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Managing Musculoskeletal Pain in Older Adults Through a Digital Care Solution: Secondary Analysis of a Prospective Clinical Study

2023-08Journal article Open access
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dc.contributor.authorAreias, Anabela C
dc.contributor.authorJanela, Dora
dc.contributor.authorMolinos, Maria
dc.contributor.authorMoulder, Robert G
dc.contributor.authorBento, Virgílio
dc.contributor.authorYanamadala, Vijay
dc.contributor.authorCohen, Steven P
dc.contributor.authorDias Correia, Fernando
dc.contributor.authorCosta, Fabíola
dc.date.accessioned2024-07-18T15:27:23Z
dc.date.available2024-07-18T15:27:23Z
dc.date.issued2023-08
dc.description.abstractBackground: Aging is closely associated with an increased prevalence of musculoskeletal conditions. Digital musculoskeletal care interventions emerged to deliver timely and proper rehabilitation; however, older adults frequently face specific barriers and concerns with digital care programs (DCPs). Objective: This study aims to investigate whether known barriers and concerns of older adults impacted their participation in or engagement with a DCP or the observed clinical outcomes in comparison with younger individuals. Methods: We conducted a secondary analysis of a single-arm investigation assessing the recovery of patients with musculoskeletal conditions following a DCP for up to 12 weeks. Patients were categorized according to age: ≤44 years old (young adults), 45-64 years old (middle-aged adults), and ≥65 years old (older adults). DCP access and engagement were evaluated by assessing starting proportions, completion rates, ability to perform exercises autonomously, assistance requests, communication with their physical therapist, and program satisfaction. Clinical outcomes included change between baseline and program end for pain (including response rate to a minimal clinically important difference of 30%), analgesic usage, mental health, work productivity, and non-work-related activity impairment. Results: Of 16,229 patients, 12,082 started the program: 38.3% (n=4629) were young adults, 55.7% (n=6726) were middle-aged adults, and 6% (n=727) were older adults. Older patients were more likely to start the intervention and to complete the program compared to young adults (odds ratio [OR] 1.72, 95% CI 1.45-2.06; P<.001 and OR 2.40, 95% CI 1.97-2.92; P<.001, respectively) and middle-aged adults (OR 1.22, 95% CI 1.03-1.45; P=.03 and OR 1.38, 95% CI 1.14-1.68; P=.001, respectively). Whereas older patients requested more technical assistance and exhibited a slower learning curve in exercise performance, their engagement was higher, as reflected by higher adherence to both exercise and education pieces. Older patients interacted more with the physical therapist (mean 12.6, SD 18.4 vs mean 10.7, SD 14.7 of young adults) and showed higher satisfaction scores (mean 8.7, SD 1.9). Significant improvements were observed in all clinical outcomes and were similar between groups, including pain response rates (young adults: 949/1516, 62.6%; middle-aged adults: 1848/2834, 65.2%; and older adults: 241/387, 62.3%; P=.17). Conclusions: Older adults showed high adherence, engagement, and satisfaction with the DCP, which were greater than in their younger counterparts, together with significant clinical improvements in all studied outcomes. This suggests DCPs can successfully address and overcome some of the barriers surrounding the participation and adequacy of digital models in the older adult population.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAreias AC, Janela D, Molinos M, et al. Managing Musculoskeletal Pain in Older Adults Through a Digital Care Solution: Secondary Analysis of a Prospective Clinical Study. JMIR Rehabil Assist Technol. 2023;10:e49673. doi:10.2196/49673pt_PT
dc.identifier.doi10.2196/49673pt_PT
dc.identifier.issn2369-2529
dc.identifier.urihttp://hdl.handle.net/10400.16/3011
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherJMIR Publicationspt_PT
dc.relation.publisherversionhttps://rehab.jmir.org/2023/1/e49673pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectagedpt_PT
dc.subjectdigital therapypt_PT
dc.subjecteHealthpt_PT
dc.subjectmusculoskeletal conditionspt_PT
dc.subjectolder adultspt_PT
dc.subjectpainpt_PT
dc.subjectphysical therapypt_PT
dc.subjecttelehealthpt_PT
dc.subjecttelerehabilitationpt_PT
dc.titleManaging Musculoskeletal Pain in Older Adults Through a Digital Care Solution: Secondary Analysis of a Prospective Clinical Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceCanadapt_PT
oaire.citation.startPagee49673pt_PT
oaire.citation.titleJMIR Rehabilitation and Assistive Technologiespt_PT
oaire.citation.volume10pt_PT
person.familyNameDias Correia
person.givenNameFernando
person.identifier.orcid0000-0001-8028-926X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication019a51ef-fb6c-4f1e-9c70-59f02bde8139
relation.isAuthorOfPublication.latestForDiscovery019a51ef-fb6c-4f1e-9c70-59f02bde8139

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