RECOVER Injury Research Centre, The University of Queensland, Herston, Queensland, Australia.
Department of Occupational Therapy, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia.
Eur J Pain. 2023 Jul;27(6):749-765. doi: 10.1002/ejp.2104. Epub 2023 Mar 25.
Being able to successfully self-regulate one's activity levels is a key adaptation strategy for many people with chronic pain. This study aimed to explore the clinical utility of a mobile health platform (Pain ROADMAP) for assisting with the delivery of a tailored activity modulation intervention for people with persistent pain.
Twenty adults with chronic pain undertook 1-week monitoring intervals which involved wearing an Actigraph activity monitor and entering pain, opioid use, and activity participation data into a custom-made phone app. The Pain ROADMAP online portal integrated and analysed the data to detect activities that caused a severe pain exacerbation and provided summary statistics pertaining the data collected. As part of a 15-week treatment protocol, participants received feedback from three dispersed Pain ROADMAP monitoring periods. Treatment focused on adapting pain-provoking activities, gradually increase goal-related activity and optimizing routine.
Results revealed good participant acceptability of monitoring procedures and reasonable adherence to both monitoring procedures and clinical follow-up appointments. Preliminary efficacy was established through clinically meaningful decreases in overactivity behaviour, pain variation, opioid use, depression, activity avoidance, and increases in productivity. No adverse outcomes were observed.
The results of this study provide initial support for the clinical utility of mHealth assisted activity modulation interventions that involve remote monitoring.
This is the first study to demonstrate how mHealth innovations that utilise ecological momentary assessment can be successfully integrated with wearable technologies to provide a tailored activity modulation intervention that is both highly valued by people with chronic pain and assists individuals to make constructive behavioural changes. Adaptions such as low costs sensors, increased customisability and gamification may be important for enhanced uptake, adherence and scalability.
对于许多患有慢性疼痛的人来说，能够成功地自我调节活动水平是一种关键的适应策略。本研究旨在探索移动健康平台（Pain ROADMAP）在提供定制活动调节干预方面的临床应用，以帮助患有持续性疼痛的人。
20 名慢性疼痛患者进行了为期 1 周的监测间隔，其中包括佩戴 Actigraph 活动监测器并将疼痛、阿片类药物使用和活动参与数据输入定制手机应用程序。Pain ROADMAP 在线门户集成并分析数据，以检测导致严重疼痛加剧的活动，并提供与收集的数据相关的汇总统计信息。作为 15 周治疗方案的一部分，参与者从三个分散的 Pain ROADMAP 监测期收到反馈。治疗重点是适应引起疼痛的活动，逐步增加与目标相关的活动，并优化日常生活。
结果显示监测程序的参与者接受度良好，对监测程序和临床随访预约的依从性合理。初步疗效通过过度活动行为、疼痛变化、阿片类药物使用、抑郁、活动回避的临床意义降低以及生产力的提高得到证实。没有观察到不良结果。
本研究结果初步支持涉及远程监测的移动健康辅助活动调节干预的临床应用。
这是第一项研究，证明了如何将利用生态瞬时评估的移动健康创新与可穿戴技术成功集成，以提供一种既深受慢性疼痛患者重视又能帮助个人做出建设性行为改变的定制活动调节干预。低成本传感器、增加定制性和游戏化等改进可能对于提高使用率、依从性和可扩展性很重要。
