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Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial.
BMC Musculoskelet Disord. 2019 Feb 11; 20(1):71.BM

Abstract

BACKGROUND

Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking. Our aim was to investigate the feasibility and preliminary efficacy of a patient-centred physical activity intervention, supported by health coaching and mobile health, to reduce care-seeking, pain and disability in patients with chronic low back pain after treatment discharge.

METHODS

We conducted a pilot randomised controlled trial with blinded outcome assessment. Sixty-eight participants were recruited from four public outpatient physiotherapy departments and the general community in Sydney. The intervention group received a physical activity information booklet, plus one face-to-face and 12 telephone-based health coaching sessions. The intervention was supported by an internet-based application and an activity tracker (Fitbit). Control group (standard care) received the physical activity information booklet and advice to stay active. Feasibility measures included recruitment rate, intervention compliance, data completeness, and participant satisfaction. Primary outcomes were care-seeking, pain levels and activity limitation. Outcomes were assessed at baseline, 6-month follow-up and weekly for 6 months.

RESULTS

Ninety potential participants were invited over 15 months, with 68 agreeing to take part (75%). Overall, 903 weekly questionnaires were answered by participants from a total of 1107 sent (89%). Participants were largely satisfied with the intervention (mean = 8.7 out of 10 on satisfaction scale). Intervention group participants had a 38% reduced rate of care-seeking (Incidence Rate Ratio (IRR): 0.62, 95% CI: 0.32 to 1.18, p = 0.14, using multilevel mixed-effects Poisson regression analysis) compared to standard care, although none of the estimates was statistically significant. No between groups differences were found for pain levels or activity limitation.

CONCLUSION

The health coaching physical activity approach trialed here is feasible and well accepted by participants and may reduce care-seeking in patients with low back pain after treatment discharge, although further evaluation with an adequately powered trial is needed.

TRIAL REGISTRATION

Australian and New Zealand Trial Registry ACTRN12615000189527 . Registered prospectively on 26-02-2015.

Authors+Show Affiliations

Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia. abar3926@uni.sydney.edu.au. Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 1825, Australia. abar3926@uni.sydney.edu.au.Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, Australia.Physiotherapy Department, Liverpool Hospital, South Western Sydney Local Health District, Sydney, Australia.School of Public Health, The University of Sydney, Sydney, Australia.Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil.Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark. Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30744606

Citation

Amorim, Anita B., et al. "Integrating Mobile-health, Health Coaching, and Physical Activity to Reduce the Burden of Chronic Low Back Pain Trial (IMPACT): a Pilot Randomised Controlled Trial." BMC Musculoskeletal Disorders, vol. 20, no. 1, 2019, p. 71.
Amorim AB, Pappas E, Simic M, et al. Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial. BMC Musculoskelet Disord. 2019;20(1):71.
Amorim, A. B., Pappas, E., Simic, M., Ferreira, M. L., Jennings, M., Tiedemann, A., Carvalho-E-Silva, A. P., Caputo, E., Kongsted, A., & Ferreira, P. H. (2019). Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial. BMC Musculoskeletal Disorders, 20(1), 71. https://doi.org/10.1186/s12891-019-2454-y
Amorim AB, et al. Integrating Mobile-health, Health Coaching, and Physical Activity to Reduce the Burden of Chronic Low Back Pain Trial (IMPACT): a Pilot Randomised Controlled Trial. BMC Musculoskelet Disord. 2019 Feb 11;20(1):71. PubMed PMID: 30744606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial. AU - Amorim,Anita B, AU - Pappas,Evangelos, AU - Simic,Milena, AU - Ferreira,Manuela L, AU - Jennings,Matthew, AU - Tiedemann,Anne, AU - Carvalho-E-Silva,Ana Paula, AU - Caputo,Eduardo, AU - Kongsted,Alice, AU - Ferreira,Paulo H, Y1 - 2019/02/11/ PY - 2018/07/07/received PY - 2019/02/04/accepted PY - 2019/2/13/entrez PY - 2019/2/13/pubmed PY - 2019/7/31/medline KW - Health coaching KW - Low back pain KW - Mobile health KW - Physical activity KW - Randomized controlled trial SP - 71 EP - 71 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 20 IS - 1 N2 - BACKGROUND: Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking. Our aim was to investigate the feasibility and preliminary efficacy of a patient-centred physical activity intervention, supported by health coaching and mobile health, to reduce care-seeking, pain and disability in patients with chronic low back pain after treatment discharge. METHODS: We conducted a pilot randomised controlled trial with blinded outcome assessment. Sixty-eight participants were recruited from four public outpatient physiotherapy departments and the general community in Sydney. The intervention group received a physical activity information booklet, plus one face-to-face and 12 telephone-based health coaching sessions. The intervention was supported by an internet-based application and an activity tracker (Fitbit). Control group (standard care) received the physical activity information booklet and advice to stay active. Feasibility measures included recruitment rate, intervention compliance, data completeness, and participant satisfaction. Primary outcomes were care-seeking, pain levels and activity limitation. Outcomes were assessed at baseline, 6-month follow-up and weekly for 6 months. RESULTS: Ninety potential participants were invited over 15 months, with 68 agreeing to take part (75%). Overall, 903 weekly questionnaires were answered by participants from a total of 1107 sent (89%). Participants were largely satisfied with the intervention (mean = 8.7 out of 10 on satisfaction scale). Intervention group participants had a 38% reduced rate of care-seeking (Incidence Rate Ratio (IRR): 0.62, 95% CI: 0.32 to 1.18, p = 0.14, using multilevel mixed-effects Poisson regression analysis) compared to standard care, although none of the estimates was statistically significant. No between groups differences were found for pain levels or activity limitation. CONCLUSION: The health coaching physical activity approach trialed here is feasible and well accepted by participants and may reduce care-seeking in patients with low back pain after treatment discharge, although further evaluation with an adequately powered trial is needed. TRIAL REGISTRATION: Australian and New Zealand Trial Registry ACTRN12615000189527 . Registered prospectively on 26-02-2015. SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/30744606/Integrating_Mobile_health_health_coaching_and_physical_activity_to_reduce_the_burden_of_chronic_low_back_pain_trial__IMPACT_:_a_pilot_randomised_controlled_trial_ L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2454-y DB - PRIME DP - Unbound Medicine ER -