JMIR Publications

ABSTRACT

Background:

The recommended first-line treatment for non-specific and degenerative back pain consists of movement exercises and patient education.

Objective:

Using a pragmatic, randomized controlled trial, we evaluated the effectiveness of a digital home exercise program on self-reported pain intensity, compared to the standard of care of physiotherapy.

Methods:

Participant recruitment was based on newspaper advertisements and a consecutive on-site assessment for eligibility and enrolment. Participants with unspecific and degenerative back pain were randomized to receive a 12-week stand-alone digital home exercise program (n = 108) or physiotherapy (n = 105), respectively. The digital home exercise program included four exercises daily, while physiotherapy included six to twelve sessions, depending on severity of symptoms.

Results:

Throughout the study, the mean pain intensity decreased significantly in patients using the digital therapeutic by -53.1% (SD = 29.5%) and in the control group by -14.6% (SD = 25.3%). The pain reduction achieved was considered clinically relevant for patients using the digital therapeutic, but not for the control group (p < .001). Additionally, the home exercise program proved to achieve significantly greater pain reductions than physiotherapy during follow-up, demonstrating a superior effectiveness over physiotherapy after two, six, and twelve weeks. Retention rates of 89.9% in the intervention group and 97.3% in the control group were maintained throughout the study.

Conclusions:

The use of an app-based home exercise leads to a highly significant and clinically relevant reduction in pain intensity throughout the 12-week duration of the program. The intervention studied shows superior improvement in pain intensity when compared to the standard of care. Clinical Trial: The trial is registered at DRKS (Germany Clinical Trials Register; WHO Primary Register) with the identifier DRKS00022781.