e-Exercise Low Back Pain: Stratified blended physiotherapy for patients with nonspecific low back pain

Abstract

Nonspecific low back pain (LBP) is a leading contributor to disability-adjusted life years worldwide, and its socioeconomic burden is enormous. Self-management support tailored to the needs and abilities of individual patients is an important recommendation in clinical guidelines for physiotherapy treatment of patients with LBP and may support cost-effective management of LBP. However, providing adequate individually tailored self-management support is difficult. The integration of online applications in face-to-face care, i.e., blended care, seems to be promising to optimize tailored treatment and enhance patients’ self-management and consequently may reduce LBP-related costs. The general aim of this thesis was to evaluate the results of the use of e-Exercise low back pain, a stratified blended physiotherapy intervention, in daily physiotherapy practice and to describe its effect on clinical and economic outcome measures. The results showed that e-Exercise low back pain was not more effective, nor more cost-effective, compared to face-to-face physiotherapy in patients with nonspecific LBP. The results of our e-Exercise low back pain trial show that integrating an app within face-to-face physiotherapy can help to support patients’ adherence to prescribed management in the home setting where good management of nonspecific LBP is essential. From that perspective, the integration of an app within face-to-face physiotherapy can be useful to reveal patients’ behaviour regarding the management of their nonspecific LBP and can subsequently help a physiotherapist guide further management. However, further refinement is needed before the implementation of e-Exercise low back pain in clinical physiotherapy practice as a complement to face-to-face physiotherapy can be considered.