This study aims to evaluate the effectiveness of minimal intervention and therapeutic alliance in pain, specific and general disability, global perceived effect, empathy, credibility and expectation of improvement in patients with chronic non-specific low back pain
Low back pain remains a global public health problem. The classification of patients in low back pain subgroups aims to optimize the health system and provide the quantity and the type of proper technique for each patient. Several factors may influence physical therapy. The therapeutic alliance may be defined as harmony or social connection between the therapist and the patient and may influence the treatment effect. The aim of this study is to evaluate the effectiveness of the addition of the therapeutic alliance to a minimum intervention for the treatment of chronic non-specific low back pain with low risk of psychosocial factors.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
222
Intervention involving reassurance and information related to the return to daily activities, advice on dealing with the pain and clear explanation of signs and symptoms. The session will take 60 minutes and will be structured to increase the therapeutic alliance and empathy. Patients will be instructed to return in a week for further consultation to clarify doubts.
Information about low back pain based on Back Book. The therapy will be performed with limited interaction between patient and therapist and the information will be transmitted in a clear and direct way. The limited interaction between patient and therapist in this group will be established at the first session lasting 45-60 minutes. Patients will be instructed to return for a visit after a week to clarify questions.
Physical Therapy Outpatient Department
São Paulo, São Paulo, Brazil
Pain intensity
Pain intensity will be measured by an 11-point Pain Numerical Rating Scale
Time frame: One month after randomization
Specific disability
Specific disability associated with low back pain will be measured by the 11-point Patient Specific Functional Scale.
Time frame: One month after randomization
Pain intensity
Pain intensity will be measured by an 11-point Pain Numerical Rating Scale
Time frame: Six and twelve months after randomization
Specific disability
Specific disability associated with low back pain will be measured by the 11-point Patient Specific Functional Scale.
Time frame: Six and twelve months after randomization
Disability
Disability associated with low back pain will be measured by the 0-100 scale of the Oswestry Disability Index
Time frame: One, six and twelve months after randomization
Global impression of recovery
Global impression of recovery will be measured by an 11-point Global Perceived Effect Scale
Time frame: One, six and twelve months after randomization
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Patients will not receive intervention in the first month in which they are enrolled. After a year, the treatment offered to the Positive Therapeutic Alliance or Usual Care group will be available for patients who are interested.