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Mobile Health (mHealth) for Chronic Low Back Pain Assessment: Design, Development, and Usability Evaluation.

Zakiy F Alfikri1, Marit E Johnson2, Brad E Dicianno1,3,4

  • 1Department of Bioengineering University of Pittsburgh Swanson School of Engineering Pittsburgh Pennsylvania USA.

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Summary

A new mobile health system aids chronic low back pain (cLBP) assessment by collecting biomechanical and behavioral data. This user-friendly system improved patient compliance and therapist efficiency for better cLBP phenotyping.

Keywords:
ecological momentary assessmentlow back painmobile applicationsphysical therapyrehabilitationtelemedicineuser‐centered design

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Area of Science:

  • Digital Health
  • Biomedical Engineering
  • Rehabilitation Medicine

Background:

  • Chronic low back pain (cLBP) necessitates precise phenotyping for effective treatment strategies.
  • Current assessment methods may not capture the full spectrum of biomechanical and behavioral data crucial for understanding cLBP.
  • Mobile health (mHealth) offers a promising avenue for comprehensive and continuous patient data collection.

Purpose of the Study:

  • To introduce and evaluate an integrated mHealth system designed for detailed phenotyping of individuals with cLBP.
  • To assess the usability and effectiveness of the mHealth system in both clinical and at-home settings.
  • To facilitate the collection of extensive biomechanical and behavioral data from a large cohort of cLBP patients.

Main Methods:

  • A user-centered design approach was employed to develop two mobile applications: one for clinicians and one for patients.
  • The system integrated in-clinic assessments with seven-day at-home ecological momentary assessments (EMA).
  • Usability was evaluated using the mHealth App Usability Questionnaire (MAUQ) and qualitative feedback, with iterative design refinements based on results.

Main Results:

  • Both the clinician-facing and patient-facing applications demonstrated good usability, with high median MAUQ scores.
  • Iterative design modifications successfully enhanced navigation, responsiveness, and user interface, leading to improved overall usability.
  • Physical therapists utilized the in-clinic app for 1000 cLBP patients, and 989 patients used the at-home app for EMA completion.

Conclusions:

  • The developed mHealth system is a viable tool for comprehensive cLBP assessment and phenotyping.
  • The system's user-friendly design facilitated high patient compliance with at-home assessments.
  • The successful implementation supports the use of mHealth technology for improving chronic pain management and research.