Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 24, 2023
Date Accepted: Jul 12, 2023
Availability, evidence, and quality of mobile Health applications for the treatment of nonspecific low back pain in German language: A systematic assessment
ABSTRACT
Background:
Nonspecific low back pain (NSLBP) is of high socio-economic relevance and causes high levels of suffering for those affected. The effectiveness of app-based treatment has been confirmed and clinicians are recommended to use such interventions. Since 88.8% of the German population use smartphones, apps could support therapy. The available apps in the stores for mobile applications are hardly regulated and their quality can be variable. Overviews of the availability and quality of mobile applications for Australia, Great Britain and Spain have been compiled, but not yet for Germany.
Objective:
To create an overview of the availability and content-related quality of apps for the treatment of NSLBP in German language.
Methods:
A systematic search for applications (apps) on iOS and Android was conducted on 07/06/2022 in the Apple App Store and the Google Play Store. Inclusion and exclusion criteria were defined before the search. Apps in German language, that were available in both stores were eligible. To check for evidence, the apps found were assessed using checklists based on the German national guideline for NSLBP (GNG) and the British equivalent by the National Institute for Health and Care Excellence (NICE). The quality of the apps was measured using the Mobile Application Rating Scale (MARS). To control potential inaccuracies, a second reviewer re-surveyed the outcomes for 30% of the apps and checked the inclusion and exclusion criteria for these apps. The outcomes measured with the assessment tools were presented in tables with descriptive statistics. Furthermore, the characteristics of the included applications were summarized. This study was preregistered in the open science framework register (osf.io/sq435).
Results:
Eight apps were included for assessment. Provided features with different frequencies were: Exercise tracking of prefabricated and/or adaptable workout programs, educational aspects, artificial intelligence based therapy or workout programs, and motion detection. All apps met some recommendations by the GNG as well as using forms of exercises as recommended by the NICE guideline. The applications met a mean of 5.75 (SD = 2.71) out of 16 items. The best rated application answered 11 items “Yes”. The mean MARS quality score was 3.61 (SD = 0.55). The highest mean score was obtained in “Section B – Functionality” with 3.81 (SD = .54).
Conclusions:
Available apps in German language meet guideline recommendations and are mostly of acceptable or good quality. Their use as a therapy supplement could help to promote the implementation of home exercise protocols. A new assessment tool to obtain ratings on apps for the treatment of NSLBP combining aspects of quality and evidence based best practice could be useful. Clinical Trial: osf.io/sq435
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