Abstract：
BACKGROUND: Telerehabilitation for musculoskeletal (MSK) conditions may produce similar or better outcomes than usual care, but most telerehabilitation studies address only chronic or postsurgical pain.
OBJECTIVE: We aimed to examine pain and function at 3, 6, and 12 weeks for individuals with acute and subacute MSK pain who took part in a digital MSK program versus a nonparticipant comparison group.
METHODS: We conducted an observational, longitudinal study with a nonparticipant comparison group. The intervention group had video visits with physical therapists who recommended exercise therapies and educational articles delivered via an app. Nonparticipants were those who were registered but unable to participate because their benefit coverage had not yet begun. We collected pain and function outcomes through surveys delivered at 3-, 6-, and 12-week follow-ups. We conducted descriptive analyses, unadjusted regression, and mixed effects regression adjusting for baseline characteristics, time as fixed effects, and a time*group interaction term.
RESULTS: The analysis included data from 675 nonparticipants and 262 intervention group participants. Compared to baseline, the intervention group showed significantly more pain improvement at 3, 6, and 12 weeks versus nonparticipants after adjusting for baseline factors. Specifically, the intervention group\'s pain scores decreased by 55.8% at 3 weeks versus baseline, 69.1% at 6 weeks, and 73% at 12 weeks. The intervention group\'s adjusted pain scores decreased from 43.7 (95% CI 41.1-46.2) at baseline to 19.3 (95% CI 16.8-21.8) at 3 weeks to 13.5 (95% CI 10.8-16.2) at 6 weeks to 11.8 (95% CI 9-14.6) at 12 weeks. In contrast, nonparticipants\' pain scores decreased by 30.8% at 3 weeks versus baseline, 45.8% at 6 weeks, and 46.7% at 12 weeks. Nonparticipants\' adjusted pain scores decreased from 43.8 (95% CI 42-45.5) at baseline to 30.3 (95% CI 27.1-33.5) at 3 weeks to 23.7 (95% CI 20-27.5) at 6 weeks to 23.3 (95% CI 19.6-27) at 12 weeks. After adjustments, the percentage of participants reporting that pain was better or much better at follow-up was significantly higher by 40.6% at 3 weeks, 31.4% at 6 weeks, and 31.2% at 12 weeks for intervention group participants versus nonparticipants. After adjustments, the percentage of participants with meaningful functional improvement at follow-up was significantly higher by 15.2% at 3 weeks and 24.6% at 12 weeks for intervention group participants versus nonparticipants.
CONCLUSIONS: A digital MSK program may help to improve pain and function in the short term among those with acute and subacute MSK pain.
OBJECTIVE: We aimed to examine pain and function at 3, 6, and 12 weeks for individuals with acute and subacute MSK pain who took part in a digital MSK program versus a nonparticipant comparison group.
METHODS: We conducted an observational, longitudinal study with a nonparticipant comparison group. The intervention group had video visits with physical therapists who recommended exercise therapies and educational articles delivered via an app. Nonparticipants were those who were registered but unable to participate because their benefit coverage had not yet begun. We collected pain and function outcomes through surveys delivered at 3-, 6-, and 12-week follow-ups. We conducted descriptive analyses, unadjusted regression, and mixed effects regression adjusting for baseline characteristics, time as fixed effects, and a time*group interaction term.
RESULTS: The analysis included data from 675 nonparticipants and 262 intervention group participants. Compared to baseline, the intervention group showed significantly more pain improvement at 3, 6, and 12 weeks versus nonparticipants after adjusting for baseline factors. Specifically, the intervention group\'s pain scores decreased by 55.8% at 3 weeks versus baseline, 69.1% at 6 weeks, and 73% at 12 weeks. The intervention group\'s adjusted pain scores decreased from 43.7 (95% CI 41.1-46.2) at baseline to 19.3 (95% CI 16.8-21.8) at 3 weeks to 13.5 (95% CI 10.8-16.2) at 6 weeks to 11.8 (95% CI 9-14.6) at 12 weeks. In contrast, nonparticipants\' pain scores decreased by 30.8% at 3 weeks versus baseline, 45.8% at 6 weeks, and 46.7% at 12 weeks. Nonparticipants\' adjusted pain scores decreased from 43.8 (95% CI 42-45.5) at baseline to 30.3 (95% CI 27.1-33.5) at 3 weeks to 23.7 (95% CI 20-27.5) at 6 weeks to 23.3 (95% CI 19.6-27) at 12 weeks. After adjustments, the percentage of participants reporting that pain was better or much better at follow-up was significantly higher by 40.6% at 3 weeks, 31.4% at 6 weeks, and 31.2% at 12 weeks for intervention group participants versus nonparticipants. After adjustments, the percentage of participants with meaningful functional improvement at follow-up was significantly higher by 15.2% at 3 weeks and 24.6% at 12 weeks for intervention group participants versus nonparticipants.
CONCLUSIONS: A digital MSK program may help to improve pain and function in the short term among those with acute and subacute MSK pain.
摘要：
背景：针对肌肉骨骼（MSK）疾病的远程康复可能会产生与常规护理相似或更好的结果，但是大多数远程康复研究仅针对慢性或术后疼痛。
目的：我们旨在研究参与数字MSK项目的急性和亚急性MSK疼痛患者在第3、6和12周时的疼痛和功能。
方法：我们进行了一项观察，非参与者比较组的纵向研究。干预组与物理治疗师进行了视频访问，他们建议通过应用程序提供运动疗法和教育文章。非参与者是那些已注册但由于其福利尚未开始而无法参与的人。我们通过在3月3日进行的调查收集疼痛和功能结果，6-，和12周的随访。我们进行了描述性分析，未调整回归，和混合效应回归调整基线特征，时间作为固定的效果，和一个时间*群体互动术语。
结果：分析包括来自675名非参与者和262名干预组参与者的数据。与基线相比，在校正基线因素后,干预组在第3,6和12周时的疼痛改善显著高于非参与者.具体来说,干预组的疼痛评分在3周时比基线下降了55.8%，6周时69.1%，12周时为73%。干预组调整后的疼痛评分从基线时的43.7(95%CI41.1-46.2)降至3周时的19.3(95%CI16.8-21.8)，6周时的13.5(95%CI10.8-16.2)降至12周时的11.8(95%CI9-14.6)。相比之下,与基线相比，非参与者疼痛评分在3周时下降了30.8%，6周时45.8%,12周时为46.7%。非参与者调整后的疼痛评分从基线时的43.8(95%CI42-45.5)降至3周时的30.3(95%CI27.1-33.5)，6周时的23.7(95%CI20-27.5)降至12周时的23.3(95%CI19.6-27)。调整后,随访时报告疼痛好转或好得多的参与者百分比在3周时显著升高40.6%,6周时31.4%，干预组参与者与非参与者在12周时为31.2%。调整后,干预组参与者与非参与者相比,在随访时具有有意义的功能改善的参与者百分比在3周时显著高于15.2%,在12周时显著高于24.6%.
结论：数字MSK程序可能有助于在短期内改善急性和亚急性MSK疼痛患者的疼痛和功能。
目的：我们旨在研究参与数字MSK项目的急性和亚急性MSK疼痛患者在第3、6和12周时的疼痛和功能。
方法：我们进行了一项观察，非参与者比较组的纵向研究。干预组与物理治疗师进行了视频访问，他们建议通过应用程序提供运动疗法和教育文章。非参与者是那些已注册但由于其福利尚未开始而无法参与的人。我们通过在3月3日进行的调查收集疼痛和功能结果，6-，和12周的随访。我们进行了描述性分析，未调整回归，和混合效应回归调整基线特征，时间作为固定的效果，和一个时间*群体互动术语。
结果：分析包括来自675名非参与者和262名干预组参与者的数据。与基线相比，在校正基线因素后,干预组在第3,6和12周时的疼痛改善显著高于非参与者.具体来说,干预组的疼痛评分在3周时比基线下降了55.8%，6周时69.1%，12周时为73%。干预组调整后的疼痛评分从基线时的43.7(95%CI41.1-46.2)降至3周时的19.3(95%CI16.8-21.8)，6周时的13.5(95%CI10.8-16.2)降至12周时的11.8(95%CI9-14.6)。相比之下,与基线相比，非参与者疼痛评分在3周时下降了30.8%，6周时45.8%,12周时为46.7%。非参与者调整后的疼痛评分从基线时的43.8(95%CI42-45.5)降至3周时的30.3(95%CI27.1-33.5)，6周时的23.7(95%CI20-27.5)降至12周时的23.3(95%CI19.6-27)。调整后,随访时报告疼痛好转或好得多的参与者百分比在3周时显著升高40.6%,6周时31.4%，干预组参与者与非参与者在12周时为31.2%。调整后,干预组参与者与非参与者相比,在随访时具有有意义的功能改善的参与者百分比在3周时显著高于15.2%,在12周时显著高于24.6%.
结论：数字MSK程序可能有助于在短期内改善急性和亚急性MSK疼痛患者的疼痛和功能。
