University of Sydney researchers have found that smartphone apps for treating back pain have questionable value as they are generally of poor quality, and have not been rigorously evaluated.
Published in Best Practice & Research: Clinical Rheumatology, the study found there has not been thorough evaluation of apps for the self-management of back pain and there is no guidance for consumers on how to select high-quality, evidence-based apps.
Lower back pain is a major global public health issue and the leading cause of disability in most countries, affecting four out of five people in New Zealand at some stage of their life and comprising a large percentage of the 141,093 neck, back of head vertebrae and upper back soft tissue injury claims ACC received last year alone.
The study reviewed 61 current apps specifically designed to help consumers self-manage their back pain and evaluated their content, functionality, quality, and whether they recommend evidence-based interventions.
The researchers found more than 700 apps in the Australian iTunes and Google Play stores that use the keyword “back pain”.
“Treatment guidelines often recommend self-management for the symptoms of back pain, and mobile apps can represent a useful and convenient way to help people manage their own condition, however, consumers need to be aware that there is minimal regulatory control over their content,” said lead researcher Gustavo Machado from the University’s School of Public Health.
“Millions of people worldwide use these apps, however there is no independent guidance to help consumers identify which ones are safe and of high quality.
“In this study, apps generally offered questionable and poor quality information, lacked engaging and customisable features, and had poor visual appeal and questionable credibility.”
Although the recommendations in most apps were broadly aligned with the 2016 National Institute for Health and Care Excellence (NICE) treatment guidelines such as strengthening exercises and yoga, the quality of the information provided was generally low.
“Developers usually claim that consumers could rapidly improve their back pain symptoms by following their exercise programs.
“However, none of the apps have been directly tested for their effectiveness, and only very few provide the educational content and information that is key to guideline recommendations,” Gustavo Machado notes.
“Considering none of the apps included in this study had been evaluated rigorously, it is not clear whether any of them are really effective in improving symptoms in people with back pain.
“Consumers often rely on in-app or online user ratings and reviews to select an app, but our study found that this information was not associated with app quality.
“In general, the apps that required some payment were also the ones with the highest quality scores.”
Senior author Associate Professor Steven Kamper from Sydney Medical School believes app developers need to work closely with healthcare professionals, researchers, and patients to ensure app content is accurate, evidence-based, and engaging to improve the quality of existing apps for low back pain.
“They also need to devise ways to appropriately evaluate these emerging technologies to ensure that they are beneficial to patients,” he adds.
