Artikel
Achieving clinically relevant reductions in pain intensity through a digital home exercise program – insights from a post-marketing response analysis
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Autoren
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Bettina Schmiedchen
- Vivira Health Lab GmbH, Deutschland
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Annette Schmidt
- Vivira Health Lab GmbH, Deutschland
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Leo Benning
- Medical Center – University of Freiburg, University Emergency Center, Freiburg, Deutschland; Vivira Health Lab GmbH, Deutschland; University of Freiburg, Faculty of Medicine, Freiburg, Deutschland
| Veröffentlicht: | 15. September 2022 |
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Gliederung
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Hintergrund: The high prevalence of musculoskeletal disorders and the increased need for care are addressed by digital exercise programs available for prescription as DiGA, following BfArM evaluation. To approximate the effectiveness of a home exercise program from observational data, the characterization of the individual pain reduction is of interest.
Fragestellung: Can the use of a digital home exercise program in a real-world use scenario lead to clinically relevant improvements of musculoskeletal pain?
Methoden: This retrospective observational study is based on complete follow-up-assessments from patients suffering from upper back (n=104), lower back (n=173), knee (n=49) and hip (n=30) pain, with baseline pain scores on a verbal numerical rating scale (VNRS, 0-10) >= 4. A Skillings-Mack test was used to calculate differences between baseline and follow-up pain assessments. To quantify individual levels of pain reductions, response analyses were performed with following thresholds: improvement of >= 1.4 points on VNRS and pain reduction of at least 30%.
Ergebnisse: After the 12-weeks exercise period, a significant pain reduction was achieved for all indication areas (each p<0.001). Response analyses (weeks 0 vs. 12) reveal a clinically relevant reduction in pain intensity in the upper back (68.3–70.2% of patients), lower back (66.5–69.4%), knee (73.5–77.6%) and hip (73.3–76.6%).
Diskussion: The results underline that a digital home exercise program can not only lead to statistically significant, but also to clinically relevant reductions in pain intensity. These reductions are particularly prominent among patients who enter the program with at least moderate pain intensity and those with low attrition. This supports the association between adherence and improved outcomes in the therapy of musculoskeletal conditions. To substantiate this association, studies with confirmatory power are needed.
Take Home Message für die Praxis: The sustained use of a digital home exercise program can lead to statistically significant and clinically relevant improvements of pain intensity in patients with nonspecific and degenerative back, hip and knee pain.
