and adherence rates are presented.

Results:

A total of 2’517 participants met the inclusion criteria and provided sufficient data to be included in the analyses. Overall, initial self-reported pain scores decreased significantly from 5.19 out of 10 (SD = 1.96) to 3.35 out of 10 (SD = 2.38) after twelve weeks. Post-hoc analyses indicate a particularly emphasized pain score reduction over the early use phases. Additionally, participants with back pain showed significant improvements in strength and mobility scores, whereas participants with hip or knee pain demonstrated significant improvements in their coordination scores. Across all pain areas and pain durations, a high yet expected attrition rate could be observed.

Conclusions:

The observational study at hand provides first insights into the clinical outcomes of an exercise program for unspecific and degenerative back, hip, and knee pain. Furthermore, it demonstrates a potential secondary benefit of improved functionality (i.e., strength, mobility, coordination). Yet, as this study lacks confirmatory power, further research is required to substantiate the clinical outcomes of the program assessed. Clinical Trial: The study received approval from the ethics committee of the Landesärztekammer Baden-Württemberg (state physician chamber of Baden-Württemberg) under the reference F-2020-075 and is registered with the German Clinical Trials Register (DRKS) under the reference DRKS00021785.