mHealth Apps for Low Back Pain Self-management: Scoping Review.

BACKGROUND: The role of self-management in health promotion, as well as prevention and rehabilitation, is increasing through the use of mobile health (mHealth) apps. Such mHealth apps are also increasingly being used for self-management of low back pain (LBP), but their effectiveness has not been sufficiently explored. OBJECTIVE: The aim of this scoping review was to provide an overview of the literature on self-management mHealth apps and their effects on the levels of pain and disability in people with LBP. METHODS: We applied the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology, including a priori research questions. A literature search was conducted in 2 databases (PubMed and PEDro) for studies published between January 1, 2015, and June 17, 2021. Interventional, cohort, or case series studies with an interventional period were included if the mHealth app included built-in self-management content, the app was used for self-management for people with LBP, and the study reported outcomes regarding pain and disability in people with LBP. RESULTS: In total, 7 studies were selected for the review with overall 2307 persons with LBP, of whom 1328 (57.56%) were women. Among the studies (5/7, 71%) that reported the type of pain, 85% (390/459) of the participants were experiencing chronic LBP. A total of 5 different mHealth apps were identified, of which 4 contributed to a statistically significant reduction in LBP and clinically meaningful changes. Of the 7 studies, 4 (57%) used 4 different assessments for disability, of which 3 (75%) showed statistically significant improvements in the level of functional ability of participants in the experimental groups using an mHealth app with built-in self-management content for LBP. CONCLUSIONS: This scoping review supports the conclusion that people with LBP may benefit from mHealth apps that provide self-management content. However, the generalizability of the findings is limited because of heterogeneity in the pain characterization of the included participants and the intervention durations. More high-quality studies with longer follow-up periods to investigate personalized mHealth approaches are recommended for LBP self-management.

The relationship between anthropometric factors and body-balancing movements in postural balance.

OBJECTIVE: To evaluate the relationship between anthropometric characteristics and body-balancing movements when standing on 2 legs with eyes open and eyes closed. DESIGN: Cross-sectional. SETTING: A university physiatry laboratory. PARTICIPANTS: One hundred randomly selected subjects (50 men, 50 women; age range, 31-80y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Anthropomorphic: body height, weight, lower-extremity distances, foot lengths, and widest widths of the forefeet and heels. Body movements: 2-legged stance with eyes open and eyes closed, measured with the MacReflex Motion Capture System and calculated as maximal and total movements in 3 dimensions. The relation between the measured anthropometric characteristics and body-balancing movements was calculated by using regression analysis. RESULTS: In the eyes-open condition, maximal lateral knee movement was related to body height and foot length (R(2)=.065, P<.05). Both anteroposterior (AP) head movement (R(2)=.068, P<.05) and AP navel movement (R(2)=.083, P<.05) were related to heel width. AP knee movement was related to foot length and heel width (R(2)=.089, P<.05). Body mass index was related to AP ankle movement (R(2)=.074, P<.05) and to vertical ankle movement (R(2)=.063, P<.05). In the eyes-closed condition, body mass index was related to the vertical navel movement (R(2)=.059, P<.05) and body height to AP knee movement (R(2)=.041, P<.05). CONCLUSION: The levels of significance are not high but warrant attention. It seems that there was no single anthropometric factor that explained the variations in body-balancing movements during standing.

Motion analysis measurements of body movements during standing: association with age and sex.

The purpose of this study was to evaluate the association between balancing movements and age and sex in standing on two legs with the eyes open and closed using the motion analysis system. The collected data may help in developing balance evaluation and training in rehabilitation. The study sample consisted of 100 healthy, randomly selected people from the City of Oulu (men and women aged 31 to 80 years). The participants were divided into 10 groups by age decade and sex. The body movements in standing on two legs with the eyes open and closed were measured with the Mac Reflex motion analysis system (Qualisys AB, Partille, Sweden) and calculated as maximal anterior-posterior and total movements. The associations between movement values and age and sex were analysed. During standing on two legs with the eyes open, there was a statistically significant difference in the maximal anterior-posterior head movement between the age groups (P < 0.05) but the results did not show any other statistically significant differences between the balancing movements of the separate body parts of the groups or between the balance measurement values of men and women in standing on two legs with the eyes open and closed. In standing on two legs with the eyes closed all the measured body parts moved more than in standing with the eyes open (P < 0.001). It was concluded that healthy men and women seem to control their steady standing position with quite similar ranges of body adjustment. Standing balance control should also possibly be evaluated and trained in more difficult circumstances, because some changes do not necessarily appear in easier balance tasks or performance.

Recovering motor performance of the foot after Achilles rupture repair: a randomized clinical study about early functional treatment vs. early immobilization of Achilles tendon in tension.

The purpose of the study was to examine the recovery of some motor performance aspects of the lower extremity after Achilles tendon (AT) rupture repair by early functional postoperative treatment and early postoperative immobilization of the AT in tension in the early phase of recovery. The measured motor performance aspects were reaction time, speed of movement, foot tapping speed and coordination. The study population comprised 30 patients operated on for an acute, complete, closed AT rupture. The surgical technique was Kessler sutures plus one aponeurosis flap in all cases, and postoperatively the subjects were randomly divided to have immobilization with a plaster cast or an active brace. Measurements were made 12 and 24 weeks after the operation. There were no statistically significant differences in the results between the operated and contralateral nonoperated lower extremities 12 and 24 weeks after the operation in either group. When the results were compared between the plaster cast and active brace groups, no statistically significant differences were seen in reaction times, speed of movement, tapping speed and anterior-posterior coordination on either side, but the lateral coordination value of the operated leg was higher in the plaster cast group than in the active brace group 12 weeks after the operation (p<0.05). By 24 weeks after the operation, this unique difference had disappeared. It seems that the recovery of the above mentioned motor performance functions of the leg does not depend on whether the leg is in a plaster cast with the AT in tension or in an active brace during the early postoperative period after AT rupture repair. These functions of the operated leg had recovered to the level of the contralateral nonoperated leg by 12 weeks after the operation.