TY  - JOUR
AU  - Kryger, Michael Alan
AU  - Crytzer, Theresa M
AU  - Fairman, Andrea
AU  - Quinby, Eleanor J
AU  - Karavolis, Meredith
AU  - Pramana, Gede
AU  - Setiawan, I Made Agus
AU  - McKernan, Gina Pugliano
AU  - Parmanto, Bambang
AU  - Dicianno, Brad E
PY  - 2019
DA  - 2019/08/28
TI  - The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial
JO  - J Med Internet Res
SP  - e14305
VL  - 21
IS  - 8
KW  - cellular phone
KW  - emergency departments
KW  - hospitalization
KW  - mobile applications
KW  - pressure ulcer
KW  - rehabilitation
KW  - self-care
KW  - spinal cord injury
KW  - telemedicine
KW  - urinary tract infections
AB  - Background: Individuals with spinal cord injury (SCI) are at risk for secondary medical complications, such as urinary tract infections (UTIs) and pressure injuries, that could potentially be mitigated through improved self-management techniques. The Interactive Mobile Health and Rehabilitation (iMHere) mobile health (mHealth) system was developed to support self-management for individuals with disabilities. Objective: The main objective of this study was to determine if the use of iMHere would be associated with improved health outcomes over a 9-month period. A secondary objective was to determine if the use of iMHere would be associated with improved psychosocial outcomes. Phone usage, app usage, and training time data were also collected to analyze trends in iMHere use. Methods: Overall, 38 participants with SCI were randomized into either the intervention group who used the iMHere system and received standard care or the control group who received standard care without any technology intervention. Health outcomes were recorded for the year before entry into the study and during the 9 months of the study. Participants completed surveys at baseline and every 3 months to measure psychosocial outcomes. Results: The intervention group had a statistically significant reduction in UTIs (0.47 events per person; P=.03; number needed to treat=2.11). Although no psychosocial outcomes changed significantly, there was a nonsignificant trend toward a reduction in mood symptoms in the intervention group compared with the control group meeting the threshold for clinical significance. Approximately 34 min per participant per month were needed on average to manage the system and provide technical support through this mHealth system. Conclusions: The use of the iMHere mHealth system may be a valuable tool in the prevention of UTIs or reductions in depressive symptoms. Given these findings, iMHere has potential scalability for larger populations. Trial Registration: ClinicalTrials.gov NCT02592291; https://clinicaltrials.gov/ct2/show/NCT02592291. 
SN  - 1438-8871
UR  - http://www.jmir.org/2019/8/e14305/
UR  - https://doi.org/10.2196/14305
UR  - http://www.ncbi.nlm.nih.gov/pubmed/31464189
DO  - 10.2196/14305
ID  - info:doi/10.2196/14305
ER  -