Barun Blaž, Divić Zdravko, Martinović Kaliterna Dušanka, Poljičanin Ana, Benzon Benjamin, Aljinović Jure
Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia.
University of Split School of Medicine, 21000 Split, Croatia.
Diagnostics (Basel). 2024 Dec 4;14(23):2729. doi: 10.3390/diagnostics14232729.
Can mobile app intervention via push notifications increase adherence to exercise and reduce disability and pain after a whiplash injury?
A randomized controlled trial was conducted with concealed allocation, blinding of some assessors, and an intention-to-treat analysis. Participants who sustained whiplash injury at most 3 months prior were divided into active and control groups. Both groups completed a two-part physiotherapist-supervised physical therapy program (3-week break in between, ten sessions each, 5x/week). The program included TENS, therapeutic ultrasound, and exercises (breathing, ROM, deep neck flexor activation, and stretching). Both groups were encouraged to exercise at home. The active group additionally received push notifications through the mobile app once a day as a reminder to exercise. Outcomes were adherence to exercise (four-point Likert scale), physical functioning (NDI), pain intensity (VAS), perceived recovery (three-point Likert scale), work information, psychological functioning (PCS), and HRQoL (SF-12) at baseline and 6-month follow-up.
At month 6, when comparing the groups, the intervention group showed higher adherence to home exercise (3 [2-4] vs. 2 [2-4]; p = 0.005, median [IQR]) and improved HRQoL (∆SF-12) (20 [6-36] vs. 15 [9-23]; p = 0.038). Unlike the control group, the intervention group showed a significant decrease in pain catastrophizing (31%; p = 0.01). A multivariant analysis showed that mobile app intervention influenced adherence most (≈1 Likert point). The groups did not differ in NDI, pain VAS, perceived recovery, or work limitation.
Mobile app intervention increased adherence to home exercise, reduced pain catastrophizing, and increased HRQoL six months after a whiplash injury.
ClinicalTrials.gov NCT05704023.
通过推送通知进行的移动应用程序干预能否提高挥鞭伤后的运动依从性，并减少残疾和疼痛？
进行了一项随机对照试验，采用隐蔽分组、部分评估者设盲和意向性分析。在最多3个月前遭受挥鞭伤的参与者被分为干预组和对照组。两组均完成了由物理治疗师监督的两部分物理治疗计划（中间休息3周，各进行10次治疗，每周5次）。该计划包括经皮电刺激神经疗法（TENS）、超声治疗和运动（呼吸、关节活动度、颈深屈肌激活和拉伸）。两组均被鼓励在家中进行锻炼。干预组每天还通过移动应用程序接收一次推送通知，以提醒其进行锻炼。观察指标为基线时和6个月随访时的运动依从性（四分制李克特量表）、身体功能（颈部残疾指数，NDI）、疼痛强度（视觉模拟评分法，VAS）、感知恢复情况（三分制李克特量表）、工作信息、心理功能（心理综合评定量表，PCS）和健康相关生活质量（简短健康调查量表，SF-12）。
在第6个月时，比较两组发现，干预组的家庭锻炼依从性更高（3[2-4]比2[2-4]；p = 0.005，中位数[四分位间距]），健康相关生活质量（∆SF-12）有所改善（20[6-36]比15[9-23]；p = 0.038）。与对照组不同，干预组的疼痛灾难化显著降低（31%；p = 0.01）。多变量分析显示，移动应用程序干预对依从性的影响最大（约1个李克特评分点）。两组在NDI、疼痛VAS、感知恢复情况或工作受限方面无差异。
移动应用程序干预提高了挥鞭伤6个月后的家庭锻炼依从性，减少了疼痛灾难化，并提高了健康相关生活质量。
ClinicalTrials.gov NCT05704023。
