Evaluation and Cost-Consequence Analysis of a Community-Based Digital Exercise Intervention for People With...

The objectives of this study are to evaluate the impact and cost-consequence analysis of a new digital intervention providing water- and land-based exercises for people with musculoskeletal (MSK) conditions.

Data were collected from May 2021 to December 2023, during which the number of sites providing the intervention increased from 20 to 136. Participant recruitment and characteristics, pain intensity (0-100), physical function (Patient Specific Complaint, 0-100), and health and wellbeing (Office for National Statistics 4, ONS4) were measured. A minimal clinically important detectable (MCID) change of 15% was used. Symptoms, function and wellbeing were measured at 6, 12 and 26 weeks. A cost-consequence analysis was conducted comparing 12 digital exercise sessions to 6 face-to-face (F2F) physiotherapy sessions.

In total, 4429 participants with MSK conditions, who completed at least 1 exercise session, were included in this study. 3515 (79.4%) were female, average age 58.7 ± 15.3 years old, 13% registered as ethnicity other than white, 33.5% were in the third quartile for high deprivation and 44.2% were sedentary. The knee (33.3%) was the most affected body region. In total, 40,995 exercise sessions were completed (91.6% water-based), and the average sessions per user were 9.3. Small significant (p < 0.05) improvements in function, happiness, and anxiety were seen at 6 weeks, with improvement in function and anxiety maintained at 12- and 26-week follow-ups. At 6 and 12 weeks, 33.8% and 38.6% reached MCID in pain intensity and 40% and 45% in physical function, improvements which are similar when compared to expected outcome of face-to-face physiotherapy. Cost-consequence analysis indicated an estimated saving of £168.72 per participant compared to F2F physiotherapy.

This digital MSK exercise solution delivered to people with MSK conditions had a positive effect on pain intensity and physical function with considerable potential cost savings.