The aim of this clinical trial is to develop and test the effectiveness of a smartphone app-based self-management program based on exercise and pain education for police officers and firefighters with chronic low back pain.
Low back pain is the leading cause of year lived with disability worldwide. Workers exposed to physically demanding activities and inappropriate postures, such as those performed by police officers and firefighters, are highly affected by chronic low back pain. Smartphone app-based self-managed interventions have been shown to be an alternative for chronic non-specific low back pain treatment. However, there is still little research on the development and testing of remotely-delivered programs for the management of chronic low back pain, especially in police and fire professionals. The aim of this clinical trial is to develop and test the effectiveness of a smartphone app-based self-management program based on exercise and pain education for police officers and firefighters with chronic low back pain.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
66
Telerehabilitation is defined as providing techniques for therapeutic rehabilitation remotely or off-site using telecommunication technologies. Thus, our intervention will be based on the use of a smartphone application created especially for the study that will contain a program of progressive physical exercises with images and descriptions, educational messages and an online booklet for the study subjects, totaling 8 weeks of training and pain education.
An online booklet containing information about chronic low back pain and weekly messages about low back pain causes, suggestions for lifestyle modifications and behavior will be delivered, as well as an incentive to perform physical exercises.
Escola Superior de Educação Física
Pelotas, Rio Grande do Sul, Brazil
Pain Intensity at post-treatment follow-up
The primary outcome will be pain intensity measured using the Pain Numerical Rating Scale, a numerical scale of 11 domains, where 0 indicates no pain and 10 indicates maximum pain intensity.
Time frame: Post-treatment follow-up (8 weeks)
Disability at post-treatment follow-up
The primary outcome will be disability measured using the Roland Morris Disability Questionnaire, a 24-item questionnaire that assesses normal activities of daily living, where a higher score indicating a higher level of disability.
Time frame: Post-treatment follow-up (8 weeks)
Pain intensity at 4 months follow-up
Measured using the Pain Numerical Rating Scale, a numerical scale of 11 domains, where 0 indicates no pain and 10 indicates maximum pain intensity.
Time frame: 4 months follow-up
Disability at 4 months follow-up
Measured using the Roland Morris Disability Questionnaire, a 24-item questionnaire that assesses normal activities of daily living, where a higher score indicating a higher level of disability.
Time frame: 4 months follow-up
Health-Related Quality of Life
Measured with the WHOQOL-Pain, a self-reported questionnaire with 16 questions and classification of 4 facets related to the experience of chronic physical pain.
Time frame: The outcome will be evaluated after the treatment period (8 weeks) and after 4 months of randomization of each subject.
Self-efficacy
Measured with Pain Self-Efficacy Questionnaire, a questionnaire with 22 questions classified in three domains, with a score of each domain ranging from 10 to 100. A total score close to 300 indicates a greater sense of self-efficacy.
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Time frame: The outcome will be evaluated after the treatment period (8 weeks) and after 4 months of randomization of each subject.
Depression, Anxiety and Stress
Measured by the Depression Anxiety Stress Scale, a self-reported scale with 21 questions, 7 for depression, 7 for anxiety and 7 for stress. Each question ranges from 0 to 3 according to the patient's response. Scores near 21 indicate the worst results.
Time frame: The outcome will be evaluated after the treatment period (8 weeks) and after 4 months of randomization of each subject.
Sleep quality
Measured by the Pittsburgh Sleep Quality Index, a self-reported scale with 19 questions, that assess seven components of sleep. Each question ranges from 0 to 3 according to the patient's response. Scores near 21 indicate worse sleep quality.
Time frame: The outcome will be evaluated after the treatment period (8 weeks) and after 4 months of randomization of each subject.
Work ability
Measured by a single-item question: Are you working at a physically less demanding job now because of your back and/or leg pain?
Time frame: The outcome will be evaluated after the treatment period (8 weeks) and after 4 months of randomization of each subject.
Isometric muscular endurance of the trunk extensor
Measured by modified Biering-Sorensen test.
Time frame: The outcome will be evaluated after the treatment period (8 weeks).
Isometric muscular endurance of the trunk flexors
Measured by a test that consists of remaining in isometry as long as possible.
Time frame: The outcome will be evaluated after the treatment period (8 weeks).
Maximum isometric strength of the trunk extensor and flexor muscles
Measured by a load cell.
Time frame: The outcome will be evaluated after the treatment period (8 weeks).
Muscular activation of flexor and extensor muscles
Measured using the surface electromyography technique. The neuromuscular activation of flexor (rectus abdominis) and extensor (spinal erector) muscles will be measured.
Time frame: The outcome will be evaluated after the treatment period (8 weeks).
Adverse Effects
Measured by recording the number of adverse events during the intervention period.
Time frame: The outcome will be evaluated after the treatment period (8 weeks) and after 4 months of randomization of each subject.