Chronic Pain Clinical Trial
Official title:
Community-dwelling Older Adults Living With Chronic Musculoskeletal Pain: The Effect of an Evidence-based Intervention on Pain, Function, Health and Behaviour
The aim for the study is to examined the effect of an individually tailored integrated
behavioral medicine in physiotherapy intervention including functional exercise, for older
adults, having chronic musculoskeletal pain, living alone and dependent on formal care.
The study is a pragmatic randomized controlled trial with one intervention group and one
control group. The intervention is a 12-weeks home-based program. The intervention consists
of an individually tailored intervention and aims to enhance ability to perform everyday
activities by improving physical function and reduce pain-related beliefs and pain-related
disability. The comparison group achieves general advice about physical activity. All
participants will be tested at baseline, a post-assessment at 12 week and a three month
follow-up. Primary outcome is pain interference by the Brief Pain Inventory and physical
function by Short Physical Performance Battery.
Secondary outcomes measures if the goal setting is reached, self-efficacy in relation to the
goal setting, pain catastrophizing, level of physical Activity, falls efficacy and Health
related quality of life.
Intervention group
The base for the intervention is to identify a problematic everyday activity and identify
factors, including physical, psychological and environmental factors, that can inhibit and/or
promote the ability to perform the activity. The exercise that will improve the physical
factors will be based on functional exercise such as Balance training and muscle strength
training, e.g. fast walking in circle, marching on the spot with a high knee lift, leg lifts,
power walking and stair walking, squats, lunge, turning trunk and head while standing, and
walking over obstacles. Number of exercises and the dosage are based on how much the
participant are able to do and want to do and will increase progressively considering the
changes in function and health status of the participants. The content of the visits is as
follow:
Session: Identification of a problematic everyday activity and advice about physical
activity.
Session 2: Doing functional behavioural analyse including goal setting, discuss performance
dosage of training.
Session 3-5: Training in the basic physical and psychological skills relevant to goal
setting.
Session 6-9: Training to apply basic skills adequately for the goal setting, application of
basic and applied skills to other behaviours, starting with subsequent activity goals.
Discussion about how the participant can be able to maintain their new behaviour.
Discussion of problem-solving strategies, how he/she can prevent and address new activity
problems that may arise related to the goal setting and in relation to being physically
active.
During the intervention period will the participant receive visits by a physiotherapist
during intervention weeks 1-8 and 12. Under week 10 will the participants receive one
telephone call for support.
Non-intervention Group
The comparison group will receive standard care which means that the participants get one
visit from physiotherapist which consist of written and oral information about general advice
regarding physical Activity..Further will the comparison group receive telephone Calls to
remind them of being physically active according to the advice during week 1-8 and week 10.
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