A promising eHealth tool to manage musculoskeletal pain in rural areas

19/06/2024

Low back pain and osteoarthritis (OA), both classified as musculoskeletal pains, are known to hamper people’s day-to-day activities and prevent them from fully participating in most aspects of everyday life. Non-metropolitan communities’ residents are more exposed to suffering from these types of musculoskeletal pains, with the additional disadvantage of longer travel distances for access to medical care and lower healthcare professionals’ ratios. Emergent digital approaches to manage pain and deliver exercise programs are being proposed, but there is a lack of scientific evidence supporting their use. In a recently published study, a comparison of the effectiveness of digital and standard-care physical activity programs for the management of low back and knee OA pain in remote areas of Australia was assessed.

Key messages

Digital health exercise and training programs can provide sustained clinical improvements in physical function compared with standard care.
Online healthcare platforms can act as allies to standard care services for patients with musculoskeletal pain in rural communities.

Study information

Details of the study

“Effectiveness of an eHealth-delivered program to empower people with musculoskeletal pain in rural Australia: a randomized controlled trial”(1)

Methods

A parallel, two-groups, randomized controlled study which enrolled a total of 156 subjects with low back pain (62%) or knee OA (38%) is described. Patients were randomized to:

a physiotherapist-delivered eHealth group, digitally receiving a physical activity plan, teleconsultations and an exercise program adjusted to each participant’s needs; or
a standard care group, which included primary care professionals’ visits, pain treatment prescriptions, health education or home-based exercises.

Patients were followed-up three and six-months after treatment.

Patient-Specific Functional Scale (PSFS) was the primary endpoint, with a minimum three-point gap between groups established as a clinically relevant difference. Secondary endpoints included different outcomes of pain, function and quality of life.

Main results

Patients in the eHealth group had significant and clinically meaningful improvements in physical function at three and six months, compared to the standard care group. The eHealth group also reported decreased disability and an improved physical component of quality of life at three and six months, which were both statistically significant. Although improvements were reported in all other secondary outcomes in the eHealth group, these differences were not statistically significant against the standard care group.

Conclusion

Physical interventions delivered via digital platforms had positive results and led to clinically worthwhile improvements in physical function in patients with low back pain or knee OA in remote areas of Australia. These findings emphasize how novel teleconsultation techniques may improve accessibility to healthcare services for patients with musculoskeletal pain in non-metropolitan or remote communities while providing clinical benefits.

Bibliography

1. Mesa-Castrillon CI, Simic M, Ferreira ML, Bennell KL, Luscombe GM, Gater K, Beckenkamp PR, Michell A, Bauman A, de Luca K, Bunker S, Clavisi O, Ferreira PH. Effectiveness of an eHealth-Delivered Program to Empower People With Musculoskeletal Pain in Rural Australia: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2024 Apr;76(4):570-581. doi: 10.1002/acr.25272. Epub 2024 Jan 29. PMID: 37984995.

Link to the full study

This article is a summary based on the following study. For further information and details, please consult the full study. Please do not hesitate to contact us if you have any comments. https://pubmed.ncbi.nlm.nih.gov/37984995