Online Videos as a source of neck pain Physiotherapy Exercise for Patient education—A Quality Assessment (Preprint)
Authors: Zhang Xiang , Yang Yi , Shen Yi-Wei , Zhang Ke-Rui , Ma Li-Tai , Wang Bei-Yu , Ding Chen , Meng Yang , Liu Hao 
Published: May 2022

BACKGROUND

The increasing prevalence of neck pain poses a huge socioeconomic burden. Physiotherapy exercise plays a vital role in the management of neck pain; consequently, the current COVID-19 pandemic accompanying the lockdown has resulted in a shortage of physiotherapy care. YouTube, in particular, is a leading source due to its easy access to information and visual advantages for internet users. However, the nature of these videos is often unscientific, misleading, and even harmful.

OBJECTIVE

The study aimed to investigate the quality and reliability of neck pain physiotherapy exercise videos shared on YouTube and identified factors associated with the overall video quality and reliability.

METHODS

On 15 April 2022, a YouTube search was performed using the keywords “neck pain relief exercises”, “neck pain physiotherapy” and “neck pain rehabilitation”. Videos were categorized by 3 doctors based on whether the video content provided useful or misleading information. Furthermore, the reliability and quality of the videos were assessed using the Journal of the American Medical Association (JAMA) benchmark criteria, the 5-point DISCERN tool, and the 5-point global quality score criteria (GQS). Spearman correlation analysis was applied to assess the correlation between JAMA, GQS, DISCERN, and video power index (VPI). A multiple linear regression analysis was performed to identify video characteristics affecting the JAMA, GQS, DISCERN, and VPI.

RESULTS

Out of the 89 videos selected for the study, 38 (42.7%) were classified as useful, whereas 51 (57.3%) provided misleading information. A total of 36.0% of videos (32/89) were generated by nonphysicians compared to 12.4% of videos (11/89) contributed by academic sources. In the useful information group, the videos had a higher JAMA (P<.001), DISCERN (P=.004), and GQS scores (P<.001). The VPI was higher for the misleading information group (888.00 vs 575.67) but did not reach a level of statistical significance (P=.507). The uploading sources of the videos were mainly academic, physician, nonphysician, medical, commercial and individual. Statistical differences were found between the uploading source groups in terms of the JAMA, DISCERN, and GQS (P<.001). JAMA, DISCERN, and GQS scores significantly correlated with each other (JAMA score vs GQS, p<.001; JAMA score vs DISCERN, p<.001; DISCERN vs GQS, p<.001). A higher video quality or reliability score was associated with a higher probability of academic and physician (P<.001) uploading sources compared with individual sources. VPI was not significantly correlated with quality or reliability (P>.05). Even though the academic and physician group provide the highest percentage of useful information (7/11), a statistical difference was not noted between the useful and misleading video groups regarding the uploading sources (P=.144).

CONCLUSIONS

YouTube videos on neck pain physiotherapy exercises have low quality and reliability. Our findings suggest that academic and physician groups should provide and promote high-quality video content to YouTube users and patients.

CLINICALTRIAL

This study did not require a trial registration since it is not a clinical trial and only publicly available data were used.