(Golden Oldie) Increasing recreational physical activity in patients with chronic low back pain: a pragmatic controlled clinical trial

Review written by Dr Jarod Hall info

Key Points

  1. The study introduced the Enhanced Transtheoretical Model Intervention (ETMI) to address psychological barriers, such as low self-efficacy and fear avoidance, that prevent patients with chronic low back pain (CLBP) from engaging in physical activity.
All key points available for members only
Start free trial Icon
Or log in here

BACKGROUND & OBJECTIVE

According to the World Health Organization and several clinical guidelines, good clinical practice for patients with chronic low back pain (CLBP) includes increased physical activity (1,2). Physical activity has been shown to be effective in improving function, return to work, and preventing future pain in patients with CLBP. However, increasing physical activity in patients with CLBP has been shown to be challenging (3).

Trials in populations with CLBP, ranging from psychologically informed physical therapy to behavioral interventions, to psychological interventions and multidisciplinary interventions report only small to moderate effects that often are not maintained in the long term. Criticisms of current trials have suggested that there may be a need for theory-driven interventions that focus explicitly on mechanisms underpinning key obstacles to recovery.

The objective of the intervention in this trial was to increase physical activity in people with CLBP through a combination of theory-informed counseling based on behavior-change principles and targeting of known obstacles to engaging with physical activity in this group of patients. The overall aim of this trial was to examine the effectiveness of an enhanced transtheoretical model-based intervention (ETMI) versus physical therapy as usual in reducing disability in patients with CLBP.

Physical activity has been shown to be effective in improving function, return to work, and preventing future pain in patients with chronic low back pain.
bulb
Clinicians should spend more time discussing the patient's fears and beliefs about physical activity and helping them to understand that movement is safe and beneficial, even in the presence of pain.

METHODS

  • Participants were recruited from physical therapy clinics within Maccabi Healthcare Services in Israel. A total of 220 patients, aged 25 to 55, were included in the trial, all of whom had experienced CLBP for at least three months. Patients with
Start free trial Icon
to unlock full access to this review and 1109 more
Or log in here
Trustpilot