Evaluation and Cost-Consequence Analysis of a Community-Based Digital Exercise Intervention for People With Musculoskeletal Conditions.

Abstract

Objectives: The objectives of this study are to evaluate the impact and cost-consequence analysis of a new digital intervention providing water- and land-based exercises for people with musculoskeletal (MSK) conditions.

Methods: Data were collected from May 2021 to December 2023, during which the number of sites providing the intervention increased from 20 to 136. Participant recruitment and characteristics, pain intensity (0-100), physical function (Patient Specific Complaint, 0-100), and health and wellbeing (Office for National Statistics 4, ONS4) were measured. A minimal clinically important detectable (MCID) change of 15% was used. Symptoms, function and wellbeing were measured at 6, 12 and 26 weeks. A cost-consequence analysis was conducted comparing 12 digital exercise sessions to 6 face-to-face (F2F) physiotherapy sessions.

Results: In total, 4429 participants with MSK conditions, who completed at least 1 exercise session, were included in this study. 3515 (79.4%) were female, average age 58.7 ± 15.3 years old, 13% registered as ethnicity other than white, 33.5% were in the third quartile for high deprivation and 44.2% were sedentary. The knee (33.3%) was the most affected body region. In total, 40,995 exercise sessions were completed (91.6% water-based), and the average sessions per user were 9.3. Small significant (p < 0.05) improvements in function, happiness, and anxiety were seen at 6 weeks, with improvement in function and anxiety maintained at 12- and 26-week follow-ups. At 6 and 12 weeks, 33.8% and 38.6% reached MCID in pain intensity and 40% and 45% in physical function, improvements which are similar when compared to expected outcome of face-to-face physiotherapy. Cost-consequence analysis indicated an estimated saving of £168.72 per participant compared to F2F physiotherapy.

Conclusion: This digital MSK exercise solution delivered to people with MSK conditions had a positive effect on pain intensity and physical function with considerable potential cost savings.