An Educational and Exercise Mobile Phone-Based Intervention to Elicit Electrophysiological Changes and to Improve Psychological Functioning in Adults With Nonspecific Chronic Low Back Pain (BackFit App): Nonrandomized Clinical Trial

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dc.contributor.author Sitges, Carolina
dc.contributor.author Terrasa, Juan L.
dc.contributor.author García-Dopico, Nuria
dc.contributor.author Segur-Ferrer, Joan
dc.contributor.author Velasco-Roldán, Olga
dc.contributor.author Crespí-Palmer, Jaume
dc.contributor.author González-Roldán, Ana María
dc.contributor.author Montoya, Pedro
dc.date.accessioned 2022-07-20T06:17:19Z
dc.date.available 2022-07-20T06:17:19Z
dc.identifier.uri http://hdl.handle.net/11201/159458
dc.description.abstract [eng] Background: Concomitant psychological and cognitive impairments modulate nociceptive processing and contribute to chronic low back pain (CLBP) maintenance, poorly correlated with radiological findings. Clinical practice guidelines recommend self-management and multidisciplinary educational and exercise-based interventions. However, these recommendations are based on self-reported measurements, which lack evidence of related electrophysiological changes. Furthermore, current mobile health (mHealth) tools for self-management are of low quality and scarce evidence. Thus, it is necessary to increase knowledge on mHealth and electrophysiological changes elicited by current evidence-based interventions. Objective: The aim of this study is to investigate changes elicited by a self-managed educational and exercise-based 4-week mHealth intervention (BackFit app) in electroencephalographic and electrocardiographic activity, pressure pain thresholds (PPTs), pain, disability, and psychological and cognitive functioning in CLBP versus the same intervention in a face-to-face modality. Methods: A 2-arm parallel nonrandomized clinical trial was conducted at the University of the Balearic Islands (Palma, Spain). A total of 50 patients with nonspecific CLBP were assigned to a self-managed group (23/50, 46%; mean age 45.00, SD 9.13 years; 10/23, 43% men) or a face-to-face group (27/50, 54%; mean age 48.63, SD 7.54 years; 7/27, 26% men). The primary outcomes were electroencephalographic activity (at rest and during a modified version of the Eriksen flanker task) and heart rate variability (at rest), PPTs, and pressure pain intensity ratings. The secondary outcomes were pain, disability, psychological functioning (mood, anxiety, kinesiophobia, pain catastrophizing, and fear-avoidance beliefs), and cognitive performance (percentage of hits and reaction times). Results: After the intervention, frequency analysis of electroencephalographic resting-state data showed increased beta-2 (16-23 Hz; 0.0020 vs 0.0024; P=.02) and beta-3 (23-30 Hz; 0.0013 vs 0.0018; P=.03) activity. In addition, source analyses revealed higher power density of beta (16-30 Hz) at the anterior cingulate cortex and alpha (8-12 Hz) at the postcentral gyrus and lower power density of delta (2-4 Hz) at the cuneus and precuneus. Both groups also improved depression (7.74 vs 5.15; P=.01), kinesiophobia (22.91 vs 20.87; P=.002), activity avoidance (14.49 vs 12.86; P<.001), helplessness (6.38 vs 4.74; P=.02).
dc.format application/pdf
dc.relation.isformatof https://doi.org/10.2196/29171
dc.relation.ispartof Journal Of Medical Internet Research, 2022, vol. 10, num. 3, p. e29171
dc.rights , 2022
dc.subject.classification 159.9 - Psicologia
dc.subject.classification 614 - Higiene i salut pública. Contaminació. Prevenció d'accidents. Infermeria
dc.subject.other 159.9 - Psychology
dc.subject.other 614 - Public health and hygiene. Accident prevention
dc.title An Educational and Exercise Mobile Phone-Based Intervention to Elicit Electrophysiological Changes and to Improve Psychological Functioning in Adults With Nonspecific Chronic Low Back Pain (BackFit App): Nonrandomized Clinical Trial
dc.type info:eu-repo/semantics/article
dc.date.updated 2022-07-20T06:17:19Z
dc.subject.keywords chronic low back pain
dc.subject.keywords chronic pain
dc.subject.keywords mobile apps
dc.subject.keywords education
dc.subject.keywords exercise
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.identifier.doi https://doi.org/10.2196/29171


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