Innovative mHealth for addressing low back pain-related factors amongst lower-limb amputees: A quasi-experimental

Abstract

Background: Lower-limb amputees (LLAs) are highly susceptible to low back pain (LBP) because of postural instability and core muscle weakness, leading to reduced quality of life (QoL). Tailored mobile health (mHealth) interventions may offer a scalable strategy to support functional improvement.
Objectives: This study aimed to evaluate the preliminary impact of mHealth applications on QoL and to identify behavioural and physical parameters observed on LLAs.
Method: A quasi-experimental one-group pre-test–post-test longitudinal study was conducted with 22 unilateral LLAs (transtibial or transfemoral). Nineteen participants used a prosthesis, while three participants used a wheelchair. Participants engaged with a structured 3-month intervention delivered through an mHealth application. The programme consists of: (1) educational modules; (2) core-strengthening exercises; (3) automated reminders; and (4) hybrid delivery. Quality of Life was assessed using the WHOQOL-BREF, variables examined in the bivariate analyses and changes in outcomes were analysed using Wilcoxon signed-rank tests.
Results: The Wilcoxon signed-rank tests showed significant improvements in positive attitude (p = 0.007) and good core muscle strength (p = 0.020), both with large effect sizes. Descriptive analysis indicated significant overall changes in QoL. Bivariate analyses suggested that positive attitude and good core muscle strength were associated with higher QoL.
Conclusion: The use of the mHealth application was associated with improvements in QoL, and positive behavioural and physical changes among LLAs.
Contribution: This research contributes to disability rehabilitation in Southeast Asia by introducing an mHealth approach that may improve functional improvement among LLAs.