Low-dose, non-supervised, health insurance initiated exercise for the treatment and prevention of chronic low back pain in employees. Results from a randomized controlled trial

Haufe, Sven; Wiechmann, Klaus; Stein, Lothar; Kück, Momme; Smith, Andrea; Meineke, Stefan; Zirkelbach, Yvonne; Duarte, Samuel Rodriguez; Drupp, Michael; Tegtbur, Uwe

doi:10.1371/journal.pone.0178585

Cited by 15 publications

(23 citation statements)

References 46 publications

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“…Recently, a large randomized controlled trial (RCT) of a mobile Web app by Irvine et al reported a significant decrease in pain burden following long-term use of a medical app [ 10 ]. And yet, another recent study confirmed that non-supervised exercise exerted a beneficial effect on pain levels and muscle strength as compared to patients on a wait-list [ 15 ]. Thus, the finding that self-management of LBP with an app reduced user reported pain levels fits well with these earlier observations and published data.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results

Huber

Priebe

Baumann

et al. 2017

JMIR Rehabil Assist Technol

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BackgroundEven though modern concepts of disease management of unspecific low back pain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Recently, mobile health solutions have proven to be effective aides to foster self-management of many diseases.ObjectiveThe objective of this paper was to report on the retrospective short-term results of a digital multidisciplinary pain app for the treatment of LBP.MethodsKaia is a mobile app that digitalizes multidisciplinary pain treatment and is in the market as a medical product class I. For the current study, the data of anonymized Kaia users was retrospectively analyzed. User data were evaluated for 12 weeks regarding duration of use and effect on in-app user reported pain levels, using the numerical rating scale (NRS), depending on whether LBP was classified as acute, subacute, or chronic back pain according to current guidelines.ResultsData of 180 users were available. The mean age of the users was 33.9 years (SD 10.9). Pain levels decreased from baseline NRS 4.8 to 3.75 for all users at the end of the observation period. Users who completed 4, 8, or 12 weeks showed an even more pronounced decrease in pain level NRS (baseline 4.9 [SD 1.7] versus 3.6 [SD 1.5] at 4 weeks; baseline 4.7 [SD 1.8] versus 3.2 [SD [2.0] at 8 weeks; baseline 4.6 [SD 2.2] versus 2.6 [SD 2.0] at 12 weeks). In addition, subgroup analysis of acute, subacute, or chronic classification revealed no significant main effect of group (P>.30) on the reduction of pain. Conclusions: This retrospective study showed that in a pre-selected population of app users, an app digitalizing multidisciplinary rehabilitation for the self-management of LBP reduced user-reported pain levels significantly. The observed effect size was clinically relevant. Ongoing prospective randomized controlled trials (RCTs) will adjust for potential bias and selection effects.ConclusionsThis retrospective study showed that in a pre-selected population of app users, an app digitalizing multidisciplinary rehabilitation for the self-management of LBP reduced user-reported pain levels significantly. The observed effect size was clinically relevant. Ongoing prospective RCTs will adjust for potential bias and selection effects.

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Section: Discussionmentioning

confidence: 99%

Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results

Huber

Priebe

Baumann

et al. 2017

JMIR Rehabil Assist Technol

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“…In the case of intervention based on physical exercise, a quite high dispersion of effect size can be noted: large size effect for Jay et al 39 ) ; and low effect for Magalhães et al 42 ) and Staal et al 47 ) . Intervention by physical exercise in Haufe et al 35 ) and Jakobsen et al 37 ) showed a similar medium effect size. In Haufe et al 35 ) , non-supervised exercises, according to exercise planning and guidance by a physiotherapist, were instructed.…”

Section: Discussionmentioning

confidence: 75%

“…Intervention by physical exercise in Haufe et al 35 ) and Jakobsen et al 37 ) showed a similar medium effect size. In Haufe et al 35 ) , non-supervised exercises, according to exercise planning and guidance by a physiotherapist, were instructed. In Jakobsen et al 37 ) , one intervention group performed supervised exercises at work during working hours and another did so at home at their leisure.…”

Section: Discussionmentioning

confidence: 75%

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Effectiveness of workplace intervention strategies in lower back pain prevention: a review

2020

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The aim of this study was to identify effective work place intervention strategies for the prevention of low back pain (LBP). The study focused on interventions to two major groups: personal interventions and technical interventions. Data basis were searched for with inclusion criteria: study design based on randomised controlled trial; outcome measures including non-specific LBP occurrence expressed by prevalence or intensity; intervention met the definition of the technical and/or personal (physical exercises, behavioural training, educational) intervention programme. Eighteen papers were selected for full analysis. The diversification of quantitative indicators of differences between control and intervention groups were carried out using Cohen’s d index. The results of analysis showed strong differences in effects among intervention strategies, as well as among different cases within similar intervention strategies. LBP severity before intervention and the length of intervention were discussed as potentially influencing factors. The results of the analysis suggest that the most effective strategies for LBP prevention include technical modifications of the workstand and education based on practical training. Behavioural and physical training seems to be of lesser importance. LBP severity before intervention and the time when the measurements of outcome measures take place play an important role in the effectiveness of intervention.

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“…[2] Certain studies have displayed the effectiveness of non-supervised exercise in the reduction of chronic low back pain and functionality at work. [9] Exercise therapy has been shown to be more cost-effective than other treatments in the treatment of chronic and subacute low back pain. [10] However, few studies have explored the effectiveness of unsupervised, home-based exercises in patients with subacute LBP.…”

mentioning

confidence: 99%

A four-week home-based exercise programme is effective in treating subacute low back pain in adults

Lumb

Lategan²

2018

S. Afr. j. sports med

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Background: Low back pain (LBP) is a prevalent condition affecting a large portion of the population world-wide and it is one of the leading causes of morbidity and work absenteeism. Objective: To investigate the effectiveness of a four-week, home-based exercise program in treating subacute LBP in adults. Methods: A quantitative, experimental research design was employed. Twenty male and female adults aged between 18 and 65 years with subacute LBP were recruited by means of advertisements and word of mouth and allocated into either a control group (CG) or a home-based exercise group (HG). Both groups underwent a pre-test that consisted of answering two questionnaires, the Visual Analogue Scale for Pain (VASP) and the Oswestry LBP and Disability Questionnaire. The (CG) received no intervention over the four-week intervention period, while the intervention group (HG) was given an exercise program and instructed to perform the exercises at home, three times a week for four weeks. After four weeks (post-test), the two questionnaires were repeated. After eight weeks (follow-up test) both groups again completed the two questionnaires. Descriptive statistics, non-parametric inferential statistics and Cohen’s effect size (d) were used to analyse the data and statistical significance was set at a confidence level of 95% (p?0.05). Results: Following the home-based exercise intervention there were significant improvements observed in lower back pain and function for the HG. The HG’s Oswestry scores improved significantly (p=0.005) and their VASP also showed a significant improvement (p=0.011). Significant improvements also occurred between the pre-test and four-week follow-up for the HG’s Oswestry score (p=0.021) and for the HG’s VASP (p=0.005). No significant improvement was found for the CG between pre-test and post-test or between pre-test and the four-week follow-up. Large effect sizes (d>0.8) were also observed for the HG between the pre- and the post-test (d=1.59) as well as between the HG and the CG at post-test (d=1.52) and at the four-week follow-up (d=1.6). Conclusion: The exercise intervention resulted in statistically significant and clinically significant improvements in both function and pain in adults with subacute LBP.

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Low-dose, non-supervised, health insurance initiated exercise for the treatment and prevention of chronic low back pain in employees. Results from a randomized controlled trial

Cited by 15 publications

References 46 publications

Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results

Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results

Effectiveness of workplace intervention strategies in lower back pain prevention: a review

A four-week home-based exercise programme is effective in treating subacute low back pain in adults

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