@Article{信息:doi 10.2196 / / jmir。2605，作者=“Krein, Sarah L and Kadri, Reema and Hughes, Maria and Kerr, Eve A and Piette, John D and Holleman, Rob and Kim, Hyungjin Myra and Richardson, Caroline R”，标题=“基于计步器的互联网干预成人慢性腰痛:随机对照试验”，期刊=“J Med Internet Res”，年=“2013”，月=“Aug”，日=“22”，卷=“15”，数=“8”，页数=“e181”，关键词=“慢性疼痛;互联网;随机对照试验;背景:慢性疼痛，尤其是背痛，是一种常见的疾病，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成本增加有关。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启动和维持锻炼计划。目的:本研究的目的是确定以计步器为基础，以互联网为媒介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各1:1。研究人员从一个退伍军人事务部(VA)医疗保健系统招募了229名患有非特异性慢性背痛的退伍军人。 Participants randomized to the intervention received an uploading pedometer and had access to a website that provided automated walking goals, feedback, motivational messages, and social support through an e-community (n=111). Usual care participants (n=118) also received the uploading pedometer but did not receive the automated feedback or have access to the website. The primary outcome was measured using the Roland Morris Disability Questionnaire (RDQ) at 6 months (secondary) and 12 months (primary) with a difference in mean scores of at least 2 considered clinically meaningful. 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). ", issn="14388871", doi="10.2196/jmir.2605", url="//www.mybigtv.com/2013/8/e181/", url="https://doi.org/10.2196/jmir.2605", url="http://www.ncbi.nlm.nih.gov/pubmed/23969029" }