Key result
SELFBACK app benefits low back pain disability consistently regardless of age, sex, or education.
Why the study?
It was uncertain whether age, gender, or education modify the effectiveness of the selfBACK AI-based self-management app for low back pain.
Do age, gender, and education modify the effectiveness of the selfBACK app adjunct to usual care in reducing LBP-related disability in adults with low back pain?
RCT (n=461)
Open-label
1:1 allocation ratio using permuted blocks
Yes
Do age, gender, and education modify the effectiveness of the selfBACK app adjunct to usual care in reducing LBP-related disability in adults with low back pain?
Mean Difference: 2.6 (95% CI 0.4–4.9)
Sociodemographic factors like age, gender, and education do not significantly modify the overall effectiveness of an AI-based self-management app for low back pain, though older adults may derive slightly greater long-term benefit.
Supports broad SELFBACK use regardless of age, gender, or education; extends RCT evidence for equitable digital self-management benefits in low back pain.
selfBACK is an artificial intelligence based self-management app for low back pain (LBP) recently reported to reduce LBP-related disability. The aim of this study was to examine if age, gender, or education modify the effectiveness of the selfBACK intervention using secondary analysis of the selfBACK randomized controlled trial. Persons seeking care for LBP were recruited from primary care in Denmark and Norway and an outpatient clinic (Denmark). The intervention group (n = 232) received the selfBACK app adjunct to usual care. The control group (n = 229) received usual care only. Analyses were stratified by age (18-34, 35-64, ≥65 years), gender (male, female), and education (≤12, >12 years) to investigate differences in effect at three and nine months follow-up on LBP-related disability (Roland-Morris Disability Questionnaire [RMDQ]), LBP intensity and pain self-efficacy. Overall, there was no effect modification for any of the sociodemographic factors. However, data on LBP-related disability suggest that the effect of the intervention was somewhat more beneficial in older than in younger participants. The difference between the intervention and control group due to interaction was 2.6 (95% CI: 0.4 to 4.9) RMDQ points for those aged ≥65 years as compared to those aged 35-64 years. In conclusion, age, gender, or education did not influence the effect of the selfBACK intervention on LBP-related disability. However, older participants may have an additional long-term positive effect compared to younger participants. Trial registration: ClinicalTrials.gov Identifier: NCT03798288.
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Bardal et al. (2023) conducted an RCT in Low back pain (n=461). SELFBACK app vs. Usual care was evaluated on Difference in LBP-related disability (RMDQ) due to interaction for age ≥65 years vs 35-64 years at 9 months (MD 2.6, 95% CI 0.4-4.9). Age, gender, and education did not significantly modify the overall effect of the SELFBACK app on LBP-related disability, although participants aged ≥65 years experienced an additional 2.6-point reduction in RMDQ at 9 months compared to those aged 35-64 years.
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