Customizable App Capabilities Did Not Enhance Musculoskeletal Care

New research indicated that treating the musculoskeletal health of patients with neck and low back pain did not benefit significantly from an individually tailored artificial intelligence (AI)-based application.

The World Health Organization (WHO) indicated that in 2020, 619 million people around the world experienced some form of low back pain. WHO also hypothesized that this number will rise to 843 million in 2050.

The process of treating low back and neck pain requires consistent self-management, the study notes. Amid the growing presence of smartphone applications in healthcare, researchers aimed to determine how this type of resource can coexist with musculoskeletal pain treatment. Specifically, researchers compared usual care that included a customized self-management AI-based app to usual care alone or usual care along with web-based self-management tools.

Known as SELFBACK, the AI-based app was designed to provide individually tailored self-management support. Contrarily, the web-based self-management support service, known as e-Help, was not customized to each patient. 

During recruitment, eligibility requirements included being 18 years and older, having neck and low back pain, and being accepted on a specialist care waiting list. After gathering 377 patients for eligibility assessment, researchers included 294 in the study. The reasons for elimination were failure to complete the required questionnaire and lack of eligibility. Among those involved in the study, the mean age was 50.6, and 173 were women.

Following enrollment that took place between July 9, 2020, and April 29, 2021, patients were randomly assigned to three groups: app-based custom self-management support along with usual care (app group), web-based non-custom self-management support along with usual care (e-Help group), and usual care on its own (usual care group). Follow-ups with all three groups took place after six months.

Of the 294 study participants, 99 were in the app group, 98 in the e-Help group, and 97 in the usual care group. The main study outcome was a change in musculoskeletal health, measured at the three-month mark using the Musculoskeletal Health Questionnaire (MSK-HQ). Secondary outcomes included musculoskeletal health measured using the same scale but at the six-week and six-month points. They also made note of pain-related disability, pain intensity, pain-related cognition, and health-related quality of life at the six-week, three-month, and six-month points.

At the three-month point, 82.7 percent of the study population had sufficient data to determine the primary outcome. Researchers found that the adjusted mean difference in MSK-HQ scores between the app and usual care groups and the app and e-Help groups were 0.62 points and 1.08 points, respectively.

Despite this difference, there was insufficient evidence to conclude that the app group experienced more substantial benefits than the other cohorts. The researchers noted that further research is required to gather more evidence surrounding digital self-management resources.

Prior research has also indicated mixed success surrounding smartphone-based interventions.

Research from December 2022 indicated that a smartphone intervention provided inconsistent results in treating bipolar patients.

The study aimed to determine whether this type of self-management tool could improve relapse risk, alter symptom burden, and improve quality of life.

Following a randomized clinical trial, researchers found that this tool decreased depressive symptoms and improved relational quality of life. However, it did not significantly improve the time to relapse, which was the main outcome measure of the study.