Study overview
Musculoskeletal pain is common among Veterans, yet access to timely, evidence-based care can be difficult. Barriers such as rural residence, transportation, social isolation, and limited access to physical or occupational therapy can make it harder for Veterans to receive conservative care when they need it. The study notes that although musculoskeletal pain affects many Veterans, only a minority receive physical or occupational therapy care.
This pilot study, conducted in collaboration with Team Red, White & Blue, evaluated a fully remote multimodal digital care program for Veterans with musculoskeletal pain in the spine, upper limbs, or lower limbs. The program combined personalized exercise, education, cognitive behavioral therapy, real-time biofeedback, and remote monitoring by a physical therapist.
Of 75 eligible Veterans, 61 started the program and 50 completed it, representing an 82% completion rate. The study evaluated feasibility, clinical outcomes, engagement, satisfaction, and whether outcomes differed by deployment experience.
Key findings
Veterans reported reduced pain
Pain significantly improved by the end of the program, with an average reduction of 1.98 points on the Numerical Pain Rating Scale. The authors noted that this change was clinically meaningful and statistically significant.
Mental health symptoms improved among Veterans with baseline distress
Many Veterans entered the program with symptoms of anxiety or depression. Among participants with at least mild mental distress, anxiety and depression scores improved by the end of the program. Participants with at least moderate baseline depression ended the program with scores in the mild range.
Daily activity impairment decreased
Veterans also reported improved ability to perform daily activities. Among those with activity impairment, the study found a 13.33-point reduction in daily activity impairment by the end of the program.
Engagement and satisfaction were high
The program had an 82% completion rate, and Veterans completed an average of 22.3 exercise sessions. Satisfaction was also high, with an average score of 9.5 out of 10.
Outcomes were similar for deployed and non-deployed Veterans
The study found that Veterans with and without deployment experience had similar engagement and recovery patterns, with no significant differences in clinical outcome changes between groups.
No intervention-related adverse events were reported
The study reported no adverse events related to the digital care program.
Why this study matters
This study adds an important Veteran-focused access and equity lens to Sword’s clinical research library.
Veterans experience a high burden of musculoskeletal pain, often alongside mental health symptoms and access barriers that can make timely rehabilitation harder to obtain. This pilot study suggests that a fully remote, multimodal digital care program can support engagement, satisfaction, pain reduction, mental health improvement, and daily function in this population.
The study is also meaningful because it evaluates care in a real-world community setting through Team Red, White & Blue, rather than only in a traditional clinical system. That makes it relevant to organizations looking for scalable ways to expand access to evidence-based musculoskeletal care for populations that may face logistical, geographic, or behavioral barriers.
This study should be understood as a single-arm pilot study, not a randomized comparison against conventional care. Still, it provides promising evidence that remote digital rehabilitation can help improve access to clinically guided MSK care for Veterans.
About the author
Fabiola Costa
Senior Director of Clinical Research, Sword Health
