Background: Among available digital apps, those providing personalized video exercises may be helpful for individuals undergoing functional rehabilitation. Objective: We aimed to assess the effectiveness of apps providing personalized video exercises to support rehabilitation for people with short- and long-term disabling conditions, on functional capacity, confidence in exercise performance, health care consumption, health-related quality of life, adherence, and adverse events. Methods: In this systematic review, we searched MEDLINE, CENTRAL, and Embase databases up to March 2022. All randomized controlled trials evaluating the effect of apps providing personalized video exercises to support rehabilitation for any condition requiring physical rehabilitation were included. Selection, extraction, and risk of bias assessment were performed by 2 independent reviewers. The primary outcome was functional capacity at the end of the intervention. The secondary outcomes included confidence in exercise performance, care consumption, health-related quality of life, adherence, and adverse events. A meta-analysis was performed where possible; the magnitude of the effect was assessed with the standardized mean difference (SMD). Results: From 1641 identified references, 10 papers (n=1050 participants, 93% adults) were included: 7 papers (n=906 participants) concerned musculoskeletal disorders and 3 (n=144 participants) concerned neurological disorders. Two (n=332 participants) were employee based. The apps were mostly commercial (7/10); the videos were mostly elaborated on by a physiotherapist (8/10). The duration of app use was 3-48 weeks. All included studies had a high overall risk of bias. Low-quality evidence suggested that the use of apps providing personalized video exercises led to a significant small to moderate improvement in physical function (SMD 0.35, 95% CI 0.19-0.51; Phet=.86; I2=0%) and confidence in exercise performance (SMD 0.67; 95% CI 0.37-0.96; Phet=.22; I2=33%). Because of the very low quality of the evidence, the effects on quality of life and exercise adherence were uncertain. Apps did not influence the rate of adverse events. Conclusions: Apps providing personalized video exercises to support exercise performance significantly improved physical function and confidence in exercise performance. However, the level of evidence was low; more robust studies are needed to confirm these results. Trial Registration: PROSPERO CRD42022323670; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323670

Background and Objectives: The relevance of red flags in serious spinal pathology (SSP) has evolved throughout the last years. Recently, new considerations have been proposed to expand the consideration of red flags. The purpose of this study was to determine, approve and test a model for the triage and management process of SSPs based on the latest data available in the literature. Materials and Methods: The SSP model was initially built on the basis of a literature review. The model was further determined and approved by an expert panel using a Delphi process. Finally, clinical scenarios were used to test the applicability of the model. Results: After three rounds of the Delphi process, panellists reached a consensus on a final version of the model. The use of clinical scenarios by experts brought about reflexive elements both for the determined model and for the SSPs depicted in the clinical cases. Conclusions: The validation of the model and its implementation in the clinical field could help assess the skills of first-line practitioners managing spinal pain patients. To this end, the development of additional clinical scenarios fitting the determined model should be further considered.

The medical environment is prone to diagnostic errors, which can have serious consequences for patients' health status. However, healthcare professionals (HCPs) are often overconfident in their choices. In this context, there is a growing interest in the influence of variables that may negatively influence the reasoning of HCPs, namely intolerance of uncertainty (IU) and resource consumption. We challenged 127 physiotherapists to play a simulation game and choose a therapeutic strategy for three cases of low back pain of increasing difficulty (easy, medium, difficult). We measured their IU level and their resource consumption (i.e., requests for test results for each case). Our results showed that 87.4% of participants chose the most appropriate strategy for the easy case, 46.5% for the medium and 29.1% for the difficult. For the easy case, IU and resource consumption had a negative influence on the chosen therapeutic strategy, which was less adapted. Moreover, resource consumption among highly intolerant individuals had a more adverse influence on the chosen strategy. However, we did not find the same results for the medium and difficult cases. We propose hypotheses to explain this difference (i.e., system 1/system 2, consideration of the physiotherapist's speciality, perception of uncertainty). We also outline potential improvements to our tool and suggest future research avenues.

[This corrects the article DOI: 10.2196/45207.].

Work-related shoulder disorders (WRSDs) significantly impact workers’ health and well-being. Various factors contribute to WRSDs, including work environment, physical workload, psychological stressors, and an aging workforce. Despite numerous interventions proposed to address WRSDs, finding high-quality evidence to support any of them remains challenging. One potential reason is the lack of valid tools to measure physical workload and customize interventions. To address this, we developed a portable feedback system, the ShoulderWatchLoad (SWL), designed to estimate physical work demands on the shoulder. The objectives of this pilot study are (a) to evaluate the feasibility of implementing the SWL in the workplace and conducting a large-scale randomized clinical trial (RCT) by assessing recruitment success, intervention adherence, usability of the technology, and the research team’s capacity to refine the SWL and (b) to explore the SWL capacity to reduce disability, pain, work limitations, and physical work demands while increasing pain self-efficacy among workers with WRSDs. A convergent mixed methods pilot study will be conducted. The quantitative component will consist of a two-arm parallel group external pilot RCT involving 42 participants with WRSDs who will be randomized into one of the two study groups. Following baseline evaluation, all participants will attend an education session in the workplace. Following this session, participants of the experimental group will receive a 2-week workplace intervention using feedback from the SWL, while participants in the control group will not receive this intervention. All participants will undergo four evaluations over a 12-week period (baseline, 3rd, 6th, and 12th weeks). The qualitative component will be a interpretative descriptive qualitative study involving three focus groups with 21 participants from the experimental group. An innovative joint display will be used to represent the integration of qualitative and quantitative data, along with progression criteria, to draw meta-inferences about the feasibility of implementing the SWL in the workplace and conducting a full-scale RCT in the future. A holistic approach combining qualitative and quantitative elements will enable us to determine the SWL usability and whether the conduct of a full RCT is feasible. ClinicalTrials.gov NCT06693479.

UNSTRUCTURED Among available digital apps, those providing personalized video exercises may be helpful for individuals undergoing functional rehabilitation. We aimed to assess the effectiveness of apps providing personalized video exercises to support rehabilitation for people with short- and long-term disabling conditions, on functional capacity, confidence in exercise performance, health care consumption, health-related quality of life, adherence, and adverse events. In this systematic review, we searched MEDLINE, CENTRAL, and Embase databases up to March 2022. All randomized controlled trials evaluating the effect of apps providing personalized video exercises to support rehabilitation for any condition requiring physical rehabilitation were included. Selection, extraction, and risk of bias assessment were performed by 2 independent reviewers. The primary outcome was functional capacity at the end of the intervention. The secondary outcomes included confidence in exercise performance, care consumption, health-related quality of life, adherence, and adverse events. A meta-analysis was performed where possible; the magnitude of the effect was assessed with the standardized mean difference (SMD). From 1641 identified references, 10 papers (n=1050 participants, 93% adults) were included: 7 papers (n=906 participants) concerned musculoskeletal disorders and 3 (n=144 participants) concerned neurological disorders. Two (n=332 participants) were employee based. The apps were mostly commercial (7/10); the videos were mostly elaborated on by a physiotherapist (8/10). The duration of app use was 3-48 weeks. All included studies had a high overall risk of bias. Low-quality evidence suggested that the use of apps providing personalized video exercises led to a significant small to moderate improvement in physical function (SMD 0.35, 95% CI 0.19-0.51; Phet=.86; I2=0%) and confidence in exercise performance (SMD 0.67; 95% CI 0.37-0.96; Phet=.22; I2=33%). Because of the very low quality of the evidence, the effects on quality of life and exercise adherence were uncertain. Apps did not influence the rate of adverse events. Apps providing personalized video exercises to support exercise performance significantly improved physical function and confidence in exercise performance. However, the level of evidence was low; more robust studies are needed to confirm these results. PROSPERO CRD42022323670; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323670