A randomised controlled feasibility study of TRAK musculoskeletal digital self-management physiotherapy intervention for individuals with musculoskeletal pain (TRAK-MSK)

End of project summary:

Three health boards in Wales took part in this feasibility trial of the TRAK MSK intervention. The three health boards represented rural and urban areas, a range of ethnic groups and socio-economic status.

TRAK MSK treatment was found to be feasible to deliver but to make sure enough patients are recruited and followed up in a full trial, it is recommended that all potential participants are seen in person first, to make sure the TRAK MSK treatment is right for them. This was supported by interviews with patient participants and physiotherapists.

Patients and physiotherapists indicated that they found the intervention acceptable and that it had a place in future ways of working.

Physiotherapists found the self-management training helpful as evidenced by them using this approach in other areas of their work. However, this was not embedded in their practice for all patients to benefit.

Patients reported TRAK MSK worked best if people were willing to be treated online, self-confident about exercise and had basic IT skills.  Some expressed concerns around feelings of anxiety and loneliness when treated online. They reported more satisfaction with TRAK MSK when physiotherapists took a collaborative approach.

After 16 weeks of treatment changes in patient reported pain, physical activity, confidence in managing pain and health related quality of life favoured the TRAK MSK intervention.

For the usual care arm more physiotherapy appointments were reported, which doubled the physiotherapy costs.

A full trial to assess clinical and cost benefit of TRAK MSK is recommended alongside strategies to make sure TRAK MSK can be fully integrated into practice and scaled up to give people with joint pain greatest opportunity to benefit.