Background Short videos have become a primary channel for Lumbar Disc Herniation (LDH) patients to obtain disease knowledge and rehabilitation guidance. Algorithm-driven personalized recommendations may expose patients to heterogeneous LDH-related content, affecting their health anxiety and rehabilitation trajectories. Objective This study explored the impacts of LDH-related short video exposure duration and content types on health anxiety and lumbar functional rehabilitation in LDH patients, and verified the mediating role of health anxiety. Methods A 6-month prospective cohort study enrolled 213 LDH outpatients from Luoyang Orthopedic-Traumatological Hospital (Jan–Apr 2025). Demographic, clinical and short video usage data were collected. Health anxiety (MCQ-HA) and lumbar function (JOA) were assessed at baseline and follow-up. Pearson correlation, multiple linear regression, subgroup analysis and Bootstrap mediation analysis (5,000 resamplings) were used. Results At 6-month follow-up, the mean JOA score decreased from 23.00 ± 1.59 at baseline to 21.96 ± 3.03, and the mean MCQ-HA score increased from 20.77 ± 4.57–21.86 ± 6.14. Pearson correlation analysis showed that daily viewing duration and exposure frequency to awareness-motivation content were significantly negatively correlated with Δ JOA ( r = –0.36, r = –0.33; both P 0.001) and positively correlated with Δ MCQ-HA ( r = 0.31, r = 0.34; both P 0.001). Multiple linear regression indicated that Δ JOA in the 60 min daily viewing group was significantly lower than that in the 30 min group; exposure frequency to awareness-motivation content was independently negatively associated with Δ JOA and positively associated with Δ MCQ-HA (both P 0.001), with no significant associations found for other content categories (all P 0.05). Subgroup analysis based on clinical efficacy criteria revealed significant differences in recovery outcomes across viewing duration groups ( χ 2 = 18.75, P = 0.004). Bootstrap mediation analysis confirmed that Δ MCQ-HA mediated 16.13% of the total effect of daily viewing duration on Δ JOA and 20.80% of the total effect of awareness-motivation content exposure frequency on Δ JOA. Conclusion Prolonged short video exposure and frequent awareness-motivation content viewing were associated with poorer rehabilitation and higher health anxiety, with health anxiety partially mediating these relationships, providing empirical evidence for digital health guidance.
Tong et al. (Mon,) studied this question.