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Effects of behavioural exercise therapy on the effectiveness of a multidisciplinary rehabilitation for chronic non-specific low back pain: study protocol for a randomised controlled trial.
- Source :
-
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2013 Mar 11; Vol. 14, pp. 89. Date of Electronic Publication: 2013 Mar 11. - Publication Year :
- 2013
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Abstract
- Background: In Germany, a multidisciplinary rehabilitation named "behavioural medical rehabilitation" (BMR) is available for treatment of chronic low back pain (clbp). A central component of BMR is standard exercise therapy (SET), which is directed mainly to improve physical fitness. There is a need to address psychosocial factors within SET and therefore to improve behavior change with a focus on the development of self-management skills in dealing with clbp. Furthermore, short-term effectiveness of BMR with a SET has been proven, but the impact of a behavioural exercise therapy (BET) for improvement of the long-term effectiveness of BMR is unclear.<br />Methods/design: To compare the effectiveness of two exercise programs with different approaches within BMR on the effects of BMR a prospective randomized controlled trial (RCT) in two rehabilitation centres will be performed. 214 patients aged 18-65 with clbp will be, based on an "urn randomisation"-algorithm, randomly assigned to a BMR with SET (function-oriented, n=107) and BMR with BET (behaviour-oriented, n=107). Both exercise programs have a mean duration of 26 hours in three weeks and are delivered by a limited number of not-blinded study therapists in closed groups with six to twelve patients who will be masked regarding study group. The main differences of BET lie in its detailed manualised program with a theory-based, goal-orientated combination of exercise, education and behavioural elements, active participation of patients and consideration of their individual preferences and previous experiences with exercise. The primary outcome is functional ability assessed with the Hannover Functional Ability Questionnaire directly before and after the rehabilitation program, as well as a six and twelve-month follow-up.<br />Discussion: This RCT is designed to explore the effects of BET on the effectiveness of a BMR compared to a BMR with SET in the management of patients with clbp. Methodological challenges arise from conducting a RCT within routine health care as well as from ensuring high treatment integrity. Findings of this study might contribute to a better understanding of the mechanism of action of BMR and the special effects of BET and may be used to improve the quality of these interventions in routine care, therefore reducing the burden to patients with disabling clbp.<br />Trial Registration: Current controlled trials NCT01666639.
- Subjects :
- Adolescent
Adult
Aged
Chronic Pain diagnosis
Chronic Pain physiopathology
Chronic Pain psychology
Combined Modality Therapy
Disability Evaluation
Germany
Goals
Health Knowledge, Attitudes, Practice
Humans
Low Back Pain diagnosis
Low Back Pain physiopathology
Low Back Pain psychology
Middle Aged
Pain Measurement
Patient Education as Topic
Prospective Studies
Rehabilitation Centers
Self Care
Surveys and Questionnaires
Time Factors
Treatment Outcome
Young Adult
Behavior Therapy
Chronic Pain rehabilitation
Exercise Therapy
Low Back Pain rehabilitation
Research Design
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2474
- Volume :
- 14
- Database :
- MEDLINE
- Journal :
- BMC musculoskeletal disorders
- Publication Type :
- Academic Journal
- Accession number :
- 23496822
- Full Text :
- https://doi.org/10.1186/1471-2474-14-89