Non-specific Low Back Pain Clinical Trial
Official title:
Effect of an Educational Based Intervention on Danish Workers With Low Back Pain. A Randomized Controlled Single Blinded Study.
RCT study of the effect of an educational-based intervention on low back pain-related outcomes concerning beliefs and behaviour.
Previous studies have strongly implied that information is a valuable means for people
suffering from LBP in terms of coping appropriately. Most studies have tested the effect of
information as part of a multimodal intervention.
Four Nordic studies testing the effect of 'reassuring information' based on the 'Functional
Disturbance'-model (proposed by Indahl et al. 1999 - also called the 'non-injury'-model) have
all been effective at positively altering the functional level and/or days of sickness
absence - when provided in combination with other elements to people with subacute/chronic
back pain. The present study set out to test the effect of this kind of resassuring
information alone.
Between November 2012 and September 2013, we included app. 500 municipal workers perfoming
either manual work, administrative work or a combination of the two. Participants worked in 5
different municipal workplaces. These workplaces were characterized by being devided into
'natural working unit', which had no or very little daily contact. All 5 workplaces
participated with at least 2 units. Thus 11 units contributed to the data. Baseline
assessment took place during right upon recruitment prior to randomization.
We cluster-randomized the 11 units into an intervention and a control group using a simple
stepwise randomization-metod.
The intervention group received two 45-minute lectures at the workplace with an interval of 2
weeks. The lectures were coherent allthough different. They consisted of information on the
scientific knowledge on the etiology of LBP, basic anatomy, common myths about LBP, a theory
of non-specific LBP being caused by muscular functional disturbances (Indahl 1999), pain
physiology, and scientific knowledge on seemingly appropriate coping strategies to prevent a
prolonged course. Emphasis was made to reduce pain-related fear of movement and
catastrophizing thoughts and beliefs. Instead, activity during pain episodes was promoted as
well as a natural use of the back despite pain. A non-directive approach was used
(non-imperativ wording and absence of giving advice). The purpose was to provide information
but let the participant make their own conclusions on how and if to use the information in
present/future coping with pain.
In addition to the lecture, the intervention group participants were provided with a leaflet
showing various relevenat stretching exercises (back and related muscles) and they were
offered the option to make a call to the primary investigator in case any questions would
arise subsequently.
The control group was untreated by us. Both groups had access to all 'usual' help (workplace,
general practitioner etc).
Upon completion of the lectures, twelve monthly assessments were conducted using Text
Messaging (SMS). During each assessment, participants answered questions on no. of LBP days,
no. of LBP-related cutdown days, no. of LBP-related sick days, no. of LBP-related healthcare
visits, overall workability, bothersomeness last week, restricted activity last week, and use
of pain medicine or degree of sadness/depression.
In addition, a separate assessment was performed at app. 5.5 monts to obtain responses on
back beliefs.
The data collection was completed in 2014. Analysis are nearly finished. The sicentific paper
on the study is anticipated to take place in the beginning of 2016.
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