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

Abstract

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.

Benefits of Mobile Apps in Pain Management: Systematic Review

“…Characteristics of included studies are shown in Table 1 and in Multimedia Appendix 2 . A total of 7 RCTs [ 21 - 27 ], 6 before-after studies [ 28 - 33 ], 1 controlled before-after study [ 34 ], and one retrospective data analysis [ 35 ] with a total of 1962 patients were reviewed. Of these, 11 studies were conducted in an out-clinic setting and 4 studies in an in-clinic setting.…”

“…In addition, 8 of the studies were controlled (7 RCTs and 1 controlled before-after study); 1 was a 3-armed RCT. Moreover, 7 studies were single arm, 6 of which compared baseline to follow-up parameters (before and after), and 1 was a retrospective analysis of collected data [ 35 ]. Studies were published between 2015 and early 2018.…”

Optimizing telehealth pain care after COVID-19

“…For patients with more complex chronic pain conditions, especially those who may require multidisciplinary pain management, E-consults may yet prove effective. 48 , 82 If a physical examination is indicated, a primary care provider's physical examination of a complex chronic pain condition is of value but not a substitute for one performed by a pain-trained physician.…”

Design of a clinician dashboard to facilitate co-decision making in the management of non-specific low back pain

“…A short-term retrospective study has been reported which evaluates the efficacy of the Kaia app (Huber et al 2017). Kaia, which is available for iPhones and Androids, uses a multidisciplinary approach, including education about back pain, physiotherapy, and mindfulness techniques.…”