Evidence map›Paper›PMID 40488767›Full record

ArticleJMIR mHealth and uHealth2025

Combined Use of Digital and Analog Physical Therapy in Patients With Musculoskeletal Disorders and Indicators of Chronicity: German Claims Data Analysis.

Silke Frey, Annika Schmitz, Udo Schneider, Linda Kerkemeyer, Birgitta Weltermann

Abstract read
In one paragraph

Article in JMIR mHealth and uHealth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Silke FreyInstitute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, Bonn, 53127, Germany, +49 228 287 11156.ORCID 0000-0002-9963-7647
Annika SchmitzInstitute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, Bonn, 53127, Germany, +49 228 287 11156.ORCID 0009-0005-7918-6569
Udo SchneiderTechniker Krankenkasse, Hamburg, Germany.ORCID 0000-0001-7079-4721
Linda KerkemeyerLiKe Healthcare Research GmbH, Berlin, Germany.ORCID 0000-0002-7185-3399
Birgitta WeltermannInstitute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, Bonn, 53127, Germany, +49 228 287 11156.ORCID 0000-0002-1285-1545

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Musculoskeletal disorders are highly prevalent worldwide and contribute significantly to the overall burden of disease. Regular physical therapy with trained physiotherapists is recommended in the guidelines. Recently, digital physical therapy offered by digital health interventions was shown to be effective. However, the evidence on its real-world usage in health care systems is limited. Objective: Based on claims data, this study examined the current usage of digital health applications (DiGAs) for musculoskeletal disorders in the German health care system. Patients with standalone digital physical therapy were compared to those with a combination of analog and digital physical therapy. In addition, predictors for concomitant use were identified. Methods: This retrospective cohort study analyzed claims data from Germany's largest statutory health insurance. Patients who used DiGA for musculoskeletal disorders at least once were included. Sociodemographic and medical characteristics of patients receiving standalone and concomitant physical therapy were compared. Statistical analyses comprised univariate analyses and binomial logistic regression. Results: Of the 6090 individuals, 58.2% (3543/6090) were prescribed physical therapy within 6 months before or after DiGA prescription. In this population, 36.3% (2210/6090) used DiGA and analog physical therapy at the same time. Concomitant physical therapy was significantly more likely in patients with chronicity risk (odds ratio [OR] 1.49, 95% CI 1.31-1.69; P<.001) or established chronicity (OR 2.76, 95% CI 2.22-3.47; P<.001), female gender (OR 1.48, 95% CI 1.33-1.66; P<.001), and higher age (OR 1.02, 95% CI 1.02-1.02; P<.001). Conclusions: The findings highlight the diverse utilization patterns of DiGAs among patients with musculoskeletal disorders. Chronicity emerged as an important predictor for combined digital and analog physical therapy. These findings support considerations on integrating digital health interventions into current guidelines.

Indexed as

Musculoskeletal DiseasesPhysical Therapy ModalitiesAdultAgedChronic DiseaseCohort StudiesFemaleGermanyHumansInsurance Claim ReviewMaleMiddle AgedRetrospective Studieschronicityclaims analysisDiGAdigital health applicationsdigital health interventionsexercise therapymHealthmusculoskeletal disordersphysical therapyutilization

Identifiers

PMID40488767
PMCPMC12168610

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.