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The following is a summary of “Evaluating Digital Rehabilitation Outcomes in Chronic Musculoskeletal Conditions Across Non-Obesity, Obesity, and Severe Obesity,” published in the January 2025 issue of Pain by Pereira et al.
Recognizing obesity as a substantial risk factor and exacerbating factor for musculoskeletal (MSK) conditions, the rising prevalence of obesity necessitates the development of scalable solutions to manage the complex clinical profiles and key to care challenges within this population.
Researchers conducted a retrospective study to evaluate the engagement and clinical outcomes of a fully remote digital care program for patients with MSK conditions, focusing on those with and without comorbid obesity.
They performed a post-hoc analysis of a prospective, longitudinal, single-arm observational study from August 2023 to August 2024 involving adults with chronic MSK pain. Participants were categorized by body mass index (BMI) into non-obesity, obesity, and severe obesity groups. Outcomes assessed included completion rates, engagement, satisfaction, pain (minimal clinically important change: 30%), impairment in daily activities, and patient global impression of change (PGIC). Latent basis growth analysis and logistic regression were applied to evaluate clinical outcomes.
The results showed the completion rates were high across all BMI groups (77.5%–85.6%), with slightly lower rates in the obesity groups. Engagement was similar across exercise sessions (1.9–2.2 per week) and educational content (8.10–9.31 videos watched). The obesity groups interacted more with physical therapists compared to the non-obesity group (severe obesity: 24.6 (SD 10.1); obesity: 23.2 (SD 10.46); non-obesity: 22.4 (SD 9.8), P < 0.001). Despite greater baseline risk and clinical impairment, all groups showed significant pain reductions, with pain responder rates ranging from 56.6% to 63.6%, the lowest in the severe obesity group. Improvements in daily activities and positive PGIC were observed in all groups (50.4%–53.6%). Satisfaction exceeded 9/10 in all BMI groups.
Investigators concluded that despite of severe baseline conditions, individuals with obesity showed high program completion rates, engagement, and clinical improvements comparable to the non-obesity group, highlighting the potential of digital programs for effectively addressing MSK conditions.
