Intervention group: m-health-based pain education and exercise
chronic pain, pain
CHRONIC PAIN
Patients allocated to the experimental group received a login and password for individual access to the smartphone app (The exercise component (app “training” function) included 8 weeks of training, with two sessions per week (non-consecutive days) of core strengthening exercises. The exercise program was developed by exercise professionals with at least 5 years of clinical experience, specialists in chronic pain treatment, and who used exercise-based treatment. The training periodization followed the progression of pre-established protocols for CLBP treatment reported in the literature (see training periodization in Additional file The app provided animated Graphics Interchange Format (GIFs), descriptions, and audio of how to perform each exercise. The number of repetitions or time under tension for each exercise were prescribed with a range of target zones (e.g., 10–12 repetitions, 20–30 s). For those who cannot reach these zones, they were asked to indicate (on the app) that they could not perform the complete exercise. Exercise sessions were carried out remotely and self-managed by the participant (i.e., the participants were responsible for carrying out the exercises). The content of the training sessions was made available (visible in the app version) each week of intervention training.The message component from the app provided 8 messages (one per week), with the contents taken from the online booklet. Messages included information about the benefits of exercise, motivation, and positive messages about coping with pain.The online booklet contained general information about self-management of chronic pain, including pain education, advice on healthy lifestyle and sleeping habits, and promotion of exercises. The “Contact” function from the app provided participants a direct communication with the researcher to answer questions about the app, its features, and information about possible app errors. In addition, to improve training adherence, the app provided a count and progression bar (%) of the number of completed training days. Adherence was defined as the absolute and relative frequency of the number of sessions performed.