File
R. Maskeliūnas1, R. Damaševiˇcius2, A. Kulikajevas1, J. Marley3, S. McDonough4, S. Howes3, F. Piccinini5, E. Ekvall Hansson6, C. Larsson6
1Kaunas University of Technology (KUT), Department of Multimedia Engineering, Kaunas, Lithuania, 2Kaunas University of Technology, Department of Software Engineering, Kaunas, Lithuania, 3Ulster University, School of Health Science, Londonderry, United Kingdom, 4RCSI, School of Physiotherapy, Dublin, Ireland, 5INCRA, Centre for Socio-Economic Research on Ageing, Ancona, Italy, 6Lund University, Department of Health Sciences, Human Movement Health and Rehablitation, Lund, Sweden
Background: Low back pain (LBP) is a leading cause of disability worldwide, putting a significant strain on individuals, their families and society. Self-management, education, and adopting healthy lifestyle behaviors are recommended interventions. Access to services provided by healthcare professionals can be limited and costly. Serious games and dedicated apps have been shown to be a successful strategies to support the self-management of a range of different health conditions including LBP. Although serious games show promise, there are still many questions surrounding how these games should be developed, organized, and delivered and as such there is a need for pragmatic evaluations to inform theory around the proposed mechanism by which the game works and the influence it has on patient outcomes.
Purpose: The main aim of this study was to investigate use of a mobile app to facilitate knowledge and skills of working adults with regards to evidenced based strategies for managing LBP.
Methods: The MyRelief Serious game was developed to incorporate self-management, behavior change strategies, educational information, and based on self-assessment models implemented through ontology-based mechanics. An active gameplay challenged the user in three ways
(1) self-assessment and tracking of symptoms
(2) physical activity monitoring
(3) a knowledge base of learning materials transformed into interactive quizzes and links to handbook material.
Through travelling and combating pain monsters within the actual interaction with the user, performance and feedback in the game were closely related to a gain in pain knowledge.
Functional disability was evaluated with Oswestry disability Qustionnaire (ODQ), a modified version of the Patient enablement Index (PEI) was used to evaluatethe individual’s ability to understand and cope with illness after using the MyRelief Serious game.The System usability scale (SUS) was used to evaluate app usability.
(1) self-assessment and tracking of symptoms
(2) physical activity monitoring
(3) a knowledge base of learning materials transformed into interactive quizzes and links to handbook material.
Through travelling and combating pain monsters within the actual interaction with the user, performance and feedback in the game were closely related to a gain in pain knowledge.
Functional disability was evaluated with Oswestry disability Qustionnaire (ODQ), a modified version of the Patient enablement Index (PEI) was used to evaluatethe individual’s ability to understand and cope with illness after using the MyRelief Serious game.The System usability scale (SUS) was used to evaluate app usability.
Results: 48 office workers with LBP in Lithuania were included. The first 21participants, serving as control, the remaining playing the game during a period of three months. Participants were surveyed in 2020 and in 2021.The mean age of participants was 34 years (range 24-76) and 18% were female. The mean ODQ at baseline indicated severe disability both in the intervention group (53.68%) and in the control group (56.95%). Following the use of the app a larger improvement was found for ODQ in intervention group (42.07%), than in the control group (50.76%) (p < 0.001). The mean PEI was 5.7 among those taking part in the intervention compared to 4.8 in the control group. Although the difference between the groups was not statistically significant (p = 0.182) the level of the score is comparable to similar studies. The SUS score of 77.6 suggests good usability.
Conclusions: The results suggest that the MyRelief Serious Game may be usable, however potential components within the serious game need to be further investigated.
Implications: A serious game, such as MyRelief is an accessible and scalable intervention that may encourage wider participation and potentially minimize costs associated with LBP.
Funding acknowledgements: Co-funded by the Erasmus programme of the European Union, project-ID: 2018-1-SE01-KA204-039144
Keywords:
Serious game
Self-management
Low back pain
Serious game
Self-management
Low back pain
Topics:
Innovative technology: robotics
Education: clinical
Pain & pain management
Innovative technology: robotics
Education: clinical
Pain & pain management
Did this work require ethics approval? Yes
Institution: Faculty of Informatics, Kaunas University of Technology, Lithuania.
Committee: The Ethics Committee in the Faculty of Informatics, KTU, Lithuania.
Ethics number: EALTV20180222-1
All authors, affiliations and abstracts have been published as submitted.
