Physical activity plays an important role in the management of chronic low back pain (LBP). Engaging in an active lifestyle is associated with a better prognosis. Nevertheless, there is evidence to suggest that patients with chronic LBP are less likely to meet recommended physical activity levels. Furthermore, while exercise therapy has been endorsed by recent clinical practice guidelines, evidence from systematic reviews suggests that its effect on pain and disability are at best moderate and not sustained over time. A limitation of current exercises programs for chronic LBP is that these programs are not designed to change patient's behaviour toward an active lifestyle. Therefore, the objective of this study is to investigate the short and long-term efficacy of a multimodal intervention consisting of supervised exercises, health coaching and use of an activity monitor (i.e. Fitbit Flex) compared to supervised exercises plus sham coaching and a sham activity monitor on physical activity levels, pain intensity and disability in patients with chronic nonspecific LBP.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
160
Participants will receive a group exercise program, health coaching sessions and an activity monitor.
Participants will receive a group exercise program, sham health coaching sessions and a sham activity monitor.
Sao Paulo State University
Presidente Prudente, São Paulo, Brazil
Physical activity levels - Counts per minute
Counts per minute will be measured with the Actigraph GT3X (ActiGraph, LLC, Pensacola, FL, USA).
Time frame: Post-intervention (i.e. 3 months after randomisation)
Pain intensity
Numerical Rating Scale for Pain assessment (NRS) (0-10)
Time frame: Post-intervention (i.e. 3 months after randomisation)
Disability
Roland Morris Disability Questionnaire (RMDQ) (0-24)
Time frame: Post-intervention (i.e. 3 months after randomisation)
Physical activity levels - Counts per minute
Counts per minute will be measured with the Actigraph GT3X (ActiGraph, LLC, Pensacola, FL, USA).
Time frame: 6 and 12-month assessment after randomisation
Pain intensity
Numerical Rating Scale for Pain assessment (NRS) (0-10)
Time frame: 6 and 12-month assessment after randomisation
Disability
Roland Morris Disability Questionnaire (RMDQ) (0-24)
Time frame: 6 and 12-month assessment after randomisation
Physical activity levels - light physical activity
Time spent in light physical activity will be measured with the Actigraph GT3X (ActiGraph, LLC, Pensacola, FL, USA).
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Physical activity levels - moderate-to-vigorous physical activity
Time spent in moderate-to-vigorous physical activity will be measured with the Actigraph GT3X (ActiGraph, LLC, Pensacola, FL, USA).
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Physical activity levels - steps
Number of steps will be measured with the Actigraph GT3X (ActiGraph, LLC, Pensacola, FL, USA).
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Sedentary behavior
Time spent in sedentary behavior will be measured with the Actigraph GT3X (ActiGraph, LLC, Pensacola, FL, USA).
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Self-reported physical activity level
Baecke Habitual Physical Activity Questionnaire
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Self-reported sedentary behavior
Questions about the time spent in sedentary behavior
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Depression
The Center for Epidemiological Studies - Depression (CES-D) scale (0-60)
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
General quality of life
EuroQol visual analogue scale (EQ-VAS) (0-100)
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Pain self-efficacy
Pain Self-Efficacy Questionnaire (PSEQ) (0-60)
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Weight-related outcomes - Body mass index
Body mass index
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Weight-related outcomes - Waist-to-hip circumference
Waist-to-hip circumference
Time frame: Post-intervention (i.e. 3 months after randomisation) and at 6 and 12-month follow-up
Global Perceived Effect Scale (GPES)
Perception of recovery
Time frame: Post-intervention (i.e. 3 months after randomisation)
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