Feasibility, Usability and Implementation Context of an Internet-Based Pain Education and Exercise Program for Chronic Musculoskeletal Pain: a pilot trial of the REABILITADOR program

Background: Internet-based self-management programs and telerehabilitation initiatives have grown with the development of new technologies and have been extensively used for delivering healthcare in many areas. These programs overcome common barriers that patients face with traditional face-to-facehealthcare, such as travel, lack of time, and high demand on the public health system. In the past years, during the emergence of the COVID-19 pandemic, this mode of delivery has become even more popular. However, there is still a lack of studies testing this mode of delivery, especially in low- and middle-income countries.
Objective: To evaluate the feasibility, usability, and implementation context of a self-management internet-based program based on exercises and pain education in people with chronic musculoskeletal pain.
Design: Parallel pilot study of a prospectively registered, assessor blinded, 2-arm randomised controlled trial with economic evaluation.
Participants: 65 patients with chronic musculoskeletal pain (more than 12 weeks) with an age between 18 and 60 years.
Interventions: A 8-week telerehabilitation program based on exercises and pain education (intervention group) compared with an online self-management booklet (control group).
Outcome measures: We measured implementation outcomes and program fit with the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM), and the System Usability Scale after treatment. We measured costs by the estimate of intervention costs, healthcare utilization costs, patients costs, and loss of productivity costs.
Results: 56 participants were analysed at the 8-week follow-up. The participants were mostly women(67%), with a mean age of 39.5 (SD 11.3), mean pain intensity of 6.3 points (SD 1.6). Adherence to the program was high (mean of 7.2(SD: 1.4) weeks accessing the website). For the intervention group, satisfactory scores were found in 100% of responses for AIM, IAM and FIM scales. For the control group, satisfactory scores were found in 95% to 99% of responses for AIM, IAM and FIM scales. Most patients rated the usability of the system as excellent or best imaginable. A total of US$278.3 per patient were expended by the intervention group and US$141.52 per patient was expended by the control group.
Conclusions: We found that the program is feasible, appropriate, and acceptable from the users’ implementation perspective.