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Ruiz Romero MV, Lobato Parra E, Porrúa Del Saz A, Martínez Monrobé MB, Pereira Delgado CM, Gómez Hernández MB. [Management of chronic non-oncologic pain by multicomponent programs using non-pharmacologic therapies: A systematic review of the literature]. J Healthc Qual Res 2024; 39:168-187. [PMID: 38556371 DOI: 10.1016/j.jhqr.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 04/02/2024]
Abstract
Chronic pain is a public health problem suffered by 20% of the world's population. Pharmacological approaches are insufficient, so a multi-therapeutic approach that also includes non-pharmacological therapies (psychological therapies, meditation, physical exercise, healthy habits, etc.) is proposed. The aim of this review was to review the existing scientific evidence on the effect of multicomponent programs with non-pharmacological therapies in people with chronic non-oncologic pain. To this end, a search for scientific articles was carried out in three databases (PubMed, Web of Science and PsycINFO) and 17 articles were selected, following the PRISMA recommendations. The patients who participated in these programs were mostly women, aged 18 to 80years, working or on sick leave due to pain, with secondary education or less and married. The most frequent pain was musculoskeletal, mainly low back pain. All the articles studied the effectiveness of two or more therapies, highlighting psychological therapies, physical exercise and education. Positive results were obtained in the reduction of different variables such as pain, pain catastrophizing, anxiety and depression, in addition to improving functionality and quality of life. It has also been shown that patients' prior expectations regarding the intervention influence its effectiveness. Although throughout the review there was great heterogeneity in the interventions, in the evaluation methods and in the results themselves, it can be concluded that multicomponent programs show positive results in the management of chronic pain, and should therefore be incorporated as a routine therapeutic treatment.
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Affiliation(s)
- M V Ruiz Romero
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España; Universidad Internacional de Valencia, Valencia, España
| | - E Lobato Parra
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
| | - A Porrúa Del Saz
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
| | - M B Martínez Monrobé
- Unidad de Psicología, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
| | - C M Pereira Delgado
- Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
| | - M B Gómez Hernández
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
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Ruiz Romer MV, Porrúa Del Saz A, Gómez Hernández MB, Lobato Parra E, Soler Jiménez A, Pereira Delgado C. [Impact of a multicomponent program with nonpharmacological therapies for patients with chronic pain]. J Healthc Qual Res 2024; 39:109-119. [PMID: 38402091 DOI: 10.1016/j.jhqr.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION 25.9% of Spanish people suffer from chronic pain. An integrated, interdisciplinary approach is recommended, with pharmacological and non-pharmacological therapies, involving patients in their self-care. OBJECTIVE To evaluate the effectiveness and impact on resources of a program with non-pharmacological therapies in the control of non-oncological chronic pain in the short and medium term. MATERIAL AND METHODS Quasi-experimental before-after study, follow-up 3-6 months, measuring: pain, well-being, quality of life, self-esteem, resilience, anxiety/depression (validated scales); patient-reported outcomes of workshop impact on pain management, habits and mood; ED and office visits; drug consumption and employment status. RESULTS One hundred and forty-two patients completed the program; 131 (92.3%) were women, age: 56.0. Decreased: pain (scale 0-10) (start: 6.0; end of workshop: 4.0; 3 months: 5.0); anxiety (12.9; 10.4; 8.8) and depression (12.3; 7.23; 6.47) (scales 0-21). They increased: well-being (scale 0-10) (4.0; 6.0; 4.0); quality of life (scale 0-1) (0.418; 0.580; 0.536); health status (scale 0-100) (47.5; 60.0; 60.0); self-esteem (scale 9-36) (24.1; 27.5; 26.7); resilience (scale 6-30) (14.8; 17.4; 18.6). Patient-reported outcomes were performed by 136 patients at the end of the workshop and 79 at 3 months: pain decreased (end of program: 104, 76.5%; 3 months: 66, 83.5%); medication decreased (96, 76.2%; 60, 78.9%); habits improved (112, 88.2%; 69, 90.8%). Forty patients (37.4%) reduced visits to the emergency room, 40 (37.4%) reduced scheduled visits. Overall satisfaction: 9.8 out of 10. CONCLUSIONS Patients learn to mitigate their pain, participate in their self-care and improve their quality of life, self-esteem and emotional state. The effects remained for 3-6 months.
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Affiliation(s)
- M V Ruiz Romer
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - A Porrúa Del Saz
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - M B Gómez Hernández
- Fisioterapia. Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España.
| | - E Lobato Parra
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - A Soler Jiménez
- Especialista interno residente de Cirugía Traumatológica y Ortopédica, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - C Pereira Delgado
- Unidad de Medicina Interna, Servicio de Medicina, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
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Wasedar V, Pangam B, Shete S, Belaval V. Complete resolution of lumbar disc sequestration with Ayurveda management: A case report. J Ayurveda Integr Med 2023; 14:100826. [PMID: 38006747 PMCID: PMC10785238 DOI: 10.1016/j.jaim.2023.100826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/27/2023] Open
Abstract
Lumbar disc herniation (LDH) is the most common spinal disorder among which disc sequestration is a severe type where the herniated disc fragment migrates and is completely separated from the parent disc. A 46-year-old female patient with severe lower back pain radiating to right lower limb, disability, and numbness in the affected extremity came to Panchakarma O.P.D of our hospital. She was a chronic case of disc sequestration where her symptoms were severely aggravated after a sudden jolt felt on her lower back while traveling on a motorcycle. The patient's Oswestry disability index (ODI) score was 90 % which indicates a bed-bound condition and even Schobar's test indicated a severe reduction in lumbar flexion capability. MRI showed postero-central herniation with disc sequestration at L5-S1 caused compression on the subarachnoid space and traversing S1 nerve roots. She was treated according to Ayurveda treatment principles and underwent Panchakarma like medicated enema (Basti) and fomentation of a lumbosacral region with oil (Kati Basti). She also received different oral medications on successive follow-ups. After 6 months of Ayurveda treatment, the patient showed remission in lower back pain (LBP), radiculopathy, and numbness. Her ODI score was reduced to 6 %. The MRI repeated post-treatment showed complete interval resolution of disc sequestration and no neurological compression was observed.
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Affiliation(s)
- Vishwanath Wasedar
- Department of Panchakarma, KLE Academy of Higher Education & Research (KAHER) Shri.B. M. kankanwadi Ayurveda College and Research Centre, Shahapur, Belagavi, Karnataka, 590003, India.
| | - Bhagyesh Pangam
- Department of Panchakarma, KLE Academy of Higher Education & Research (KAHER) Shri.B. M. kankanwadi Ayurveda College and Research Centre, Shahapur, Belagavi, Karnataka, 590003, India; Heal Hub Ayurveda & Panchakarma Hospital, Miraj, Maharashtra, 416 410, India
| | - Sarang Shete
- Department of Orthopaedics, KLE Academy of Higher Education & Research (KAHER) Jawaharlal Nehru Medical College, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Vinay Belaval
- Belcity Scan and Diagnostic Centre, Ayodhya Nagar, Belagavi, 590016, Karnataka, India
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Bise CG, Cupler Z, Mathers S, Turner R, Sundaram M, Catelani MB, Dahler S, Popchak A, Schneider M. Face-to-face telehealth interventions in the treatment of low back pain: A systematic review. Complement Ther Clin Pract 2023; 50:101671. [PMID: 36379145 PMCID: PMC9613794 DOI: 10.1016/j.ctcp.2022.101671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Christopher G Bise
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA; UPMC Health Plan - Department of Health Economics, USA.
| | - Zachary Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, USA
| | - Sean Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Rose Turner
- Department of Medicine, Health Science Library System, University of Pittsburgh, USA
| | - Meenakshi Sundaram
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Maria Beatriz Catelani
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Sarah Dahler
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Adam Popchak
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
| | - Michael Schneider
- School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA
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Hohberg V, Fuchs R, Gerber M, Künzler D, Paganini S, Faude O. Blended Care Interventions to Promote Physical Activity: A Systematic Review of Randomized Controlled Trials. SPORTS MEDICINE - OPEN 2022; 8:100. [PMID: 35907158 PMCID: PMC9339043 DOI: 10.1186/s40798-022-00489-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 07/17/2022] [Indexed: 11/22/2022]
Abstract
Background Blended care interventions combine therapeutic guidance with digital care. Current research results show the promising role of the blended care approach in clinical care. This new way of delivering health care could have the potential to effectively promote physical activity in different public health settings. Objective The aim of the systematic review is to investigate the varieties of intervention characteristics of blended care interventions to promote physical activity in terms of structure, behavior change goals, behavior change techniques, and effectiveness of blended care interventions compared to a control group. Methods We searched for randomized controlled trials published from 2000 to March 2021 in MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycINFO, and Web of Science according to the PRISMA guidelines. Risk of bias was assessed using the Cochrane Collaboration tool. Study characteristics, intervention characteristics, and outcome data were extracted. Furthermore, the effect size on the outcome of physical activity was examined or calculated. Results In total, the number of reports identified from the database searches was 4828. Of these, 25 studies were included in the review, with a total of 5923 study participants. Results indicated that the characteristics of blended care interventions showed a high heterogeneity. The combinations of therapist-guided interventions and digital interventions allowed the identification of specific subgroups, but they varied in length (range 8–52 weeks, SD 16.6), intensity, and the combination of the components. The most used combination of blended care interventions to promote physical activity was the combination of one-on-one meetings via telephone and Web-based interventions. Motivational models of behavior change were used most frequently as underlying theoretical foundations. Certain behavior change techniques were used consistently across the individual components, e.g., “problem solving” in the therapist-guided component and “feedback on behavior” in the digital component. Considering the effect size of blended care interventions compared with control groups, most studies showed a small effect. Conclusions It can be concluded that blended care interventions have potential to promote physical activity. In the future, further high-quality studies should investigate which type of blended care intervention is effective for which target group. Additionally, insights are required on which intervention characteristics are most effective, taking into account new evidence on behavior change. Registration This systematic literature review was registered in PROSPERO (CRD42020188556). Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00489-w.
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Adding Physical Activity Coaching and an Activity Monitor Was No More Effective Than Adding an Attention Control Intervention to Group Exercise for Patients With Chronic Nonspecific Low Back Pain (PAyBACK Trial): A Randomized Trial. J Orthop Sports Phys Ther 2022; 52:287-299. [PMID: 35536245 DOI: 10.2519/jospt.2022.10874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether adding physical activity coaching and an activity monitor enhanced the effects of a group exercise program on pain intensity and disability for people with chronic nonspecific low back pain. DESIGN Randomized controlled trial with concealed allocation, intention-to-treat analysis, and blinding of participants and assessors. METHODS One hundred sixty participants with chronic nonspecific low back pain who were aged between 18 and 60 years and seeking care at an outpatient physiotherapy clinic participated. Both groups received supervised group exercise therapy. The intervention group also received physical activity coaching sessions aimed at improving physical activity, and physical activity electronic feedback delivered by an activity monitor. The attention control group received modified approaches of coaching sessions and an activity monitor. Disability was measured using the Roland Morris Disability Questionnaire (0-24), and pain intensity was measured using the 11-point Numerical Rating Scale (0-10). Linear mixed models were performed to test for differences between groups. RESULTS There were no differences between groups for reductions in disability (mean difference [MD] = -0.5 out of 24 points; 95% confidence interval [CI]: -2.2, 1.1) and pain intensity (MD = -0.4 out of 10 points; 95% CI: -1.3, 0.5) at 3-month follow-up. There were no between-groups differences at 6- and 12-month follow-up assessments. CONCLUSION Adding targeted physical activity coaching and an activity monitor did not reduce pain intensity or disability more than an attention control approach in participants with chronic low back pain who were undertaking a group exercise program. J Orthop Sports Phys Ther 2022;52(5):287-299. doi:10.2519/jospt.2022.10874.
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Ho EKY, Chen L, Simic M, Ashton-James CE, Comachio J, Wang DXM, Hayden JA, Ferreira ML, Ferreira PH. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ 2022; 376:e067718. [PMID: 35354560 PMCID: PMC8965745 DOI: 10.1136/bmj-2021-067718] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine the comparative effectiveness and safety of psychological interventions for chronic low back pain. DESIGN Systematic review with network meta-analysis. DATA SOURCES Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, and CINAHL from database inception to 31 January 2021. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomised controlled trials comparing psychological interventions with any comparison intervention in adults with chronic, non-specific low back pain. Two reviewers independently screened studies, extracted data, and assessed risk of bias and confidence in the evidence. Primary outcomes were physical function and pain intensity. A random effects network meta-analysis using a frequentist approach was performed at post-intervention (from the end of treatment to <2 months post-intervention); and at short term (≥2 to <6 months post-intervention), mid-term (≥6 to <12 months post-intervention), and long term follow-up (≥12 months post-intervention). Physiotherapy care was the reference comparison intervention. The design-by-treatment interaction model was used to assess global inconsistency and the Bucher method was used to assess local inconsistency. RESULTS 97 randomised controlled trials involving 13 136 participants and 17 treatment nodes were included. Inconsistency was detected at short term and mid-term follow-up for physical function, and short term follow-up for pain intensity, and were resolved through sensitivity analyses. For physical function, cognitive behavioural therapy (standardised mean difference 1.01, 95% confidence interval 0.58 to 1.44), and pain education (0.62, 0.08 to 1.17), delivered with physiotherapy care, resulted in clinically important improvements at post-intervention (moderate quality evidence). The most sustainable effects of treatment for improving physical function were reported with pain education delivered with physiotherapy care, at least until mid-term follow-up (0.63, 0.25 to 1.00; low quality evidence). No studies investigated the long term effectiveness of pain education delivered with physiotherapy care. For pain intensity, behavioural therapy (1.08, 0.22 to 1.94), cognitive behavioural therapy (0.92, 0.43 to 1.42), and pain education (0.91, 0.37 to 1.45), delivered with physiotherapy care, resulted in clinically important effects at post-intervention (low to moderate quality evidence). Only behavioural therapy delivered with physiotherapy care maintained clinically important effects on reducing pain intensity until mid-term follow-up (1.01, 0.41 to 1.60; high quality evidence). CONCLUSIONS For people with chronic, non-specific low back pain, psychological interventions are most effective when delivered in conjunction with physiotherapy care (mainly structured exercise). Pain education programmes (low to moderate quality evidence) and behavioural therapy (low to high quality evidence) result in the most sustainable effects of treatment; however, uncertainty remains as to their long term effectiveness. Although inconsistency was detected, potential sources were identified and resolved. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019138074.
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Affiliation(s)
- Emma Kwan-Yee Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Lingxiao Chen
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Milena Simic
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Claire Elizabeth Ashton-James
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Pain Management Research Institute, Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - Josielli Comachio
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Daniel Xin Mo Wang
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jill Alison Hayden
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Manuela Loureiro Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Paulo Henrique Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Fanning J, Brooks AK, Hsieh KL, Kershner K, Furlipa J, Nicklas BJ, Rejeski WJ. Building on Lessons Learned in a Mobile Intervention to Reduce Pain and Improve Health (MORPH): Protocol for the MORPH-II Trial. JMIR Res Protoc 2021; 10:e29013. [PMID: 34279241 PMCID: PMC8329761 DOI: 10.2196/29013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Engaging in sufficient levels of physical activity, guarding against sustained sitting, and maintaining a healthy body weight represent important lifestyle strategies for managing older adults' chronic pain. Our first Mobile Health Intervention to Reduce Pain and Improve Health (MORPH) randomized pilot study demonstrated that a partially remote group-mediated diet and daylong activity intervention (ie, a focus on moving often throughout the day) can lead to improved physical function, weight loss, less pain intensity, and fewer minutes of sedentary time. We also identified unique delivery challenges that limited the program's scalability and potential efficacy. OBJECTIVE The purpose of the MORPH-II randomized pilot study is to refine the MORPH intervention package based on feedback from MORPH and evaluate the feasibility, acceptability, and preliminary efficacy of this revised package prior to conducting a larger clinical trial. METHODS The MORPH-II study is an iteration on MORPH designed to pilot a refined framework, enhance scalability through fully remote delivery, and increase uptake of the daylong movement protocol through revised education content and additional personalized remote coaching. Older, obese, and low-active adults with chronic multisite pain (n=30) will be randomly assigned to receive a 12-week remote group-mediated physical activity and dietary weight loss intervention followed by a 12-week maintenance period or a control condition. Those in the intervention condition will partake in weekly social cognitive theory-based group meetings via teleconference software plus one-on-one support calls on a tapered schedule. They will also engage with a tablet application paired with a wearable activity monitor and smart scale designed to provide ongoing social and behavioral support throughout the week. Those in the control group will receive only the self-monitoring tools. RESULTS Recruitment is ongoing as of January 2021. CONCLUSIONS Findings from MORPH-II will help guide other researchers working to intervene on sedentary behavior through frequent movement in older adults with chronic pain. TRIAL REGISTRATION ClinicalTrials.gov NCT04655001; https://clinicaltrials.gov/ct2/show/NCT04655001. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/29013.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Amber K Brooks
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | | | - Kyle Kershner
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Joy Furlipa
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | | | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
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Petkovic J, Duench S, Trawin J, Dewidar O, Pardo Pardo J, Simeon R, DesMeules M, Gagnon D, Hatcher Roberts J, Hossain A, Pottie K, Rader T, Tugwell P, Yoganathan M, Presseau J, Welch V. Behavioural interventions delivered through interactive social media for health behaviour change, health outcomes, and health equity in the adult population. Cochrane Database Syst Rev 2021; 5:CD012932. [PMID: 34057201 PMCID: PMC8406980 DOI: 10.1002/14651858.cd012932.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Social networking platforms offer a wide reach for public health interventions allowing communication with broad audiences using tools that are generally free and straightforward to use and may be combined with other components, such as public health policies. We define interactive social media as activities, practices, or behaviours among communities of people who have gathered online to interactively share information, knowledge, and opinions. OBJECTIVES We aimed to assess the effectiveness of interactive social media interventions, in which adults are able to communicate directly with each other, on changing health behaviours, body functions, psychological health, well-being, and adverse effects. Our secondary objective was to assess the effects of these interventions on the health of populations who experience health inequity as defined by PROGRESS-Plus. We assessed whether there is evidence about PROGRESS-Plus populations being included in studies and whether results are analysed across any of these characteristics. SEARCH METHODS We searched CENTRAL, CINAHL, Embase, MEDLINE (including trial registries) and PsycINFO. We used Google, Web of Science, and relevant web sites to identify additional studies and searched reference lists of included studies. We searched for published and unpublished studies from 2001 until June 1, 2020. We did not limit results by language. SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled before-and-after (CBAs) and interrupted time series studies (ITSs). We included studies in which the intervention website, app, or social media platform described a goal of changing a health behaviour, or included a behaviour change technique. The social media intervention had to be delivered to adults via a commonly-used social media platform or one that mimicked a commonly-used platform. We included studies comparing an interactive social media intervention alone or as a component of a multi-component intervention with either a non-interactive social media control or an active but less-interactive social media comparator (e.g. a moderated versus an unmoderated discussion group). Our main outcomes were health behaviours (e.g. physical activity), body function outcomes (e.g. blood glucose), psychological health outcomes (e.g. depression), well-being, and adverse events. Our secondary outcomes were process outcomes important for behaviour change and included knowledge, attitudes, intention and motivation, perceived susceptibility, self-efficacy, and social support. DATA COLLECTION AND ANALYSIS We used a pre-tested data extraction form and collected data independently, in duplicate. Because we aimed to assess broad outcomes, we extracted only one outcome per main and secondary outcome categories prioritised by those that were the primary outcome as reported by the study authors, used in a sample size calculation, and patient-important. MAIN RESULTS We included 88 studies (871,378 participants), of which 84 were RCTs, three were CBAs and one was an ITS. The majority of the studies were conducted in the USA (54%). In total, 86% were conducted in high-income countries and the remaining 14% in upper middle-income countries. The most commonly used social media platform was Facebook (39%) with few studies utilising other platforms such as WeChat, Twitter, WhatsApp, and Google Hangouts. Many studies (48%) used web-based communities or apps that mimic functions of these well-known social media platforms. We compared studies assessing interactive social media interventions with non-interactive social media interventions, which included paper-based or in-person interventions or no intervention. We only reported the RCT results in our 'Summary of findings' table. We found a range of effects on health behaviours, such as breastfeeding, condom use, diet quality, medication adherence, medical screening and testing, physical activity, tobacco use, and vaccination. For example, these interventions may increase physical activity and medical screening tests but there was little to no effect for other health behaviours, such as improved diet or reduced tobacco use (20,139 participants in 54 RCTs). For body function outcomes, interactive social media interventions may result in small but important positive effects, such as a small but important positive effect on weight loss and a small but important reduction in resting heart rate (4521 participants in 30 RCTs). Interactive social media may improve overall well-being (standardised mean difference (SMD) 0.46, 95% confidence interval (CI) 0.14 to 0.79, moderate effect, low-certainty evidence) demonstrated by an increase of 3.77 points on a general well-being scale (from 1.15 to 6.48 points higher) where scores range from 14 to 70 (3792 participants in 16 studies). We found no difference in effect on psychological outcomes (depression and distress) representing a difference of 0.1 points on a standard scale in which scores range from 0 to 63 points (SMD -0.01, 95% CI -0.14 to 0.12, low-certainty evidence, 2070 participants in 12 RCTs). We also compared studies assessing interactive social media interventions with those with an active but less interactive social media control (11 studies). Four RCTs (1523 participants) that reported on physical activity found an improvement demonstrated by an increase of 28 minutes of moderate-to-vigorous physical activity per week (from 10 to 47 minutes more, SMD 0.35, 95% CI 0.12 to 0.59, small effect, very low-certainty evidence). Two studies found little to no difference in well-being for those in the intervention and control groups (SMD 0.02, 95% CI -0.08 to 0.13, small effect, low-certainty evidence), demonstrated by a mean change of 0.4 points on a scale with a range of 0 to 100. Adverse events related to the social media component of the interventions, such as privacy issues, were not reported in any of our included studies. We were unable to conduct planned subgroup analyses related to health equity as only four studies reported relevant data. AUTHORS' CONCLUSIONS This review combined data for a variety of outcomes and found that social media interventions that aim to increase physical activity may be effective and social media interventions may improve well-being. While we assessed many other outcomes, there were too few studies to compare or, where there were studies, the evidence was uncertain. None of our included studies reported adverse effects related to the social media component of the intervention. Future studies should assess adverse events related to the interactive social media component and should report on population characteristics to increase our understanding of the potential effect of these interventions on reducing health inequities.
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Affiliation(s)
| | | | | | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Jordi Pardo Pardo
- Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | - Rosiane Simeon
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Marie DesMeules
- Social Determinants and Science Integration/ Direction des déterminants sociaux et de l'intégration scientifique, Public Health Agency of Canada/Agence de santé publique du Canada, Ottawa, Canada
| | - Diane Gagnon
- Department of Communication, University of Ottawa, Ottawa, Canada
| | | | - Alomgir Hossain
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kevin Pottie
- Family Medicine, University of Ottawa, Ottawa, Canada
| | - Tamara Rader
- Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
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10
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Mechanical detection and pain thresholds: comparability of devices using stepped and ramped stimuli. Pain Rep 2020; 5:e865. [PMID: 33294759 PMCID: PMC7717770 DOI: 10.1097/pr9.0000000000000865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
Nylon monofilaments may substitute for German Research Network on Neuropathic Pain standards in tactile but not pinprick testing. Ramped stimuli are faster but underestimate thresholds due to reaction time artefacts. Quantitative sensory testing is used to assess somatosensory function in humans. The protocol of the German Research Network on Neuropathic Pain (DFNS) provides comprehensive normative values using defined tools; however, some of these may not be feasible in low-resource settings.
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11
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Simeon R, Dewidar O, Trawin J, Duench S, Manson H, Pardo Pardo J, Petkovic J, Hatcher Roberts J, Tugwell P, Yoganathan M, Presseau J, Welch V. Behavior Change Techniques Included in Reports of Social Media Interventions for Promoting Health Behaviors in Adults: Content Analysis Within a Systematic Review. J Med Internet Res 2020; 22:e16002. [PMID: 32525482 PMCID: PMC7317628 DOI: 10.2196/16002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/26/2019] [Accepted: 03/22/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Social media are an increasingly commonly used platform for delivering health promotion interventions. Although recent research has focused on the effectiveness of social media interventions for health promotion, very little is known about the optimal content within such interventions, and the active ingredients to promote health behavior change using social media are not clear. Identifying which behavior change techniques (BCTs) are reported may help to clarify the content of interventions using a generalizable terminology that may facilitate future intervention development. OBJECTIVE This study aimed to identify which BCTs are reported in social media interventions for promoting health behavior change in adults. METHODS We included 71 studies conducted with adult participants (aged ≥18 years) and for which social media intervention was considered interactive in a Cochrane review of the effectiveness of such interventions. We developed a coding manual informed by the Behavior Change Technique Taxonomy version 1 (BCTTv1) to identify BCTs in the included studies. We identified BCTs in all study arms (including control) and described BCTs in the group and self-directed components of studies. We characterized the dose of delivery for each BCT by low and high intensity. We used descriptive analyses to characterize the reported BCTs. RESULTS Our data consisted of 71 studies published from 2001 to 2017, mainly conducted in high-income countries (n=65). Most studies (n=31) used tailored, interactive websites to deliver the intervention; Facebook was the most used mainstream platform. In developing our coding manual, we adapted some BCTTv1 instructions to better capture unique nuances of how BCTs were operationalized in social media with respect to likes, retweets, smiles, congratulations, and badges. Social support (unspecified), instruction on how to perform the behavior, and credible source were most frequently identified BCTs in intervention arms of studies and group-delivery settings, whereas instruction on how to perform the behavior was most commonly applied in self-directed components of studies, control arms, and individual participant settings. Instruction on how to perform the behavior was also the most frequently reported BCT in both intervention and control arms simultaneously. Instruction on how to perform the behavior, social support (unspecified), self-monitoring of behavior, information about health consequences, and credible source were identified in the top 5 BCTs delivered with the highest intensity. CONCLUSIONS This study within a review provides a detailed description of the BCTs and their dose to promote behavior change in web-based, interactive social media interventions. Clarifying active ingredients in social media interventions and the intensity of their delivery may help to develop future interventions that can more clearly build upon the existing evidence.
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Affiliation(s)
- Rosiane Simeon
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Omar Dewidar
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jessica Trawin
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Stephanie Duench
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Heather Manson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jordi Pardo Pardo
- Cochrane Musculoskeletal Group, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jennifer Petkovic
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Janet Hatcher Roberts
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Peter Tugwell
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, ON, Canada
| | | | - Justin Presseau
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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12
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Barbari V, Storari L, Ciuro A, Testa M. Effectiveness of communicative and educative strategies in chronic low back pain patients: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:908-929. [PMID: 31839351 DOI: 10.1016/j.pec.2019.11.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 11/12/2019] [Accepted: 11/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the effectiveness of communicative and educative strategies on 1) patient's low back pain awareness/knowledge, 2) maladaptive behavior modification and 3) compliance with exercise in patients with chronic low back pain. METHODS A systematic review was conducted. Searches were performed on 13 databases. Only randomized controlled trials enrolling patients ≥ 18 years of age were included. Risk of bias was assessed with the Cochrane Collaboration's tool and interrater agreement between authors for full-texts selection was evaluated with Cohen's Kappa. No meta-analysis was performed and qualitative analysis was conducted. RESULTS 24 randomized controlled trials which intervention included communicative and educative strategies were selected. Most of the studies were judged as low risk of bias and Cohen's Kappa was excellent ( = 0.822). Interventions addressed were cognitive behavioral therapy as unique treatment or combined with other treatments (multimodal interventions), coaching, mindfulness, pain science education, self-management, graded activity and graded exposure. CONCLUSIONS, PRACTICE IMPLICATION Patient's low back pain awareness/knowledge is still a grey area of literature. Pain science education, graded exposure and multimodal interventions are the most effective for behavior modification and compliance with exercise with benefits also in the long-term, while self-management, graded activity and coaching provide only short-term or no benefits.
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Affiliation(s)
- Valerio Barbari
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy; Studio Fisioterapico - Dott. Valerio Barbari, Rimini, Italy
| | - Lorenzo Storari
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy; Centro Retrain, Verona, Italy
| | - Aldo Ciuro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy; Madonna delle Grazie Hospital, Matera, Italy
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy.
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13
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Dejonghe LAL, Rudolf K, Becker J, Stassen G, Froboese I, Schaller A. Health coaching for promoting physical activity in low back pain patients: a secondary analysis on the usage and acceptance. BMC Sports Sci Med Rehabil 2020; 12:2. [PMID: 32025308 PMCID: PMC6996177 DOI: 10.1186/s13102-019-0154-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 12/22/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Multicomponent interventions combined with health coaching are widely recommended to improve a healthy lifestyle. The aim of the present study was to analyse the usage and acceptance of a multicomponent intervention (telephone, web and face-to-face coaching) for low back pain patients, and thereby gain an understanding of why this intervention was not as effective as expected. METHODS A secondary analysis of a randomised controlled trial, aimed at promoting physical activity, was conducted. It was a cross-sectional study based on data of a multicomponent intervention group (baseline = 201 participants). For evaluating the usage and acceptance, descriptive statistics were applied. RESULTS Over half (n = 118) of the patients participated at least once in the telephone coaching. Approximately half of the participants (44 of 90) rated the telephone coaching as "good".34 of 92 (37%) participants reported of visiting the web-platform. The web-platform was comprehensible for nearly one-quarter (n = 8 of 33) and very useful for one participant.The face-to-face-contact was rated highly (range: 79.4-88.2 out of 100). CONCLUSION Usage of the telephone coaching approach was moderate with even fewer participants visiting the web-platform. In addition, these approaches were not rated as very useful. The acceptance of the face-to-face contact was high.Since the usage and acceptance could influence the effectiveness, utilisation and acceptance studies might help to explain the reason for non-effective lifestyle interventions. Therefore, more studies analysing the usage and acceptance are needed. To improve the usage and acceptance, a stronger participatory orientation in the design of interventions and the integration of face-to-face contact could be helpful.
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Affiliation(s)
- Lea Anna Lisa Dejonghe
- Institute of Movement Therapy and Movement-Orientated Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Kevin Rudolf
- Institute of Movement Therapy and Movement-Orientated Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Jennifer Becker
- Department of Community Health, University of Applied Sciences, Gesundheitscampus 6-8, 44801 Bochum, Germany
| | - Gerrit Stassen
- Institute of Movement Therapy and Movement-Orientated Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
- Working Group Physical Activity-Related Prevention Research, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Ingo Froboese
- Institute of Movement Therapy and Movement-Orientated Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
- Center for Health through Sport and Movement, German Sport University, Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Andrea Schaller
- Institute of Movement Therapy and Movement-Orientated Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
- Working Group Physical Activity-Related Prevention Research, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
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14
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Morelhão PK, Franco MR, Oliveira CB, Hisamatsu TM, Ferreira PH, Costa LOP, Maher CG, Pinto RZ. Physical activity and disability measures in chronic non-specific low back pain: a study of responsiveness. Clin Rehabil 2018; 32:1684-1695. [DOI: 10.1177/0269215518787015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To compare the responsiveness of disability measures with physical activity measures in patients with chronic low back pain (CLBP) undergoing a course of physical therapy treatment. Design: This is a prospective cohort study with two-month follow-up. Subjects: A total of 106 patients presenting with non-specific CLBP of more than three months duration were recruited. Main measures: Disability measures investigated were Quebec Back Pain Disability Scale and Roland Morris Disability Questionnaire. Physical activity measures analyzed include the Baecke Habitual Physical Activity Questionnaire and objective measures derived from an accelerometer (i.e. total time spent in moderate-to-vigorous and light physical activity, number of steps and counts per minute). Disability and physical activity measures were collected at the baseline and after eight weeks of treatment. For the responsiveness analyses, effect size (ES) and standardized response mean (SRM) were calculated. Correlations between the change in disability and physical activity measures were calculated. Results: Responsiveness for disability measures was considered to be large with ESs ranging from −1.03 to −1.45 and SRMs ranging from −0.99 to −1.34, whereas all physical activity measures showed values lower than 0.20. Changes in disability measures did not correlate with changes in physical activity measures (correlation coefficients ranged from −0.10 to 0.09). Conclusion: Disability measures were responsive after a course of physical therapy treatment in patients with CLBP. The lack of responsiveness in the physical activity measures might be due to the inability of these measures to detect change over time or the use of an intervention not designed to increase physical activity levels.
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Affiliation(s)
- Priscila K Morelhão
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Márcia R Franco
- Department of Physical Therapy, Centro Universitário UNA, Contagem, Brazil
| | - Crystian B Oliveira
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Thalysi M Hisamatsu
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Paulo H Ferreira
- Discipline of Physiotherapy, Faculty of Health Science, The University of Sydney, Sydney, Australia
| | - Leonardo OP Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Chris G Maher
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Rafael Zambelli Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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15
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Schaller A, Petrowski K, Pfoertner TK, Froboese I. Effectiveness of a theory-based multicomponent intervention (Movement Coaching) on the promotion of total and domain-specific physical activity: a randomised controlled trial in low back pain patients. BMC Musculoskelet Disord 2017; 18:431. [PMID: 29110703 PMCID: PMC5674836 DOI: 10.1186/s12891-017-1788-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/25/2017] [Indexed: 11/22/2022] Open
Abstract
Background The promotion of physical activity is a major field in rehabilitation and health promotion but evidence is lacking on what method or strategy works best. Ensuing from this research gap, the present study compared the effectiveness of a comprehensive theory based multicomponent intervention (Movement Coaching) to a low intensity intervention in low back pain patients. Methods A monocenter randomized controlled trial with three measuring points (T0 = baseline, T1 = six month follow-up, T2 = twelve month follow-up) was conducted. N = 412 chronic low back pain patients participated. The Movement Coaching group (n = 201) received a comprehensive multicomponent intervention with small-group intervention, phone- and web 2.0-intervention. The low intensity control (n = 211) received two oral presentations that were available for download afterwards. Main outcome was total physical activity measured by Global Physical Activity Questionnaire at 12 month follow-up. Additionally, workplace, leisure time and transportation activities were compared. A split-plot anova was conducted for evaluating repeated measure effects and between group effects. Results At six and twelve month follow-up there were no statistically significant between group differences in total (T1: p = 0.79; T2: p = 0.30) as well as domain-specific physical activity (workplace (T1: p = 0.16; T2: p = 0.65), leisure time (T1: p = 0.54; T2: p = 0.89), transportation (T1: p = 0.29; T2: p = 0.77) between Movement Coaching and the control group. In both groups, workplace physical activity showed the highest proportion of total physical activity. From baseline to twelve month follow-up the results showed a decline in total physical activity (Movement Coaching: p = 0.04; control group: p = 0.50). Conclusions The comprehensive Movement Coaching intervention was not found to be more effective than a low intensity intervention in promoting total and domain-specific physical activity in chronic low back pain patients. Trial registration This study is registered at German Clinical Trials Register (DRKS)-ID: DRKS00004878.
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Affiliation(s)
- Andrea Schaller
- IST-Hochschule University of Applied Sciences, Erkrather Str. 220 a-c, 40233, Düsseldorf, Germany. .,Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
| | - Katja Petrowski
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Timo-Kolja Pfoertner
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, 50933, Cologne, Germany
| | - Ingo Froboese
- Center for Health through Sport and Movement, German Sport University Cologne, 50933, Cologne, Germany
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16
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Barriers to Physical Activity in Low Back Pain Patients following Rehabilitation: A Secondary Analysis of a Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6925079. [PMID: 29209630 PMCID: PMC5676355 DOI: 10.1155/2017/6925079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 12/02/2022]
Abstract
Background Promoting health-enhancing physical activity following rehabilitation is a well-known challenge. This study analysed the barriers to leisure time activity among low back pain patients. Methods A subset of 192 low back pain patients who participated in a randomized controlled trial promoting physical activity was analysed. Physical activity, barriers, and sociodemographic and indication-related variables were assessed by a questionnaire. Differences in barriers between active and inactive participants were tested by Pearson's chi squared test. A logistic regression model was fitted to identify influencing factors on physical activity at six months following rehabilitation. Results Inactive and active participants differed significantly in nine of the 19 barriers assessed. The adjusted regression model showed associations of level of education (OR = 5.366 [1.563; 18.425]; p value = 0.008) and fear of pain (OR = 0.612 [0.421; 0.889]; p value = 0.010) with physical activity. The barriers included in the model failed to show any statistically significant association after adjustment for sociodemographic factors. Conclusions Low back pain patients especially with a low level of education and fear of pain seem to need tailored support in overcoming barriers to physical activity. This study is registered at German Clinical Trials Register (DRKS00004878).
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