The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial
Abstract BackgroundClinical guidelines for nonspecific low back pain (LBP) recommend self-management tailored to individual needs and capabilities as a first-line treatment. Mobile health solutions are a promising method for delivering tailored self-management interventions to patients with nonspec...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-08-01
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| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2023/1/e40422 |
| _version_ | 1797690771096207360 |
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| author | Anne Lovise Nordstoga Lene Aasdahl Louise Fleng Sandal Tina Dalager Atle Kongsvold Paul Jarle Mork Tom Ivar Lund Nilsen |
| author_facet | Anne Lovise Nordstoga Lene Aasdahl Louise Fleng Sandal Tina Dalager Atle Kongsvold Paul Jarle Mork Tom Ivar Lund Nilsen |
| author_sort | Anne Lovise Nordstoga |
| collection | DOAJ |
| description |
Abstract
BackgroundClinical guidelines for nonspecific low back pain (LBP) recommend self-management tailored to individual needs and capabilities as a first-line treatment. Mobile health solutions are a promising method for delivering tailored self-management interventions to patients with nonspecific LBP. However, it is not clear if the effectiveness of such self-management interventions depends on patients’ initial pain characteristics. High pain intensity and long-term symptoms of LBP have been associated with an unfavorable prognosis, and current best evidence indicates that long-term LBP (lasting more than 3 months) requires a more extensive treatment approach compared to more acute LBP. The artificial intelligence–based selfBACK
ObjectiveThis study aims to explore if the baseline duration and intensity of LBP influence the effectiveness of the selfBACK intervention in a secondary analysis of the selfBACK randomized controlled trial.
MethodsIn the selfBACK trial, 461 adults (18 years or older) who sought care for nonspecific LBP in primary care or at an outpatient spine clinic were randomized to receive the selfBACK intervention adjunct to usual care (n=232) or usual care alone (n=229). In this secondary analysis, the participants were stratified according to the duration of the current LBP episode at baseline (≤12 weeks vs >12 weeks) or baseline LBP intensity (≤5 points vs >5 points) measured by a 0-10 numeric rating scale. The outcomes were LBP-related disability measured by the Roland-Morris Disability Questionnaire (0- to 24-point scale), average LBP intensity, pain self-efficacy, and global perceived effect. To assess whether the duration and intensity of LBP influenced the effect of selfBACK,
ResultsOverall, there was no difference in effect for patients with different durations or intensities of LBP at either the 3- or 9-month follow-ups. However, there was suggestive evidence that the effect of the selfBACK intervention on LBP-related disability at the 3-month follow-up was largely confined to people with the highest versus the lowest LBP intensity (mean difference between the intervention and control group −1.8, 95% CI −3.0 to −0.7 vs 0.2, 95% CI −1.1 to 0.7), but this was not sustained at the 9-month follow-up.
ConclusionsThe results suggest that the intensity and duration of LBP have negligible influence on the effectiveness of the selfBACK intervention on LBP-related disability, average LBP intensity, pain self-efficacy, and global perceived effect. |
| first_indexed | 2024-03-12T02:03:58Z |
| format | Article |
| id | doaj.art-1ea54b1c772a4ab0b5aca330f8744a01 |
| institution | Directory Open Access Journal |
| issn | 2291-5222 |
| language | English |
| last_indexed | 2024-03-12T02:03:58Z |
| publishDate | 2023-08-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR mHealth and uHealth |
| spelling | doaj.art-1ea54b1c772a4ab0b5aca330f8744a012023-09-07T05:45:25ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222023-08-0111e40422e4042210.2196/40422The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled TrialAnne Lovise Nordstoga0http://orcid.org/0000-0001-6675-169XLene Aasdahl1http://orcid.org/0000-0003-4276-1345Louise Fleng Sandal2http://orcid.org/0000-0001-8436-1046Tina Dalager3http://orcid.org/0000-0002-6632-7001Atle Kongsvold4http://orcid.org/0000-0003-4887-8288Paul Jarle Mork5http://orcid.org/0000-0003-3355-2680Tom Ivar Lund Nilsen6http://orcid.org/0000-0001-8251-3544Norwegian University of Science and TechnologyUnicare Helsefort Rehabilitation CenterUniversity of Southern DenmarkUniversity of Southern DenmarkNorwegian University of Science and TechnologyNorwegian University of Science and TechnologyNorwegian University of Science and Technology Abstract BackgroundClinical guidelines for nonspecific low back pain (LBP) recommend self-management tailored to individual needs and capabilities as a first-line treatment. Mobile health solutions are a promising method for delivering tailored self-management interventions to patients with nonspecific LBP. However, it is not clear if the effectiveness of such self-management interventions depends on patients’ initial pain characteristics. High pain intensity and long-term symptoms of LBP have been associated with an unfavorable prognosis, and current best evidence indicates that long-term LBP (lasting more than 3 months) requires a more extensive treatment approach compared to more acute LBP. The artificial intelligence–based selfBACK ObjectiveThis study aims to explore if the baseline duration and intensity of LBP influence the effectiveness of the selfBACK intervention in a secondary analysis of the selfBACK randomized controlled trial. MethodsIn the selfBACK trial, 461 adults (18 years or older) who sought care for nonspecific LBP in primary care or at an outpatient spine clinic were randomized to receive the selfBACK intervention adjunct to usual care (n=232) or usual care alone (n=229). In this secondary analysis, the participants were stratified according to the duration of the current LBP episode at baseline (≤12 weeks vs >12 weeks) or baseline LBP intensity (≤5 points vs >5 points) measured by a 0-10 numeric rating scale. The outcomes were LBP-related disability measured by the Roland-Morris Disability Questionnaire (0- to 24-point scale), average LBP intensity, pain self-efficacy, and global perceived effect. To assess whether the duration and intensity of LBP influenced the effect of selfBACK, ResultsOverall, there was no difference in effect for patients with different durations or intensities of LBP at either the 3- or 9-month follow-ups. However, there was suggestive evidence that the effect of the selfBACK intervention on LBP-related disability at the 3-month follow-up was largely confined to people with the highest versus the lowest LBP intensity (mean difference between the intervention and control group −1.8, 95% CI −3.0 to −0.7 vs 0.2, 95% CI −1.1 to 0.7), but this was not sustained at the 9-month follow-up. ConclusionsThe results suggest that the intensity and duration of LBP have negligible influence on the effectiveness of the selfBACK intervention on LBP-related disability, average LBP intensity, pain self-efficacy, and global perceived effect.https://mhealth.jmir.org/2023/1/e40422 |
| spellingShingle | Anne Lovise Nordstoga Lene Aasdahl Louise Fleng Sandal Tina Dalager Atle Kongsvold Paul Jarle Mork Tom Ivar Lund Nilsen The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial JMIR mHealth and uHealth |
| title | The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial |
| title_full | The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial |
| title_fullStr | The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial |
| title_full_unstemmed | The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial |
| title_short | The Role of Pain Duration and Pain Intensity on the Effectiveness of App-Delivered Self-Management for Low Back Pain (selfBACK): Secondary Analysis of a Randomized Controlled Trial |
| title_sort | role of pain duration and pain intensity on the effectiveness of app delivered self management for low back pain selfback secondary analysis of a randomized controlled trial |
| url | https://mhealth.jmir.org/2023/1/e40422 |
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