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Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Study protocol

Integrating Mobile health and Physical Activity to reduce the burden of Chronic low back pain Trial (IMPACT): a pilot trial protocol

Authors: Anita B. Amorim, Evangelos Pappas, Milena Simic, Manuela L. Ferreira, Anne Tiedemann, Matthew Jennings, Paulo H. Ferreira

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

It is well recognised that low back pain is a significant public health problem and engagement in moderate levels of physical activity is associated with positive outcomes.
Conservative active care, such as exercise, is effective in reducing pain and disability associated with chronic low back pain. However, a rapid decline in clinical outcomes is commonly seen after discharge from treatment.

Methods/Design

We will conduct a randomised controlled trial to investigate the effectiveness of a mobile health supported physical activity intervention (compared to standard care) in care-seeking, pain and disability in people with chronic low back pain after discharge from treatment. We will recruit 68 patients with chronic low back pain following discharge from an outpatient hospital program, who will be randomly allocated to the physical activity intervention (n = 34) or the standard care group (n = 34) and monitored for 6 months. The physical activity intervention will involve a physical activity advice booklet, a face-to-face health coaching session and 12 fortnightly follow-up telephone-based health coaching sessions. This intervention will be supported by provision of a specifically designed web app and a physical activity monitoring device (FitBit). The standard care group will receive the physical activity advice booklet only.

Discussion

This pilot trial will investigate a new model to prevent clinical decline in people following conservative treatment for chronic low back pain. If proven to be effective, this approach will constitute a major advance in the management of low back pain. Chronic patients who experience recurrent pain and disability after treatment are prone to seek additional care in the form of physiotherapy, medication, emergency department attendance, specialist consultation or spinal surgery. This model aims to maintain functional levels and reduce care-seeking empowering patients to self-manage their low back pain by offering them a contemporary patient-centred physical activity program with the support of mobile health technology. The outcomes of this trial will have immediate implications for clinical practice.

Trial registration

Literature
1.
go back to reference Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15 Suppl 2:S192–300.CrossRefPubMedPubMedCentral Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15 Suppl 2:S192–300.CrossRefPubMedPubMedCentral
2.
go back to reference Walker BF, Muller R, Grant WD. Low back pain in Australian adults: the economic burden. Asia Pac J Public Health. 2003;15(2):79–87.CrossRefPubMed Walker BF, Muller R, Grant WD. Low back pain in Australian adults: the economic burden. Asia Pac J Public Health. 2003;15(2):79–87.CrossRefPubMed
3.
go back to reference Suzman R, Beard J. Global Health and Aging. U.S. Department of Health and Human Services/World Health Organization. 2011; 11-7737. Suzman R, Beard J. Global Health and Aging. U.S. Department of Health and Human Services/World Health Organization. 2011; 11-7737.
4.
go back to reference Kongsted A, Kent P, Hestbaek L, Vach W. Patients with low back pain had distinct clinical course patterns that were typically neither complete recovery nor constant pain. A latent class analysis of longitudinal data. Spine J. 2015;15(5):885–94.CrossRefPubMed Kongsted A, Kent P, Hestbaek L, Vach W. Patients with low back pain had distinct clinical course patterns that were typically neither complete recovery nor constant pain. A latent class analysis of longitudinal data. Spine J. 2015;15(5):885–94.CrossRefPubMed
5.
go back to reference Dunn KM, Croft PR. Epidemiology and natural history of low back pain. Eura Medicophys. 2004;40(1):9–13.PubMed Dunn KM, Croft PR. Epidemiology and natural history of low back pain. Eura Medicophys. 2004;40(1):9–13.PubMed
6.
go back to reference Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain. 2007;131(1-2):31–7.CrossRefPubMed Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain. 2007;131(1-2):31–7.CrossRefPubMed
7.
go back to reference van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol. 2010;24(2):193–204.CrossRefPubMed van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol. 2010;24(2):193–204.CrossRefPubMed
8.
go back to reference Enthoven P, Skargren E, Oberg B. Clinical course in patients seeking primary care for back or neck pain: a prospective 5-year follow-up of outcome and health care consumption with subgroup analysis. Spine. 2004;29(21):2458–65.CrossRefPubMed Enthoven P, Skargren E, Oberg B. Clinical course in patients seeking primary care for back or neck pain: a prospective 5-year follow-up of outcome and health care consumption with subgroup analysis. Spine. 2004;29(21):2458–65.CrossRefPubMed
9.
go back to reference Pinto RZ, Ferreira PH, Kongsted A, Ferreira ML, Maher CG, Kent P. Self-reported moderate-to-vigorous leisure time physical activity predicts less pain and disability over 12 months in chronic and persistent low back pain. Eur J Pain. 2014;18(8):1190–8.CrossRefPubMed Pinto RZ, Ferreira PH, Kongsted A, Ferreira ML, Maher CG, Kent P. Self-reported moderate-to-vigorous leisure time physical activity predicts less pain and disability over 12 months in chronic and persistent low back pain. Eur J Pain. 2014;18(8):1190–8.CrossRefPubMed
10.
go back to reference Vuori IM. Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc. 2001;33(6 Suppl):S551–86. discussion 609-10.CrossRefPubMed Vuori IM. Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc. 2001;33(6 Suppl):S551–86. discussion 609-10.CrossRefPubMed
11.
go back to reference Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometers to increase physical activity and improve health: a systematic review. Jama. 2007;298(19):2296–304.CrossRefPubMed Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometers to increase physical activity and improve health: a systematic review. Jama. 2007;298(19):2296–304.CrossRefPubMed
12.
go back to reference Macedo LG, Bostick GP, Maher CG. Exercise for prevention of recurrences of nonspecific low back pain. Phys Ther. 2013;93(12):1587–91.CrossRefPubMed Macedo LG, Bostick GP, Maher CG. Exercise for prevention of recurrences of nonspecific low back pain. Phys Ther. 2013;93(12):1587–91.CrossRefPubMed
13.
go back to reference Mansi S, Milosavljevic S, Baxter GD, Tumilty S, Hendrick P. A systematic review of studies using pedometers as an intervention for musculoskeletal diseases. BMC Musculoskelet Disord. 2014;15:231.CrossRefPubMedPubMedCentral Mansi S, Milosavljevic S, Baxter GD, Tumilty S, Hendrick P. A systematic review of studies using pedometers as an intervention for musculoskeletal diseases. BMC Musculoskelet Disord. 2014;15:231.CrossRefPubMedPubMedCentral
14.
go back to reference McDonough SM, Tully MA, Boyd A, O'Connor SR, Kerr DP, O'Neill SM, et al. Pedometer-driven walking for chronic low back pain: a feasibility randomized controlled trial. Clin J Pain. 2013;29(11):972–81.CrossRefPubMedPubMedCentral McDonough SM, Tully MA, Boyd A, O'Connor SR, Kerr DP, O'Neill SM, et al. Pedometer-driven walking for chronic low back pain: a feasibility randomized controlled trial. Clin J Pain. 2013;29(11):972–81.CrossRefPubMedPubMedCentral
15.
go back to reference Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med. 2007;32(5):419–34.CrossRefPubMed Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med. 2007;32(5):419–34.CrossRefPubMed
16.
go back to reference Lichtenstein E, Glasgow RE, Lando HA, Ossip-Klein DJ, Boles SM. Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence. Health Educ Res. 1996;11(2):243–57.CrossRefPubMed Lichtenstein E, Glasgow RE, Lando HA, Ossip-Klein DJ, Boles SM. Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence. Health Educ Res. 1996;11(2):243–57.CrossRefPubMed
17.
go back to reference Allen KD, Oddone EZ, Coffman CJ, Datta SK, Juntilla KA, Lindquist JH, et al. Telephone-based self-management of osteoarthritis: A randomized trial. Ann Intern Med. 2010;153(9):570–9.CrossRefPubMed Allen KD, Oddone EZ, Coffman CJ, Datta SK, Juntilla KA, Lindquist JH, et al. Telephone-based self-management of osteoarthritis: A randomized trial. Ann Intern Med. 2010;153(9):570–9.CrossRefPubMed
18.
go back to reference Castro CM, King AC. Telephone-assisted counseling for physical activity. Exerc Sport Sci Rev. 2002;30(2):64–8.CrossRefPubMed Castro CM, King AC. Telephone-assisted counseling for physical activity. Exerc Sport Sci Rev. 2002;30(2):64–8.CrossRefPubMed
19.
go back to reference O'Hara BJ, Phongsavan P, Venugopal K, Eakin EG, Eggins D, Caterson H, et al. Effectiveness of Australia's Get Healthy Information and Coaching Service(R): translational research with population wide impact. Prev Med. 2012;55(4):292–8.CrossRefPubMed O'Hara BJ, Phongsavan P, Venugopal K, Eakin EG, Eggins D, Caterson H, et al. Effectiveness of Australia's Get Healthy Information and Coaching Service(R): translational research with population wide impact. Prev Med. 2012;55(4):292–8.CrossRefPubMed
20.
go back to reference Iles R, Taylor NF, Davidson M, O'Halloran P. Telephone coaching can increase activity levels for people with non-chronic low back pain: a randomised trial. J Physiother. 2011;57(4):231–8.CrossRefPubMed Iles R, Taylor NF, Davidson M, O'Halloran P. Telephone coaching can increase activity levels for people with non-chronic low back pain: a randomised trial. J Physiother. 2011;57(4):231–8.CrossRefPubMed
21.
go back to reference Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Journal of pharmacology & pharmacotherapeutics. 2010;1(2):100–7.CrossRef Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Journal of pharmacology & pharmacotherapeutics. 2010;1(2):100–7.CrossRef
22.
go back to reference Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRefPubMed Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRefPubMed
23.
go back to reference Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS. Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Rep. 2011;22(1):7–14.PubMed Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS. Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Rep. 2011;22(1):7–14.PubMed
24.
go back to reference Hagstromer M, Troiano RP, Sjostrom M, Berrigan D. Levels and patterns of objectively assessed physical activity--a comparison between Sweden and the United States. Am J Epidemiol. 2010;171(10):1055–64.CrossRefPubMed Hagstromer M, Troiano RP, Sjostrom M, Berrigan D. Levels and patterns of objectively assessed physical activity--a comparison between Sweden and the United States. Am J Epidemiol. 2010;171(10):1055–64.CrossRefPubMed
25.
go back to reference (WHO) WHO. Global recommendations on physical activity for health. Geneva: WHO Press; 2012. (WHO) WHO. Global recommendations on physical activity for health. Geneva: WHO Press; 2012.
27.
go back to reference Kiresuk TJ, Sherman RE. Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community Ment Health J. 1968;4(6):443–53.CrossRefPubMed Kiresuk TJ, Sherman RE. Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community Ment Health J. 1968;4(6):443–53.CrossRefPubMed
28.
go back to reference Von Korff M, Jensen MP, Karoly P. Assessing global pain severity by self-report in clinical and health services research. Spine. 2000;25(24):3140–51.CrossRef Von Korff M, Jensen MP, Karoly P. Assessing global pain severity by self-report in clinical and health services research. Spine. 2000;25(24):3140–51.CrossRef
29.
go back to reference Waddell G. The Back Pain Revolution. Edinburgh: Churchill Livingstone; 1998. Waddell G. The Back Pain Revolution. Edinburgh: Churchill Livingstone; 1998.
30.
go back to reference Costa LO, Maher CG, Latimer J, Ferreira PH, Ferreira ML, Pozzi GC, et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine. 2008;33(22):2459–63.CrossRefPubMed Costa LO, Maher CG, Latimer J, Ferreira PH, Ferreira ML, Pozzi GC, et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine. 2008;33(22):2459–63.CrossRefPubMed
31.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRefPubMed
32.
go back to reference Turner-Stokes PL. Goal Attainment Scaling (GAS) in Rehabilitation: A practical guide. Clin Rehabil. 2009;23(4):362–70.CrossRefPubMed Turner-Stokes PL. Goal Attainment Scaling (GAS) in Rehabilitation: A practical guide. Clin Rehabil. 2009;23(4):362–70.CrossRefPubMed
33.
go back to reference Hurn J, Kneebone I, Cropley M. Goal setting as an outcome measure: A systematic review. Clin Rehabil. 2006;20(9):756–72.CrossRefPubMed Hurn J, Kneebone I, Cropley M. Goal setting as an outcome measure: A systematic review. Clin Rehabil. 2006;20(9):756–72.CrossRefPubMed
34.
go back to reference Magalhaes MO, Franca FJ, Burke TN, Ramos LA, de Moura Campos Carvalho e Silva AP, Almeida GP, et al. Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial. BMC Musculoskelet Disord. 2013;14:36. Magalhaes MO, Franca FJ, Burke TN, Ramos LA, de Moura Campos Carvalho e Silva AP, Almeida GP, et al. Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial. BMC Musculoskelet Disord. 2013;14:36.
35.
go back to reference Farrar JT, Young Jr JP, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149–58.CrossRefPubMed Farrar JT, Young Jr JP, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149–58.CrossRefPubMed
36.
go back to reference Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33(1):90–4.CrossRefPubMed Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33(1):90–4.CrossRefPubMed
37.
go back to reference Schaller A, Froboese I. Movement coaching: study protocol of a randomized controlled trial evaluating effects on physical activity and participation in low back pain patients. BMC Musculoskelet Disord. 2014;15:391.CrossRefPubMedPubMedCentral Schaller A, Froboese I. Movement coaching: study protocol of a randomized controlled trial evaluating effects on physical activity and participation in low back pain patients. BMC Musculoskelet Disord. 2014;15:391.CrossRefPubMedPubMedCentral
38.
go back to reference Tiedemann A, Paul S, Ramsay E, O'Rourke SD, Chamberlain K, Kirkham C, et al. What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals?: Study protocol for a randomised controlled trial. BMC Public Health. 2015;15(1):477.CrossRefPubMedPubMedCentral Tiedemann A, Paul S, Ramsay E, O'Rourke SD, Chamberlain K, Kirkham C, et al. What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals?: Study protocol for a randomised controlled trial. BMC Public Health. 2015;15(1):477.CrossRefPubMedPubMedCentral
Metadata
Title
Integrating Mobile health and Physical Activity to reduce the burden of Chronic low back pain Trial (IMPACT): a pilot trial protocol
Authors
Anita B. Amorim
Evangelos Pappas
Milena Simic
Manuela L. Ferreira
Anne Tiedemann
Matthew Jennings
Paulo H. Ferreira
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0852-3

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