针对急慢性疼痛的数字肌肉骨骼项目的临床结果：一项有对照组的观察性纵向研究。

Clinical Outcomes After a Digital Musculoskeletal Program for Acute and Subacute Pain: Observational, Longitudinal Study With Comparison Group.

作者信息

Wang Grace, Yang Manshu, Hong Mindy, Krauss Jeffrey, Bailey Jeannie F

机构信息

Hinge Health, Inc, San Francisco, CA, United States.

Department of Psychology, University of Rhode Island, Kingston, RI, United States.

出版信息

JMIR Rehabil Assist Technol. 2022 Jun 27;9(2):e38214. doi: 10.2196/38214.

DOI:10.2196/38214

PMID:35759317

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9274396/

Abstract

BACKGROUND

Telerehabilitation for musculoskeletal (MSK) conditions may produce similar or better outcomes than usual care, but most telerehabilitation studies address only chronic or postsurgical pain.

OBJECTIVE

We aimed to examine pain and function at 3, 6, and 12 weeks for individuals with acute and subacute MSK pain who took part in a digital MSK program versus a nonparticipant comparison group.

METHODS

We conducted an observational, longitudinal study with a nonparticipant comparison group. The intervention group had video visits with physical therapists who recommended exercise therapies and educational articles delivered via an app. Nonparticipants were those who were registered but unable to participate because their benefit coverage had not yet begun. We collected pain and function outcomes through surveys delivered at 3-, 6-, and 12-week follow-ups. We conducted descriptive analyses, unadjusted regression, and mixed effects regression adjusting for baseline characteristics, time as fixed effects, and a time*group interaction term.

RESULTS

The analysis included data from 675 nonparticipants and 262 intervention group participants. Compared to baseline, the intervention group showed significantly more pain improvement at 3, 6, and 12 weeks versus nonparticipants after adjusting for baseline factors. Specifically, the intervention group's pain scores decreased by 55.8% at 3 weeks versus baseline, 69.1% at 6 weeks, and 73% at 12 weeks. The intervention group's adjusted pain scores decreased from 43.7 (95% CI 41.1-46.2) at baseline to 19.3 (95% CI 16.8-21.8) at 3 weeks to 13.5 (95% CI 10.8-16.2) at 6 weeks to 11.8 (95% CI 9-14.6) at 12 weeks. In contrast, nonparticipants' pain scores decreased by 30.8% at 3 weeks versus baseline, 45.8% at 6 weeks, and 46.7% at 12 weeks. Nonparticipants' adjusted pain scores decreased from 43.8 (95% CI 42-45.5) at baseline to 30.3 (95% CI 27.1-33.5) at 3 weeks to 23.7 (95% CI 20-27.5) at 6 weeks to 23.3 (95% CI 19.6-27) at 12 weeks. After adjustments, the percentage of participants reporting that pain was better or much better at follow-up was significantly higher by 40.6% at 3 weeks, 31.4% at 6 weeks, and 31.2% at 12 weeks for intervention group participants versus nonparticipants. After adjustments, the percentage of participants with meaningful functional improvement at follow-up was significantly higher by 15.2% at 3 weeks and 24.6% at 12 weeks for intervention group participants versus nonparticipants.

CONCLUSIONS

A digital MSK program may help to improve pain and function in the short term among those with acute and subacute MSK pain.

摘要

背景

肌肉骨骼疾病的远程康复可能产生与常规护理相似或更好的效果，但大多数远程康复研究仅针对慢性疼痛或术后疼痛。

目的

我们旨在比较参与数字肌肉骨骼项目的急性和亚急性肌肉骨骼疼痛患者与未参与者对照组在3周、6周和12周时的疼痛和功能情况。

方法

我们进行了一项带有未参与者对照组的观察性纵向研究。干预组接受了物理治疗师的视频问诊，物理治疗师通过应用程序推荐运动疗法和教育文章。未参与者是那些已注册但因医保尚未生效而无法参与的人。我们通过在3周、6周和12周随访时进行的调查收集疼痛和功能结果。我们进行了描述性分析、未调整回归分析以及针对基线特征、时间作为固定效应和时间*组交互项进行调整的混合效应回归分析。

结果

分析纳入了675名未参与者和262名干预组参与者的数据。与基线相比，在调整基线因素后，干预组在3周、6周和12周时的疼痛改善情况显著优于未参与者。具体而言，干预组的疼痛评分在3周时较基线下降了55.8%，6周时下降了69.1%，12周时下降了73%。干预组调整后的疼痛评分从基线时的43.7（95%CI 41.1 - 46.2）降至3周时的19.3（95%CI 16.8 - 21.8），6周时降至13.5（95%CI 10.8 - 16.2），12周时降至11.8（95%CI 9 - 14.6）。相比之下，未参与者的疼痛评分在3周时较基线下降了30.8%，6周时下降了45.8%，12周时下降了46.7%。未参与者调整后的疼痛评分从基线时的43.8（95%CI 42 - 45.5）降至3周时的30.3（95%CI 27.1 - 33.5），6周时降至23.7（95%CI 20 - 27.5），12周时降至23.3（95%CI 19.6 - 27）。调整后，干预组参与者在随访时报告疼痛有所改善或明显改善的比例在3周时比未参与者高40.6%，6周时高31.4%，12周时高31.2%。调整后，可以看出干预组参与者在随访时有显著功能改善的比例在3周时比未参与者高15.2%，12周时高24.6%。