Almhdawi KA, Obeidat DS, Kanaan SF, et al. Efficacy of an innovative smartphone application for office workers with chronic non-specific low back pain: a pilot randomized controlled trial. Clin Rehabil. 2020 Jun 30:269215520937757. doi: 10.1177/0269215520937757. (Original study)

OBJECTIVE: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application.

DESIGN: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG).

SETTING: Governmental and private institutions.

PARTICIPANTS: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months.

INTERVENTIONS: The EG received full version of the application 'Relieve my back' included evidence-based instructions and therapeutic exercises for LBP management, whereas the CG received placebo version included instructions about nutrition.

MAIN MEASURES: Primary outcome measures included pain measured by Visual Analogue Scale (VAS), disability measured by Oswestry Disability Index (ODI), and quality of life measured by Short-Form Health Survey (SF-12).

RESULTS: Following six weeks of using the application, compared to CG, the EG group demonstrated significant decrease in pain intensity (-3.45 (2.21) vs -0.11 (1.66), P < 0.001), in ODI score (-11.05 (10.40) vs -0.58 (9.0), P = 0.002), and significant increase in physical component of SF-12 (12.85 (17.20) vs -4.63 (12.04), P = 0.001).

CONCLUSION: 'Relieve my back' application might be efficacious in reducing pain and disability and improving the quality of life of office workers with non-specific LBP.

Discipline Area Score
Rehab Clinician (OT/PT) 5 / 7
Physician 5 / 7
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Comments from MORE raters

Physician rater

This is a very small study with approximately 20 in each group. The placebo group was not even given home exercise instructions. The app may be better than nothing but no therapy group would offer nothing for patients seeking help. The placebo group should have at least been given a text message to get up and stretch.

Rehab Clinician (OT/PT) rater

An innovative use for a smartphone app. Small numbers in the study, but it was only a pilot study. A short duration of follow-up, but the authors noted this as a limitation. It is an exciting new application of technology that has the potential to have far-reaching effects.

Rehab Clinician (OT/PT) rater

As a kinesiologist, I find this is promising to incorporate into treatment plan for patients. After an evaluation and identifying client needs, it may be useful to direct them to this app if it fits with their health and injury profile. It may be useful to help walk the client through the apps features and what they should expect from it.

Rehab Clinician (OT/PT) rater

Aspects of the methodology (e.g. small sample size, BMI variability between groups) suggest limitations in the research findings.

Rehab Clinician (OT/PT) rater

Considering the current pandemic related challenges, it is good to see that self management options for patients can benefit and possibly support care. This is an article that support self care with the right instruction can be beneficial. Interesting read.

Rehab Clinician (OT/PT) rater

In spite of the limitations identified in the article, the key clinical message is relevant and newsworthy. Providing office workers with non-specific chronic low back pain with a mobile application containing evidence-based exercises and proper body mechanics education for six weeks appeared beneficial in reducing their pain, disability and improving their quality of life.
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