TY - JOUR
T1 - Asynchronous and Tailored Digital Rehabilitation of Chronic Shoulder Pain
T2 - A Prospective Longitudinal Cohort Study
AU - Janela, Dora
AU - Costa, Fabíola
AU - Molinos, Maria
AU - Moulder, Robert G.
AU - Lains, Jorge
AU - Francisco, Gerard E.
AU - Bento, Virgílio
AU - Cohen, Steven P.
AU - Correia, Fernando Dias
N1 - Funding Information:
The authors acknowledge the team of physical therapists responsible for the management of participants. The authors also acknowledge the contributions of João Tiago Silva and Quemuel Araújo in data validation (both employed at SWORD Health).
Publisher Copyright:
© 2022 Janela et al. This work is published and licensed by Dove Medical Press Limited.
PY - 2022
Y1 - 2022
N2 - Background: Chronic shoulder pain (SP) is responsible for significant morbidity, decreased quality of life and impaired work ability, resulting in high socioeconomic burden. Successful SP management is dependent on adherence and compliance with effective evidence-based interventions. Digital solutions may improve accessibility to such treatments, increasing convenience, while reducing healthcare-related costs. Purpose: Present the results of a fully remote digital care program (DCP) for chronic SP. Patients and Methods: Interventional, single-arm, cohort study of individuals with chronic SP applying for a digital care program. Primary outcome was the mean change between baseline and 12 weeks on the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Secondary outcomes were change in pain (NPRS), analgesic consumption, intention to undergo surgery, anxiety (GAD-7), depression (PHQ-9), fearavoidance beliefs (FABQ-PA), work productivity (WPAI) and engagement. Results: From 296 patients at program start, 234 (79.1%) completed the intervention. Changes in QuickDASH between baseline and end-of-program were both statistically (p < 0.001) and clinically significant, with a mean reduction of 51.6% (mean −13.45 points, 95% CI: 11.99; 14.92). Marked reductions were also observed in all secondary outcomes: 54.8% in NPRS, 44.1% ceased analgesics consumption, 55.5% in surgery intent, 37.7% in FABQ-PA, 50.3% in anxiety, 63.6% in depression and 66.5% in WPAI overall. Higher engagement was associated with higher improvements in disability. Mean patient satisfaction score was 8.7/10.0 (SD 1.6). Conclusion: This is the first real-world cohort study reporting the results of a multimodal remote digital approach for chronic SP rehabilitation. High completion and engagement rates were observed, which were associated with clinically significant improvement in all healthrelated outcomes, as well as marked productivity recovery. These promising results support the potential of digital modalities to address the global burden of chronic musculoskeletal pain.
AB - Background: Chronic shoulder pain (SP) is responsible for significant morbidity, decreased quality of life and impaired work ability, resulting in high socioeconomic burden. Successful SP management is dependent on adherence and compliance with effective evidence-based interventions. Digital solutions may improve accessibility to such treatments, increasing convenience, while reducing healthcare-related costs. Purpose: Present the results of a fully remote digital care program (DCP) for chronic SP. Patients and Methods: Interventional, single-arm, cohort study of individuals with chronic SP applying for a digital care program. Primary outcome was the mean change between baseline and 12 weeks on the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Secondary outcomes were change in pain (NPRS), analgesic consumption, intention to undergo surgery, anxiety (GAD-7), depression (PHQ-9), fearavoidance beliefs (FABQ-PA), work productivity (WPAI) and engagement. Results: From 296 patients at program start, 234 (79.1%) completed the intervention. Changes in QuickDASH between baseline and end-of-program were both statistically (p < 0.001) and clinically significant, with a mean reduction of 51.6% (mean −13.45 points, 95% CI: 11.99; 14.92). Marked reductions were also observed in all secondary outcomes: 54.8% in NPRS, 44.1% ceased analgesics consumption, 55.5% in surgery intent, 37.7% in FABQ-PA, 50.3% in anxiety, 63.6% in depression and 66.5% in WPAI overall. Higher engagement was associated with higher improvements in disability. Mean patient satisfaction score was 8.7/10.0 (SD 1.6). Conclusion: This is the first real-world cohort study reporting the results of a multimodal remote digital approach for chronic SP rehabilitation. High completion and engagement rates were observed, which were associated with clinically significant improvement in all healthrelated outcomes, as well as marked productivity recovery. These promising results support the potential of digital modalities to address the global burden of chronic musculoskeletal pain.
KW - Chronic pain
KW - Digital therapeutic
KW - EHealth
KW - Physical therapy
KW - Telerehabilitation
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U2 - 10.2147/JPR.S343308
DO - 10.2147/JPR.S343308
M3 - Article
C2 - 35035234
AN - SCOPUS:85123944453
SN - 1178-7090
VL - 15
SP - 53
EP - 66
JO - Journal of Pain Research
JF - Journal of Pain Research
ER -