Can Physical Therapy Deliver Clinically Meaningful Improvements in Pain and Function Through a Mobile App? An Observational Retrospective Study.

ABSTRACT

Objective: To examine the effect of digital physical therapy (PT) delivered by mobile application (app) on reducing pain and improving function for people with a variety of musculoskeletal conditions. Design: An observational, longitudinal, retrospective study using survey data collected pre- and postdigital PT to estimate multilevel models with random intercepts for patient episodes. Setting: Privately insured employees participating in app-based PT as an employer health care benefit. Participants: The study sample included 814 participants (N=814) 18 years or older who completed their digital PT program with reported final clinical outcomes between February 2019 (program launch) through December 2020. Mean age of the sample at baseline was 40.9±11.89 years, 47.5% were female, 21% sought care for lower back pain, 16% for shoulders, 15% for knees, and 13% for neck. Interventions: Digital PT consisted of a synchronous video evaluation with a physical therapist followed by a course of PT delivered through a mobile app. Main Outcome Measures: Pain was measured by the visual analog scale from 0 "no pain" to 10 "worst pain imaginable" and physical function by the Patient-Specific Functional Scale on a scale from 0 "completely unable to perform" to 10 "able to perform normally." Results: After controlling for significant demographics, comorbid conditions, adverse symptoms, chronicity, and severity, the results from multilevel random intercept models showed decreased pain (-2.69 points; 95% CI, -2.86 to -2.53; P<.001) and increased physical function (+2.67 points; 95% CI, 2.45-2.89; P<.001) after treatment. Conclusions: Digital PT was associated with clinically meaningful improvements in pain and function among a diverse set of participants. These early data are an encouraging indicator of the clinical benefit of digital PT.