Innovative mHealth for addressing low back pain-related factors amongst lower-limb amputees: A quasi-experimental

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Muh Syaiful Akbar, Muhammad Syafar, Yahya Thamrin, Djohan Aras, Indar Indar, Muhammad Arsyad

2026 African Journal of Disability Vol. 15 Article Cited by 0

Abstract

Background: Lower-limb amputees (LLAs) are highly susceptible to low back pain (LBP) because of postural instability and core muscle weakness, leading to reduced quality of life (QoL). Tailored mobile health (mHealth) interventions may offer a scalable strategy to support functional improvement. Objectives: This study aimed to evaluate the preliminary impact of mHealth applications on QoL and to identify behavioural and physical parameters observed on LLAs. Method: A quasi-experimental one-group pre-test–post-test longitudinal study was conducted with 22 unilateral LLAs (transtibial or transfemoral). Nineteen participants used a prosthesis, while three participants used a wheelchair. Participants engaged with a structured 3-month intervention delivered through an mHealth application. The programme consists of: (1) educational modules; (2) core-strengthening exercises; (3) automated reminders; and (4) hybrid delivery. Quality of Life was assessed using the WHOQOL-BREF, variables examined in the bivariate analyses and changes in outcomes were analysed using Wilcoxon signed-rank tests. Results: The Wilcoxon signed-rank tests showed significant improvements in positive attitude (p = 0.007) and good core muscle strength (p = 0.020), both with large effect sizes. Descriptive analysis indicated significant overall changes in QoL. Bivariate analyses suggested that positive attitude and good core muscle strength were associated with higher QoL. Conclusion: The use of the mHealth application was associated with improvements in QoL, and positive behavioural and physical changes among LLAs. Contribution: This research contributes to disability rehabilitation in Southeast Asia by introducing an mHealth approach that may improve functional improvement among LLAs. © 2026. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/).

Affiliations

Faculty of Public Health, Hasanuddin University, Makassar, Indonesia; Department of Biology, Faculty of Mathematics and Natural Sciences, Makassar State University, Makassar, Indonesia; Department of Health Promotion and Behavioural Science, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia; Department of Occupational Safety and Health, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia; Department of Physiotherapy, Faculty of Nursing, Hasanuddin University, Makassar, Indonesia; Department of Hospital Management, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia