TY -的盟Krein莎拉•L AU - Kadri瑞玛·AU -休斯,玛丽亚AU -克尔,夏娃盟——移液管,约翰•D AU - Holleman Rob盟——金正日Hyungjin玛拉盟-理查森,卡罗琳R PY - 2013 DA - 2013/08/22 TI - Pedometer-Based Internet-Mediated干预成人慢性下腰痛:随机对照试验乔- J地中海互联网Res SP - e181六世- 15 - 8 KW -慢性疼痛千瓦互联网KW -随机对照试验KW -运动疗法AB -背景:慢性疼痛，特别是背部疼痛，是一种普遍的疾病，与残疾、健康状况不佳、焦虑和抑郁、生活质量下降以及卫生服务使用和费用增加有关。目前的证据表明，锻炼是控制慢性疼痛的有效策略。然而，很少有临床项目使用普遍可用的工具和相对低成本的方法来帮助慢性背痛患者开始和维持锻炼计划。目的:本研究的目的是确定基于计步器的、互联网介导的干预是否可以减少慢性背痛相关的残疾。方法:采用平行组随机对照试验，干预组和常规护理组按1:1分配。229名患有非特异性慢性背痛的退伍军人从一个退伍军人事务部(VA)医疗保健系统招募。随机参与干预的参与者收到了一个上传计步器，并可以访问一个网站，该网站通过电子社区提供自动步行目标、反馈、激励信息和社会支持(n=111)。普通护理参与者(n=118)也收到了上传计步器，但没有收到自动反馈或访问网站。主要结局在6个月(次要)和12个月(主要)时使用Roland Morris残疾问卷(RDQ)进行测量，平均得分差异至少为2分，被认为具有临床意义。 Both a complete case and all case analysis, using linear mixed effects models, were conducted to assess differences between study groups at both time points. Results: Baseline mean RDQ scores were greater than 9 in both groups. Primary outcome data were provided by approximately 90% of intervention and usual care participants at both 6 and 12 months. At 6 months, average RDQ scores were 7.2 for intervention participants compared to 9.2 for usual care, an adjusted difference of 1.6 (95% CI 0.3-2.8, P=.02) for the complete case analysis and 1.2 (95% CI -0.09 to 2.5, P=.07) for the all case analysis. A post hoc analysis of patients with baseline RDQ scores ≥4 revealed even larger adjusted differences between groups at 6 months but at 12 months the differences were no longer statistically significant. Conclusions: Intervention participants, compared with those receiving usual care, reported a greater decrease in back pain-related disability in the 6 months following study enrollment. Between-group differences were especially prominent for patients reporting greater baseline levels of disability but did not persist over 12 months. Primarily, automated interventions may be an efficient way to assist patients with managing chronic back pain; additional support may be needed to ensure continuing improvements. Trial Registration: ClinicalTrials.gov NCT00694018; http://clinicaltrials.gov/ct2/show/NCT00694018 (Archived by WebCite at http://www.webcitation.org/6IsG4Y90E). SN - 14388871 UR - //www.mybigtv.com/2013/8/e181/ UR - https://doi.org/10.2196/jmir.2605 UR - http://www.ncbi.nlm.nih.gov/pubmed/23969029 DO - 10.2196/jmir.2605 ID - info:doi/10.2196/jmir.2605 ER -