Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT05226156 |
| Other study ID # |
Back study 3 months |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
April 27, 2021 |
| Est. completion date |
March 16, 2022 |
Study information
| Verified date |
May 2022 |
| Source |
Joint Academy |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Exercise and education is recommended as the first-line treatment by evidence-based,
international guidelines for low back pain (LBP). Despite consensus regarding treatment,
there is a gap between guidelines and what is offered to patients and less than half of the
patients with nonspecific low back pain receive proper first-line care.
The aim of this study was to examine the short-term effect in pain and function in people
with nonspecific LBP, participating in the digitally delivered treatment program Joint
Academy.
Description:
Low back pain (LBP) is the 4th leading cause of Disability Adjusted Life Years (DALYs) among
adults aged 25-49.. According to evidence-based clinical guidelines, exercise and education
constitute the first-line intervention. In an attempt to support the implementation of the
guidelines, the BetterBack Modell of Care (MoC), a face-to-face concept including exercise
and education, was developed and tested in primary care clinics in Sweden since 2017.
The BetterBack (MoC) is a package of education and training that includes structured
assessment by a physiotherapist, information on cause and prognosis for LBP and
individualised exercise. BetterBack has so far shown that physiotherapists experience
increased self-efficacy for assessing and treating patients with LBP and that patients
experience improved knowledge for self-care. Despite clinical guidelines for LBP, there is a
gap between guidelines and what is offered to patients with LBP, and valuable health
resources are still used for examinations and treatments that are proven ineffective or even
harmful.
Traditional face-to-face interventions present barriers, such as limited access and lack of
flexibility, which may limit the patients' adherence with the interventions. Digital delivery
of the management program may be one way of overcoming such barriers. Telehealth, defined as
the 'delivery of healthcare at a distance using information and communication technology'
(ICT) could be a solution to many access barriers and has been rapidly adopted by many
healthcare professions and accelerating even more throughout the COVID-19 pandemic.
Literature investigating the use of telehealth for the management of musculoskeletal pain is
growing. Systematic reviews have demonstrated that telehealth can provide improvements in
pain, physical function and disability that are similar to that of usual face-to-face care
for individuals with musculoskeletal conditions such as osteoarthritis and non-specific low
back pain. The use of telehealth also seems to increase exercise adherence for a variety of
musculoskeletal conditions. However, there is a vast heterogeneity between studies included
in these systematic reviews with respect to the intervention (type of exercise and education)
and the ICT strategy provided, highlighting the need for further evidence-based digital
programs to strengthen these findings.
Joint Academy® (JA), a digitally delivered treatment program with exercise and education was
developed to increase access to and facilitate implementation of guideline derived and
evidence-based treatment for musculoskeletal pain. The first JA program was introduced in
2016 for persons with hip- and knee OA and showed reduced pain and improved function. A
recent randomized controlled trial on patients with knee OA showed that the digital program
was superior to usual care. During 2021, a similar programme for persons with LBP, inspired
by the Swedish face-to-face Better Back MoC was introduced.
The purpose of this study was to evaluate 3-months changes in pain and function during
participation in the digitally delivered Joint Academy® (JA) exercise and education treatment
program for patients with low back pain. A second aim was to examine the association of
sociodemographis, health-related and treatment-related factors with outcome.
