The impact of algorithm-driven exposure to disease-related short videos on rehabilitation outcomes in lumbar disc herniation patients: content heterogeneity and psychological mediating mechanisms

BackgroundShort 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.ObjectiveThis 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.MethodsA 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.ResultsAt 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 ΔJOA (r = –0.36, r = –0.33; both P < 0.001) and positively correlated with ΔMCQ-HA (r = 0.31, r = 0.34; both P < 0.001). Multiple linear regression indicated that ΔJOA 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 ΔJOA and positively associated with ΔMCQ-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 (χ2 = 18.75, P = 0.004). Bootstrap mediation analysis confirmed that ΔMCQ-HA mediated 16.13% of the total effect of daily viewing duration on ΔJOA and 20.80% of the total effect of awareness-motivation content exposure frequency on ΔJOA.ConclusionProlonged 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.