{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:26:16Z","timestamp":1792805176908,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Daegu-Gyeongbuk Medical Innovation Foundation","id":[{"id":"https:\/\/ror.org\/05cc1v231","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chronic lower back pain (CLBP) is a global health issue leading to significant disability and socioeconomic burden. Traditional treatments, including exercise and cognitive behavioral therapy (CBT), are often limited by physical and temporal constraints. This study aimed to evaluate the efficacy of multidisciplinary digital therapeutics (MORA Cure LBP) compared to conventional treatments. Methods: This multicenter, randomized, controlled pilot study enrolled 46 participants. Participants were randomly assigned in a 1:1 ratio to either a MORA Cure LBP group or control group, which received conventional treatment. Results: At eight weeks, both groups demonstrated improvements compared to baseline. No statistically significant differences were observed between the MORA Cure LBP and control groups in reductions in usual pain intensity (MORA Cure LBP: 3.1 \u00b1 1.9 vs. control: 3.0 \u00b1 1.5, p = 0.809), worst pain intensity (MORA Cure LBP: 5.00 \u00b1 2.18 vs. control: 4.27 \u00b1 1.83, p = 0.247), and functional disability (ODI, MORA Cure LBP: 15.6 \u00b1 9.6 vs. control: 15.6 \u00b1 10.0, p &gt; 0.999). Compliance was significantly higher in the MORA Cure LBP group during the first 4 weeks (MORA Cure LBP: 74.7% \u00b1 27.4 vs. control: 53.1% \u00b1 28.6, p &lt; 0.001). Conclusions: Both multidisciplinary digital therapeutics (MORA Cure LBP) and conventional treatments were effective in reducing pain and functional disability in patients with CLBP, with no significant differences between the two groups. Digital therapeutics, particularly those that integrate CBT and exercise, offer promising alternatives to conventional therapies by improving accessibility and potentially enhancing patient engagement.<\/jats:p>","DOI":"10.3390\/jcm13237377","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T06:38:25Z","timestamp":1733294305000},"page":"7377","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multidisciplinary Digital Therapeutics for Chronic Low Back Pain Versus In-Person Therapeutic Exercise with Education: A Randomized Controlled Pilot Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-0150","authenticated-orcid":false,"given":"Dong-Ho","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea"},{"name":"Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5619-4818","authenticated-orcid":false,"given":"Jae Hyeon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Hanyang University College of Medicine, Guri-si 11923, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan","family":"Yoon","sequence":"additional","affiliation":[{"name":"EverEx, Seoul 06641, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2120-1111","authenticated-orcid":false,"given":"Chi-Hyun","family":"Choi","sequence":"additional","affiliation":[{"name":"EverEx, Seoul 06641, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghee","family":"Lee","sequence":"additional","affiliation":[{"name":"EverEx, Seoul 06641, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3783-7691","authenticated-orcid":false,"given":"Tae Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"EverEx, Seoul 06641, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-687X","authenticated-orcid":false,"given":"Sam Yeol","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"},{"name":"Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Ho","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Hanyang University College of Medicine, Guri-si 11923, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S169","DOI":"10.1007\/s00586-006-1071-2","article-title":"European guidelines for the management of acute nonspecific low back pain in primary care","volume":"15","author":"Becker","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_2","first-page":"1874","article-title":"Non-specific low back pain","volume":"379","author":"Kuijer","year":"2012","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","article-title":"What low back pain is and why we need to pay attention","volume":"391","author":"Hartvigsen","year":"2018","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1016\/S0140-6736(18)30489-6","article-title":"Prevention and treatment of low back pain: Evidence, challenges, and promising directions","volume":"391","author":"Foster","year":"2018","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Abbafati","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Costa, L.D.M., Henschke, N., Maher, C.G., Refshauge, K.M., Herbert, D.R., McAuley, J.H., Das, A., and Costa, L.O.P. (2007). Prognosis of chronic low back pain: Design of an inception cohort study. BMC Musculoskelet. Disord., 8.","DOI":"10.1186\/1471-2474-8-11"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.jclinepi.2008.09.004","article-title":"Systematic reviews of low back pain prognosis had variable methods and results: Guidance for future prognosis reviews","volume":"62","author":"Hayden","year":"2009","journal-title":"J. Clin. Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"968","DOI":"10.31616\/asj.2021.0371","article-title":"An updated overview of low back pain management","volume":"16","author":"Hong","year":"2022","journal-title":"Asian Spine J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/papr.13093","article-title":"Burden of chronic low back pain: Association with pain severity and prescription medication use in five large European countries","volume":"22","author":"Perrot","year":"2022","journal-title":"Pain Pract."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Baroncini, A., Maffulli, N., Sch\u00e4fer, L., Manocchio, N., Bossa, M., Foti, C., Klimuch, A., and Migliorini, F. (2024). Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: A level I Bayesian network meta-analysis. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-62276-9"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s00586-010-1541-4","article-title":"A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain","volume":"20","author":"Kuijpers","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/j.spinee.2020.04.006","article-title":"Guideline summary review: An evidence -based clinical guideline for the diagnosis and treatment of low back pain","volume":"20","author":"Kreiner","year":"2020","journal-title":"Spine J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1136\/bjsports-2017-097810","article-title":"NICE low back pain guidelines: Opportunities and obstacles to change practice","volume":"51","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"669","DOI":"10.2147\/JPR.S71536","article-title":"A long-term, open-label safety study of single-entity hydrocodone bitartrate extended release for the treatment of moderate to severe chronic pain","volume":"7","author":"Nalamachu","year":"2014","journal-title":"J. Pain Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3233\/BMR-2009-0234","article-title":"Efficacy of two multimodal treatments on physical strength of occupationally subgrouped male with low back pain","volume":"22","author":"Kumar","year":"2009","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.pain.2006.12.008","article-title":"Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial","volume":"131","author":"Ferreira","year":"2007","journal-title":"Pain"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s10067-007-0815-7","article-title":"Comparison of three different approaches in the treatment of chronic low back pain","volume":"27","author":"Atay","year":"2008","journal-title":"Clin. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1097\/01.brs.0000222043.09835.72","article-title":"Traction for low back pain with or without sciatica: An updated systematic review within the framework of the Cochrane Collaboration","volume":"31","author":"Clarke","year":"2006","journal-title":"Spine"},{"key":"ref_20","first-page":"24","article-title":"Psychological interventions for chronic, non-specific low back pain: Systematic review with network meta-analysis","volume":"376","author":"Ho","year":"2022","journal-title":"Br. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The Oswestry disability index","volume":"25","author":"Fairbank","year":"2000","journal-title":"Spine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3109\/07853890109002087","article-title":"EQ-5D: A measure of health status from the EuroQol Group","volume":"33","author":"Rabin","year":"2001","journal-title":"Ann. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.jpain.2017.05.003","article-title":"Development and validation of a daily pain catastrophizing scale","volume":"18","author":"Darnall","year":"2017","journal-title":"J. Pain"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/0304-3959(93)90127-B","article-title":"A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability","volume":"52","author":"Waddell","year":"1993","journal-title":"Pain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jbmt.2017.07.005","article-title":"The prone bridge test: Performance, validity, and reliability among older and younger adults","volume":"22","author":"Bohannon","year":"2018","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_27","first-page":"153","article-title":"Determinants of single limb stance balance performance","volume":"26","author":"Balogun","year":"1997","journal-title":"Afr. J. Med. Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/s41746-019-0109-x","article-title":"App-based multidisciplinary back pain treatment versus combined physiotherapy plus online education: A randomized controlled trial","volume":"2","author":"Toelle","year":"2019","journal-title":"npj Digit. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e56580","DOI":"10.2196\/56580","article-title":"The physical and psychological effects of telerehabilitation-based exercise for patients with nonspecific low back pain: Prospective randomized controlled trial","volume":"12","author":"Shi","year":"2024","journal-title":"JMIR mHealth uHealth"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41746-018-0076-7","article-title":"Randomized controlled trial of a 12-week digital care program in improving low back pain","volume":"2","author":"Shebib","year":"2019","journal-title":"npj Digit. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1002\/ejp.2080","article-title":"The selfBACK artificial intelligence-based smartphone app can improve low back pain outcome even in patients with high levels of depression or stress","volume":"27","author":"Rughani","year":"2023","journal-title":"Eur. J. Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2862","DOI":"10.1007\/s00586-018-5788-5","article-title":"Smartphone app in self-management of chronic low back pain: A randomized controlled trial","volume":"27","author":"Chhabra","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1177\/0269215520937757","article-title":"Efficacy of an innovative smartphone application for office workers with chronic non-specific low back pain: A pilot randomized controlled trial","volume":"34","author":"Almhdawi","year":"2020","journal-title":"Clin. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1111\/j.1526-4637.2010.00879.x","article-title":"painACTION-back pain: A self-management Website for people with chronic back pain","volume":"11","author":"Chiauzzi","year":"2010","journal-title":"Pain Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4632946","DOI":"10.1155\/2019\/4632946","article-title":"Smartphone-based remote self-management of chronic low back pain: A preliminary study","volume":"2019","author":"Yang","year":"2019","journal-title":"J. Healthc. Eng."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e18729","DOI":"10.2196\/18729","article-title":"Usability and acceptability of an app (SELFBACK) to support self-management of low back pain: Mixed methods study","volume":"7","author":"Nordstoga","year":"2020","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e29171","DOI":"10.2196\/29171","article-title":"An educational and exercise mobile phone-based intervention to elicit electrophysiological changes and to improve psychological functioning in adults with nonspecific chronic low back pain (BackFit app): Nonrandomized clinical trial","volume":"10","author":"Sitges","year":"2022","journal-title":"JMIR mHealth uHealth"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Vad, V.B., Madrazo-Ibarra, A., Estrin, D., Pollak, J.P., Carroll, K.M., Vojta, D., Vad, A., and Trapness, C. (2022). Back Rx, a personalized mobile phone application for discogenic chronic low back pain: A prospective pilot study. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05883-9"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e26658","DOI":"10.2196\/26658","article-title":"App-based feedback for rehabilitation exercise correction in patients with knee or hip osteoarthritis: Prospective cohort study","volume":"23","author":"Biebl","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e2320400","DOI":"10.1001\/jamanetworkopen.2023.20400","article-title":"Effect of an Artificial Intelligence-Based Self-Management App on musculoskeletal Health in Patients with Neck and\/or Low Back Pain Referred to Specialist Care: A Randomized Clinical Trial","volume":"6","author":"Marcuzzi","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1060","DOI":"10.1002\/hsr2.1060","article-title":"Impact of an AI app-based exercise program for people with low back pain compared to standard care: A longitudinal cohort-study","volume":"6","author":"Hartmann","year":"2023","journal-title":"Health Sci. Rep."},{"key":"ref_42","first-page":"23","article-title":"Pain outcomes with an elliptical regimen (POWER) study: Identifying the proper dosage of exercise for therapeutic effect in persons with chronic back pain","volume":"2","author":"Dillingham","year":"2020","journal-title":"J. Phys. Med. Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e32251","DOI":"10.2196\/32251","article-title":"Effects on adherence to a mobile app-based self-management digital therapeutics among patients with coronary heart disease: Pilot randomized controlled trial","volume":"10","author":"Li","year":"2022","journal-title":"JMIR mHealth uHealth"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Areias, A.C., Costa, F., Janela, D., Molinos, M., Moulder, R.G., Lains, J., Scheer, J.K., Bento, V., Yanamadala, V., and Correia, F.D. (2022). Long-term clinical outcomes of a remote digital musculoskeletal program: An ad hoc analysis from a longitudinal study with a non-participant comparison group. Healthcare, 10.","DOI":"10.3390\/healthcare10122349"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7377\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:46:22Z","timestamp":1760114782000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,4]]},"references-count":44,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13237377"],"URL":"https:\/\/doi.org\/10.3390\/jcm13237377","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,4]]}}}