Mobile App Intervention Increases Adherence to Home Exercise Program After Whiplash Injury-A Randomized Controlled Trial (RCT).

Autor: Barun B; Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia., Divić Z; Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia., Martinović Kaliterna D; University of Split School of Medicine, 21000 Split, Croatia., Poljičanin A; Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia.; Department of Health Studies, University of Split, 21000 Split, Croatia., Benzon B; Departments of Anatomy, Histology and Embryology, School of Medicine, University of Split, 21000 Split, Croatia., Aljinović J; Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia.; University of Split School of Medicine, 21000 Split, Croatia.; Department of Health Studies, University of Split, 21000 Split, Croatia.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2024 Dec 04; Vol. 14 (23). Date of Electronic Publication: 2024 Dec 04.
DOI: 10.3390/diagnostics14232729
Abstrakt: Objective: Can mobile app intervention via push notifications increase adherence to exercise and reduce disability and pain after a whiplash injury?
Methods: A randomized controlled trial was conducted with concealed allocation, blinding of some assessors, and an intention-to-treat analysis. Participants who sustained whiplash injury at most 3 months prior were divided into active and control groups. Both groups completed a two-part physiotherapist-supervised physical therapy program (3-week break in between, ten sessions each, 5x/week). The program included TENS, therapeutic ultrasound, and exercises (breathing, ROM, deep neck flexor activation, and stretching). Both groups were encouraged to exercise at home. The active group additionally received push notifications through the mobile app once a day as a reminder to exercise. Outcomes were adherence to exercise (four-point Likert scale), physical functioning (NDI), pain intensity (VAS), perceived recovery (three-point Likert scale), work information, psychological functioning (PCS), and HRQoL (SF-12) at baseline and 6-month follow-up.
Results: At month 6, when comparing the groups, the intervention group showed higher adherence to home exercise (3 [2-4] vs. 2 [2-4]; p = 0.005, median [IQR]) and improved HRQoL (∆SF-12) (20 [6-36] vs. 15 [9-23]; p = 0.038). Unlike the control group, the intervention group showed a significant decrease in pain catastrophizing (31%; p = 0.01). A multivariant analysis showed that mobile app intervention influenced adherence most (≈1 Likert point). The groups did not differ in NDI, pain VAS, perceived recovery, or work limitation.
Conclusions: Mobile app intervention increased adherence to home exercise, reduced pain catastrophizing, and increased HRQoL six months after a whiplash injury.
Trial Registration: ClinicalTrials.gov NCT05704023.
Databáze: MEDLINE
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