MedPath

Effectiveness of a Digital Health Application for Subacute and Chronic Back Pain (Relevis)

Not Applicable
Recruiting
Conditions
Back Pain
Interventions
Behavioral: relevis
Registration Number
NCT06221956
Lead Sponsor
Gaia AG
Brief Summary

This clinical trial with 276 patients with subacute or chronic back pain aims to investigate the effectiveness of the unguided digital therapeutic relevis for patients with subacute or chronic back pain. Inclusion criteria are: age ≥ 18 years, presence of subacute (6-12 weeks) or chronic (\>12 weeks) back pain, attested by a medical certificate (relevant ICD-10-GM diagnoses: M47.8x, M47.9x, M54.5, M54.8x, M54.9x, M51.0x, M51.1x, M51.2), impaired functional ability \[Oswestry Disability Index (ODI) ≥ 21\], consent to participation, sufficient knowledge of the German language. Exclusion criteria are: change in treatment of back pain in the past month, planned change in treatment of back pain in the next 3 months, prior use of other online programs/apps for back pain, history of back, hip or knee surgery in the past 6 months, history of more than one back surgery in lifetime, presence of a specific cause for back pain (e.g., fracture, infection, neuropathies \[except when due to disc prolapse\], axial spondyloarthritis), tumor or metastases, cauda equina syndrome, acute myocardial infarction, unstable coronary heart disease/angina pectoris or heart failure, acute thrombosis, manifest osteoporosis, acute fevers, rheumatic autoimmune diseases.

Patients will be randomized and allocated to either an intervention group in a 1:1 ratio, in which they will receive access to relevis in addition to treatment as usual (TAU, n = 138), or to a control group, in which they will receive only TAU (n = 138). TAU is defined as any therapy prescribed or recommended by the GP or specialists (e. g. orthopedic surgeon, rheumatologists etc.) which may include physiotherapy, injections in the spine, drug therapy, orthesis, etc. (1,2). The primary endpoint will be the functional impairment, measured by the ODI, with three months post-allocation being the primary time point for assessment of effectiveness (T1). Six months post-allocation (T2) will be used as the follow-up assessment endpoint. Secondary endpoints will be depression, work and social functioning, pain intensity, and health-related quality of life.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
276
Inclusion Criteria
  • Age ≥ 18

  • Presence of subacute (6-12 weeks) or chronic (>12 weeks) back pain

  • Submission of a medical certificate attesting to the presence of at least one of the following ICD-10-GM diagnoses of back pain:

    • M47.8x - Spondylosis
    • M47.9x - Other spondylosis
    • M54.5 - Back pain
    • M54.8x - Other back pain
    • M54.9x - Unspecified back pain
    • M51.0x - Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with myelopathy
    • M51.1x - Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy
    • M51.2 - Other thoracic, thoracolumbar and lumbosacral intervertebral disc displacement
  • Impaired functional ability (ODI ≥ 21)

  • Consent to participate

  • Sufficient knowledge of the German language

Exclusion Criteria
  • Change in treatment of back pain in the past month

  • Planned change in treatment of back pain in the next 3 months

  • Prior use of other online programs/apps for back pain

  • History of back, knee or hip surgery in the past 6 months

  • History of more than one back surgery during lifetime

  • Presence of a specific cause for back pain, e.g.:

    • Fracture
    • Infection
    • Neuropathies (except when due to disc prolapse)
    • Axial spondyloarthritis
  • Tumor or metastases

  • Cauda equina syndrome

  • Acute myocardial infarction

  • Unstable coronary heart disease/angina pectoris or heart failure

  • Acute thrombosis

  • Manifest osteoporosis

  • Acute fevers

  • Rheumatic autoimmune diseases

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
relevis + TAUrelevisParticipants allocated to the intervention group will receive access to relevis in addition to treatment as usual (TAU). relevis is a digital health application designed for individuals with subacute or chronic back pain, accessible through a web browser. The application consists of six physical exercise modules that cover four exercises with thiree different levels of difficulty, each, and ten interactive "conversations" on different topics (changes in the body, pain development and processing, chronic pain, pain and mood, relaxation and mindfulness, becoming active against pain, stress and pain, nutrition and pain, sleep and pain, work and pain). "Conversations" are accompanied by illsutrations, audio recordings, motivating text messages, worksheets, and summaries. Users are also encouraged to regularly complete short questionnaires to monitor their complaints. Once registered, the program remains accessible for 180 days.
Primary Outcome Measures
NameTimeMethod
Functional Impairment3 months

Oswestry Low Back Pain Disability Questionnaire (ODI). Total score ranging from 0-100; higher scores mean higher functional impairment (worse outcome).

Secondary Outcome Measures
NameTimeMethod
Depressive Symptomatology3 months

Patient Health Questionnaire (PHQ-9). Total score ranging from 0-27; higher scores mean higher depressive symptomatology (worse outcome).

Health-related Quality of Life3 months

Assessment of Quality of Life - 8 Dimensions (AQoL-8D). Total score ranging from 0-100; higher scores mean higher quality of life (better outcome).

Work and Social Functioning3 months

Work and Social Adjustment Scale (WSAS). Total score ranging from 0-40; higher scores mean higher disability (worse outcome).

Intensity of Back Pain3 months

Numeric Rating Scale (NRS). Score ranging from 0-10; higher scores mean higher pain (worse outcome).

Trial Locations

Locations (1)

GAIA AG

🇩🇪

Hamburg, Germany

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