Magdalena Binder

Spondyloarthropathies (SpA) are characterized by low back pain and limited mobility. Therefore, physical activity (PA) is an essential part of the treatment, yielding positive effects on clinical symptoms. Digital health applications (DHAs) present new opportunities to promote clinical outcomes, however, their long-term effectiveness is often limited by low adherence and high dropout rates.This study investigates whether integrating personalized or AI-driven coaching enhances the therapeutic benefits of DHA in patients with SpA. SpAs patients were randomized into one of 3 groups. They were instructed to exercise at least 2–3 times per week for 6 months with the DHA according to their group (intervention groups: ViViRA (with personal coaching) or Kaia Health (with AI-based coaching); control group: ViViRA (without coaching)). Personal coaching consisted of a one-time, 30-min online coaching session prior to using DHA, while the AI coaching consisted of video-based AI integrated into DHA to provide movement guidance during each session. At baseline, after 3 and 6 months sociodemographic, questionnaires and mobility were assessed. Data from 78 participants were analyzed (mean age 51 years; 68% female). All three digital interventions showed a significant improvement in mobility (Bath Ankylosing Spondylitis Metrology Index (BASM), range: 0–10, lower scores = better mobility; BL-3 month: mean BASMI change − 0.6 to − 0.7; all p < 0.001). Pain intensity decreased substantially in all arms (PainDETECT, neuropathic pain, range: 0–38, higher scores = more severe pain; BL-6 month: mean reduction − 4.6 to − 6.6 points; all p ≤ 0.006). PAHCO (Physical Activity-related Health Competence) control competence increased over time and reached statistical significance only in the ViViRA + coaching group (PAHCO: higher scores = better physical activity-related health competence; BL-6 month: + 1.02, p = 0.013) but did not exceed the other interventions in a direct comparison. Overall, none of the coaching strategies showed significant superiority over the stand-alone digital therapy. Adherence was the same in all groups after 3 months (2–3 weekly use of DHA). Digital movement therapy with the use of DHA improves mobility and pain independently of coaching in SpAs patients. In contrast, personal coaching has been shown to improve health-related skills which could indicate potential benefits for self-management and long-term treatment adherence. Trial registration The study is registered in the German clinical trial registry (DRKS) under the following ID: DRKS00035191, https://www.drks.de/search/de/trial/DRKS00035191/details, Registration date: 01.10.2024.

Digital health interventions hold promise for improving self-management in chronic inflammatory diseases such as rheumatoid arthritis (RA). The Fimo Health App was developed to support patients with RA using a multidimensional approach combining educational modules, symptom tracking, and mind–body exercises. This pilot feasibility study aimed to evaluate the usability, adherence, and potential clinical benefit of a prototype version of the app in patients with RA. A further objective was to explore patient subgroups that may particularly gain from the intervention. In a single-arm pilot trial, 31 patients with RA used the app over 12 weeks. Usability was assessed via the System Usability Scale (SUS). Primary clinical outcomes were patient-reported quality of life (SF-36 mental and SF-36 physical = Short-Form 36 Questionnaire), fatigue (FACIT-F), and pain (Visual Rating Scale Pain = VRS Pain), Secondary outcomes included functional impairment (HAQ = Health Assessment Questionnaire), global assessment, fear of motion (TSK = Tampa Scale of Kinesiophobia) and physical activity related-health competency (PAHCO). Subgroup analyses were conducted post hoc based on clinical characteristics. Usability was high (SUS = 74.4) and engagement with core app features strong (97% any use; 70% exercise completion). Across the full cohort (n = 31), changes in the primary outcomes were small overall. Physical quality of life (SF-36) showed a within-person median increase at 6 months (Hodges–Lehmann Δ = + 5.3; r = 0.50), while fatigue (FACIT-F) and pain (VRS) exhibited only small, non-significant numerical improvements (Δ ≈ + 1 to + 4; r ≈ 0.1–0.2). Mental quality of life (SF-36 mental) remained largely stable. In the subgroup of recently diagnosed patients (≤ 2 years; n = 12), trends were more pronounced. Physical quality of life (SF-36 physical) improved consistently at 3 and 6 months (Δ = + 1.3 to + 8.7; r = 0.67–0.85), accompanied by small favorable shifts in fatigue (Δ ≈ –1.5 to + 2; r ≈ 0.2–0.3). Mental quality of life again (SF-36 mental) remained stable over time. The Fimo Health App is a usable and well-accepted digital intervention for patients with RA. Early diagnosed Patients showed signals of potential benefit.. These findings support the value of targeted digital tools early in the RA disease trajectory. Trial Registration number : DRKS00035194, registration date: 01.10.2024, https://drks.de/register/de/trial/DRKS00035194/preview .