{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:50:23Z","timestamp":1782489023427,"version":"3.54.5"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Leading cause of global disability, lower back pain, affects 84% of adults and costs the U.S. $134 billion annually. Traditional care fails to improve outcomes despite rising spending. This study assessed the effectiveness of a digital musculoskeletal integrated practice unit (IPU) in reducing pain and function in adults with back pain.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a retrospective cohort study of 784 adults (18\u201395\u00a0years) with low back pain enroled in our IPU between September 2023 and February 2025. Intervention included virtual physician\/nurse practitioner and physical therapist assessments, coordinated care with health coaching and nutrition counselling, and digital physical therapy. Primary outcomes were improvement in pain (Numeric Pain Rating Scale) and function (Single Assessment Numeric Evaluation). Analyses used paired\n t<\/jats:italic>\n \u2010tests for within\u2010subject changes, multivariable linear regression adjusting for baseline severity, follow\u2010up duration, age, sex, and comorbidities, and engagement\u2010stratified analyses to assess associations between visit frequency and outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 784 patients (mean age 60.1\u00a0\u00b1\u00a017.0\u00a0years), mean pain scores decreased 4.94\u00a0\u00b1\u00a00.07 to 2.61\u00a0\u00b1\u00a00.08 (\n p<\/jats:italic>\n \u00a0<\u00a00.001, Cohen's\n d<\/jats:italic>\n \u00a0=\u00a0\u22121.02), with 61.9% achieving the MCID of \u2265\u00a02\u2010point pain reduction. Among patients with severe baseline pain (\u2265\u00a07), 78.1% achieved pain MCID. Among the 688 patients (87.8%) with paired functional data, SANE scores increased 51.18\u00a0\u00b1\u00a00.96 to 74.97\u00a0\u00b1\u00a00.83 (\n p<\/jats:italic>\n \u00a0<\u00a00.001, Cohen's\n d<\/jats:italic>\n \u00a0=\u00a00.94), with 58.0% achieving SANE MCID of \u2265\u00a015 points.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Digital musculoskeletal IPU care for low back pain may provide convenient access to care for patients while supporting clinical effectiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/msc.70236","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T02:40:44Z","timestamp":1780540844000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lower Back Pain Management Through a Digital Musculoskeletal Practice Unit: Pain and Functional Outcomes"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7026-2536","authenticated-orcid":false,"given":"Jared","family":"Aguilar","sequence":"first","affiliation":[{"name":"Clinical Department Vori Health Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calandra","family":"White","sequence":"additional","affiliation":[{"name":"Clinical Department Vori Health Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8220-1227","authenticated-orcid":false,"given":"Myung","family":"Choi","sequence":"additional","affiliation":[{"name":"Clinical Department Vori Health Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"Grant","sequence":"additional","affiliation":[{"name":"Clinical Department Vori Health Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1435-653X","authenticated-orcid":false,"given":"Mary I.","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Clinical Department Vori Health Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"VA\/DoD Clinical Practice Guideline for the Diagnosis and Treatment of Low Back Pain","author":"Anderson M. D.","year":"2022"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2022.02.036"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.13559"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2032396"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.07.011"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229265"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0734"},{"key":"e_1_2_13_9_1","volume-title":"Pain: Clinical Manual for Nursing Practice","author":"McCaffery M.","year":"1989"},{"key":"e_1_2_13_10_1","article-title":"Correlation of the Single Assessment Numerical Evaluation to Legacy Patient\u2010Reported Outcomes","author":"Pfeil A. N.","year":"2025","journal-title":"Lumbar Fusion. Spine Open"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16\u20102367"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154\u2010016\u20109357\u20100"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.37371"}],"container-title":["Musculoskeletal Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.70236","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/msc.70236","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.70236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:15:33Z","timestamp":1782486933000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/msc.70236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/msc.70236"],"URL":"https:\/\/doi.org\/10.1002\/msc.70236","archive":["Portico"],"relation":{},"ISSN":["1478-2189","1557-0681"],"issn-type":[{"value":"1478-2189","type":"print"},{"value":"1557-0681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-11-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70236"}}