Combined Use of Digital and Analog Physical Therapy in Patients With Musculoskeletal Disorders and Indicators of Chronicity: German Claims Data Analysis
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...
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| Vydáno v: | JMIR mHealth and uHealth Ročník 13; s. e63935 |
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09.06.2025
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| Abstract | 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.
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.
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.
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).
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. |
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| AbstractList | 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.BackgroundMusculoskeletal 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.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.ObjectiveBased 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.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.MethodsThis 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.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).ResultsOf 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).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.ConclusionsThe 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. Abstract BackgroundMusculoskeletal 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. ObjectiveBased 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. MethodsThis 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. ResultsOf 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; PPPP ConclusionsThe 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. 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. 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. 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. 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. 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). 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. |
| Author | Schmitz, Annika Schneider, Udo Weltermann, Birgitta Kerkemeyer, Linda Frey, Silke |
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| Copyright | Silke Frey, Annika Schmitz, Udo Schneider, Linda Kerkemeyer, Birgitta Weltermann. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org). 2025. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © Silke Frey, Annika Schmitz, Udo Schneider, Linda Kerkemeyer, Birgitta Weltermann. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org) 2025 |
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| Keywords | chronicity exercise therapy digital health applications mHealth musculoskeletal disorders physical therapy utilization claims analysis digital health interventions DiGA |
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| License | Silke Frey, Annika Schmitz, Udo Schneider, Linda Kerkemeyer, Birgitta Weltermann. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included. |
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| Snippet | Musculoskeletal disorders are highly prevalent worldwide and contribute significantly to the overall burden of disease. Regular physical therapy with trained... Background:Musculoskeletal disorders are highly prevalent worldwide and contribute significantly to the overall burden of disease. Regular physical therapy... Abstract BackgroundMusculoskeletal disorders are highly prevalent worldwide and contribute significantly to the overall burden of disease. Regular physical... |
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| SubjectTerms | Adjustment Adult Aged Back pain Chronic Disease - therapy Cohort Studies Data analysis Data integrity Exercise Feedback Female Germany Humans Insurance Claim Review - statistics & numerical data Internet for Rehabilitation Knee Male Medical equipment mHealth for Rehabilitation mHealth in a Clinical Setting Middle Aged Musculoskeletal diseases Musculoskeletal Diseases - psychology Musculoskeletal Diseases - therapy Original Paper Patients Physical fitness Physical therapy Physical Therapy Modalities - instrumentation Physical Therapy Modalities - standards Physical Therapy Modalities - statistics & numerical data Prescribable Digital Interventions (Digital Therapeutics) Retrospective Studies Systematic review Technology in Physiotherapy Use and User Demographics of mHealth Web-based and Mobile Health Interventions |
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| Title | Combined Use of Digital and Analog Physical Therapy in Patients With Musculoskeletal Disorders and Indicators of Chronicity: German Claims Data Analysis |
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| Volume | 13 |
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