Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial
Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial
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DOI：
10.1186/s12891-019-2454-y
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发表时间：
2019-02-11
影响因子：
2.3
通讯作者：
Ferreira, Paulo H.
中科院分区：
文献类型：
--
作者：
Amorim, Anita B.;Pappas, Evangelos;Ferreira, Paulo H.
背景下腰痛是世界上最常见的肌肉骨骼疾病之一，也是导致残疾的最主要原因。其特点是经常复发，导致额外的护理寻求。参与休闲体育活动与复发率较低、预后较好以及可能减少寻求护理有关。我们的目的是调查的可行性和初步疗效的患者为中心的体力活动干预，支持健康教练和移动的健康，以减少寻求护理，疼痛和残疾的慢性腰痛患者治疗出院后discharge.MethodsWe进行了一项试点随机对照试验，盲法结果评估。从悉尼的四个公共门诊物理治疗部门和普通社区招募了68名参与者。干预组收到了一本身体活动信息手册，加上一次面对面和12次电话健康指导。干预由基于互联网的应用程序和活动跟踪器（Fitbit）支持。对照组（标准护理）接受身体活动信息手册和保持活跃的建议。可行性指标包括招募率、干预依从性、数据完整性和参与者满意度。主要结果是寻求护理，疼痛水平和活动限制。在基线、6个月随访和6个月每周随访时评估结果。结果在15个月内邀请了90名潜在参与者，其中68人同意参加（75%）。总的来说，903周问卷回答了参与者从总共1107发送（89%）。参与者对干预措施基本满意（满意度量表上的平均值=8.7/10）。与标准治疗相比，干预组参与者的求医率降低了38%（发病率比（IRR）：0.62，95% CI：0.32至1.18，p=0.14，使用多水平混合效应泊松回归分析），尽管这些估计值都没有统计学意义。没有组间差异被发现疼痛水平或活动limitation.ConclusionThe健康教练体力活动的方法trialed在这里是可行的，并接受参与者，并可能减少寻求护理的患者治疗出院后腰痛，虽然进一步评估与足够的动力trial是need.Trial registrationAustralian和新西兰试验注册ACTRN 12615000189527。于2015年2月26日前瞻性注册。
BackgroundLow 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.MethodsWe 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 6months.ResultsNinety potential participants were invited over 15months, 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.ConclusionThe 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 registrationAustralian and New Zealand Trial Registry ACTRN12615000189527. Registered prospectively on 26-02-2015.