Profiling of low back pain patients for the design of a tailored coaching application

Low back pain is a major public health problem that is the leading cause of disability in most countries. The recommendations are to propose personalized physical activity programs according to the individual characteristics (motivation, preferences, attitude towards physical activity) of each patient. However, the current management of low back pain includes rehabilitation programs that are costly and/or not always personalized. The objective of this research is to better understand the characteristics of people with chronic low back pain to identify typical profiles to inform the design of a tailored coaching mobile application. We selected eight concepts and associated scales to characterize the population: general health status (MYMOP), treatment burden (TBQ), quality of life (EQ-5D-5L), level (IPAQ), fears and beliefs (FABQ-AP) and motivation (EMAPS) for physical activity, emotional state (PHQ-9) and feeling of self-efficacy (FC-CPSES). These questionnaires were administered online via an e-cohort of low back pain patients. 193 patients with chronic low back pain were included. A clustering analysis allowed us to distinguish 4 profiles: (1) “Unmotivated,” characterized by the lowest motivation and the highest amotivation toward physical activity (i.e., they do not understand why it is useful), (2) “Cautious” with low motivation and having the highest fears and beliefs toward physical activity, (3) “Depressed” with good intrinsic motivation but also a significant level of depressive symptoms, and (4) “Confident” also showing good intrinsic motivation and having the highest self-efficacy. These four profiles of patients will be used to design a coaching mobile application tailored along the priorities (e.g., physical activity, pain management) and types of motivational messages displayed on the tailored mobile application.