数字肌肉骨骼 (MSK) 项目一年后的临床结果：一项具有非参与者对照组的观察性、纵向研究。

Clinical outcomes one year after a digital musculoskeletal (MSK) program: an observational, longitudinal study with nonparticipant comparison group.

机构信息

Hinge Health, Inc., 455 Market Street, Suite 700, CA, 94105, San Francisco, USA.

Department of Psychology, University of Rhode Island, Chafee Hall 406, 142 Flagg Road, Kingston, RI, 02881, USA.

出版信息

BMC Musculoskelet Disord. 2022 Mar 11;23(1):237. doi: 10.1186/s12891-022-05188-x.

BACKGROUND

The evidence base for the impact of digital health on musculoskeletal (MSK) outcomes is growing, but it is unclear how much digital MSK programs address pain and function in the intermediate and long term.

METHODS

This observational study of digital MSK program participants versus nonparticipants (n = 2570) examined pain, function, depression, and anxiety at 3, 6, and 12 months, and health care use at 12 months. The intervention group engaged in a digital MSK program that included exercise, education, and coaching for at least 3 months. The nonparticipant group registered, but never started the program. We collected data in app or by emailed survey at 3, 6, and 12 months after registering for the program. We conducted descriptive analyses and unadjusted and adjusted regression modeling.

RESULTS

The odds ratio of achieving a minimally clinically important difference (MCID) in pain improvement for the intervention versus the nonparticipant group was 1.97 (95% CI: 1.28, 3.02; p = .002) at 3 months, 1.44 (95% CI: 0.91, 2.25; p = .11) at 6 months, and 2.06 (95% CI: 1.38, 3.08; p = .004) at 12 months in adjusted models. The odds ratio of achieving a MCID in functional improvement for the intervention versus the nonparticipant group was 1.56 (95% CI: 1.03, 2.38; p = .01) at 3 months, 1.55 (95% CI: 1.02, 2.37; p = .04) at 6 months, and 1.35 (95% CI: 0.89, 2.06, p = 0.16) at 12 months in adjusted models. For those with moderate to severe depression or anxiety at baseline, we observed statistically significant lower odds of moderate to severe depression or anxiety at 3 months, 6 months, and 12 months for the intervention versus the nonparticipant group in adjusted models (p < .05). At 12 months, the percentage with invasive, imaging, and conservative services was higher for the nonparticipant versus intervention group by 5.7, 8.1, and 16.7 percentage points, respectively (p < 0.05).

CONCLUSIONS

A digital MSK program may offer participants sustained improvement in pain, depression, and anxiety with concomitant decreases in health care use.

背景

数字健康对肌肉骨骼 (MSK) 结果的影响的证据基础正在增加，但尚不清楚数字 MSK 计划在中期和长期内有多少能解决疼痛和功能问题。

方法

这项对数字 MSK 计划参与者与非参与者（n=2570）的观察性研究，在 3、6 和 12 个月时检查了疼痛、功能、抑郁和焦虑情况，并在 12 个月时检查了医疗保健使用情况。干预组参与了一项数字 MSK 计划，该计划至少包括 3 个月的锻炼、教育和指导。非参与者组注册了，但从未开始该计划。我们在注册该计划后的 3、6 和 12 个月，通过应用程序或电子邮件调查收集数据。我们进行了描述性分析以及未调整和调整后的回归建模。

结果

在调整后的模型中，与非参与者组相比，干预组在 3 个月时疼痛改善达到最小临床重要差异（MCID）的优势比为 1.97（95%CI：1.28，3.02；p=0.002），在 6 个月时为 1.44（95%CI：0.91，2.25；p=0.11），在 12 个月时为 2.06（95%CI：1.38，3.08；p=0.004）。在调整后的模型中，与非参与者组相比，干预组在 3 个月时功能改善达到 MCID 的优势比为 1.56（95%CI：1.03，2.38；p=0.01），在 6 个月时为 1.55（95%CI：1.02，2.37；p=0.04），在 12 个月时为 1.35（95%CI：0.89，2.06，p=0.16）。对于基线时有中度至重度抑郁或焦虑的患者，我们在调整后的模型中观察到，与非参与者组相比，干预组在 3、6 和 12 个月时，中度至重度抑郁或焦虑的可能性显著降低（p<0.05）。在 12 个月时，与干预组相比，非参与者组在侵入性、影像学和保守性服务方面的比例分别高出 5.7、8.1 和 16.7 个百分点（p<0.05）。