Toelle Thomas R, Utpadel-Fischler Daniel A, Haas Katharina-Kristina, Priebe Janosch A
1Technical University of Munich, School of Medicine, Department of Neurology, Munich, Germany.
2Technical University of Munich, School of Medicine, Center of Interdisciplinary Pain Medicine, Munich, Germany.
NPJ Digit Med. 2019 May 3;2:34. doi: 10.1038/s41746-019-0109-x. eCollection 2019.
Non-specific low back pain (LBP) is one of the leading causes of global disability. Multidisciplinary pain treatment (MPT) programs comprising educational, physical, and psychological interventions have shown positive treatment effects on LBP. Nonetheless, such programs are costly and treatment opportunities are often limited to specialized medical centers. mHealth and other digital interventions may be a promising method to successfully support patient self-management in LBP. To address these issues, we investigated the clinical effects of a multidisciplinary mHealth back pain App (Kaia App) in a randomized controlled trial (registered at German Clinical Trials Register under DRKS00016329). One-hundred one adult patients with non-specific LBP from 6 weeks to 1 year were randomly assigned to an intervention group or a control group. In the intervention group, the Kaia App was provided for 3 months. Control treatment consisted of six individual physiotherapy sessions over 6 weeks and high-quality online education. The primary outcome, pain intensity, was assessed at 12-week follow-up on an 11-point numeric rating scale (NRS). Our per-protocol analysis showed no significant differences between the groups at baseline (Kaia App group: = 5.10 (SD = 1.07) vs. control group: = 5.41 (SD = 1.15). At 12-week follow-up the Kaia App group reported significantly lower pain intensity ( = 2.70 (SD = 1.51)) compared to the control group ( = 3.40 (SD = 1.63)). Our results indicate that the Kaia App as a multidisciplinary back pain app is an effective treatment in LBP patients and is superior to physiotherapy in combination with online education.
非特异性腰痛(LBP)是导致全球残疾的主要原因之一。包含教育、物理和心理干预的多学科疼痛治疗(MPT)项目已显示出对LBP的积极治疗效果。尽管如此,此类项目成本高昂,且治疗机会通常仅限于专业医疗中心。移动健康(mHealth)及其他数字干预措施可能是成功支持LBP患者自我管理的一种有前景的方法。为解决这些问题,我们在一项随机对照试验(在德国临床试验注册中心注册,注册号为DRKS00016329)中研究了多学科移动健康腰痛应用程序(Kaia应用程序)的临床效果。101名患有非特异性LBP、病程在6周至1年的成年患者被随机分配到干预组或对照组。在干预组中,提供Kaia应用程序使用3个月。对照治疗包括在6周内进行6次个体物理治疗以及高质量的在线教育。主要结局指标疼痛强度在12周随访时采用11点数字评分量表(NRS)进行评估。我们的符合方案分析显示,两组在基线时无显著差异(Kaia应用程序组:=5.10(标准差=1.07),对照组:=5.41(标准差=1.15))。在12周随访时,Kaia应用程序组报告的疼痛强度显著低于对照组(=2.70(标准差=1.51))(对照组:=3.40(标准差=1.63))。我们的结果表明,Kaia应用程序作为一款多学科腰痛应用程序,对LBP患者是一种有效的治疗方法,且优于物理治疗与在线教育相结合的方式。