A non-randomized pilot feasibility study into Strength Back: a digital health intervention for spinal surgery patients – benefits, recruitment, drop-out and acceptability (Preprint)

Abstract

Spinal surgery patients report high levels of insecurity, pain, stress and anxiety, before and after surgery. A digital health intervention, based on Acceptance and Commitment Therapy and positive psychology has been developed to enhance psychological flexibility and well-being and to reduce postsurgical pain.

The objective of this study was to assess 1) the feasibility of a future RCT of the digital intervention called “Strength Back” in terms of benefits, recruitment and drop-out and 2) the acceptability of the intervention.

We used a non-randomized experimental design with an intervention group (n=17) and a control group (n=20). Outcome measures were pain intensity (NRS), pain interference (MPI), anxiety and depression (HADS), valued living (ELS), psychological flexibility (PIPS), and mental well-being (MHC-SF). Semi-structured interviews in combination with log data and scores on the TWente Engagement with Ehealth Technologies Scale (TWEETS) were used to assess acceptability.

A significant improvement over time on emotional and overall well-being (MHC-SF) was only found for the intervention group (resp. V = 99, p = .026; V = 55, p = .004). In addition, the intervention group showed a significantly larger decline in pain intensity (NRS) than the control group (U = 75, p = .003). On average 75% of the available weekly modules were completed and 68% of the participants used the intervention until the final interview. The majority of the participants (n=15) in the intervention group would recommend the intervention to future patients.

The current study shows that combining ACT and PP in a digital intervention such as Strength Back is promising for spinal surgery patients. A larger RCT is now warranted.