Randomized-controlled trial assessing a digital care program versus conventional physiotherapy for chronic low back pain
Open accessAbstract
Low back pain (LBP) is the world’s leading cause of years lived with disability. Digital exercise-based interventions have shown great potential in the management of musculoskeletal conditions, promoting access and easing the economic burden. However, evidence of their effectiveness for chronic LBP (CLBP) management compared to in-person physiotherapy has yet to be unequivocally established. This randomized controlled trial (RCT) aims to compare the clinical outcomes of patients with CLBP following a digital intervention versus evidence-based in-person physiotherapy. Our results demonstrate that patient satisfaction and adherence were high and similar between groups, although a significantly lower dropout rate is observed in the digital group (11/70, 15.7% versus 24/70, 34.3% in the conventional group; P = 0.019). Both groups experience significant improvements in disability (primary outcome), with no differences between groups in change from baseline (median difference: −0.55, 95% CI: −2.42 to 5.81, P = 0.412) or program-end scores (−1.05, 95% CI: −4.14 to 6.37; P = 0.671). Likewise, no significant differences between groups are found for secondary outcomes (namely pain, anxiety, depression, and overall productivity impairment). This RCT demonstrates that a remote digital intervention for CLBP can promote the same levels of recovery as evidence-based in-person physiotherapy, being a potential avenue to ease the burden of CLBP.
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Digital rehabilitation is effective among several musculoskeletal conditions regardless of race/ethnicity and socioeconomic backgrounds.
“Previous research supports its effectiveness among several musculoskeletal (MSK) conditions [16-18] regardless of race/ethnicity [19] and socioeconomic backgrounds [20].”
From Exploring the Importance of Race and Gender Concordance Between Patients and Physical Therapists in Digital Rehabilitation for Musculoskeletal Conditions: Observational, Longitudinal Study (2024) · cites this paper as [16]
The Discussion reports that the digital program produced improvements comparable to in-person physiotherapy for chronic low back pain. It does not establish effectiveness across several musculoskeletal conditions. The race/ethnicity and socioeconomic clauses have separate citations in the citing sentence and are not attributed to this paper. (LLM, conf=0.86)
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References 67 · Cited by 60
Research works printed but not linked: 1
- [10]National Guideline Centre (UK). Low back pain and sciatica in over 16s: assessment and management. London: National Institute for Health and Care Excellence UK (NICE). https://www.nice.org.uk/guidance/ng59/resources/low-back-pain-and-sciatica-in-over-16s-assessment-and-management-pdf-1837521693637 (2016). 27929617
- Authors
- Cui, D., Janela, D., Costa, F., Molinos, M., Areias, A. C., Moulder, R. G., Scheer, J. K., Bento, V., Cohen, S. P., Yanamadala, V., & Correia, F. D.
- Affiliations
- Emory University (US)
- University of California, San Francisco (US)
- Johns Hopkins University (US)
- Quinnipiac University (US)
- Corresponding author
- Correia, Fernando Dias
- ORCID
- Venue
- npj Digital Medicine
- Published
- 2023-07-07
- Volume
- 6
- Issue
- 1
- Pages
- 121-121
- ISSN
- 2398-6352 (ISSN-L)
- PMC
- PMC10329005
- OpenAlex
- W4383500249
- Cited by
- 60
- References
- 67
- Citations by year
- 2026: 20 · 2025: 24 · 2024: 14 · 2023: 2
- FWCI
- 9.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Digital Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CU Scholar (University of Colorado Boulder) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- chronic low back pain, remote physiotherapy, disability, patient satisfaction, medication adherence, dropout, anxiety, depression
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