App to Self-Manage Low Back Pain

Principal Investigator: Blair Irvine, ORCAS (the company that sells the app)
Mobile-Web App to Self-Manage Low Back Pain: Randomized Controlled Trial

A Blair Irvine, et al.
J Med Internet Res 2015 (Jan 02); 17(1):e1

Background: Nonspecific low back pain (NLBP) is the diagnosis for individuals with back pain that has no underlying medical cause (eg, tumor, infection, fracture, herniated disc, spinal stenosis).
The American College of Physicians (ACP) and American Pain Society (APS) recommend multidisciplinary treatments for NLBP that lasts more than 4 weeks.
This approach, however, is impractical for many physicians to implement, and relatively few providers offer NLBP treatment that meets the joint ACP-APS guidelines.

Objective: This study evaluated the efficacy of a mobile-Web intervention called “FitBack” to help users implement self-tailored strategies to manage and prevent NLBP occurrences

Methods: A total of 597 adults were recruited, screened, consented, and assessed online at baseline, at 2 months (T2), and at 4 months (T3). After baseline assessments, participants were randomized into three groups: FitBack intervention, alternative care group that received 8 emails urging participants to link to six Internet resources for NLBP, and control group. The FitBack group also received weekly email reminder prompts for 8 weeks plus emails to do assessments. The control group was only contacted to do assessments.
Results: Users of the FitBack program showed greater improvement compared to the control group in every comparison of the critical physical, behavioral, and worksite outcome measures at 4-month follow-up. In addition, users of the FitBack program performed better than the alternative care group on
current back pain, behavioral, and worksite outcomes at 4-month follow-up.
For example, subjects in the control group were 1.7 times more likely to
report current back pain than subjects in the FitBack group; subjects in the
alternative care group were 1.6 times more likely to report current back
pain at 4-month follow-up. Further, the users of the FitBack program showed
greater improvement compared to both the control and alternative care groups
at 4-month follow-up on patient activation, constructs of the Theory of
Planned Behavior, and attitudes toward pain. Conclusions: This research
demonstrated that a theoretically based stand-alone mobile-Web intervention
that tailors content to users’ preferences and interests can be an
effective tool in self-management of low back pain. When viewed from the
RE-AIM perspective (ie, reach, efficacy/effectiveness, adoption,
implementation fidelity, and maintenance), this study supports the notion
that there is considerable value in this type of intervention as a
potentially cost-effective tool that can reach large numbers of people. The
results are promising considering that the FitBack intervention was neither
supported by professional caregivers nor integrated within a health
promotion campaign, which might have provided additional support for
participants. Still, more research is needed on how self-guided mobile-Web
interventions will be used over time and to understand factors associated
with continuing user engagement. Clinical Trial: