None listed
Conditions
Brief summary
The study aims to investigate whether enrolment into a public NSW Get Healthy Information and Coaching Service® (GHS) with or without the support of an exercise buddy, following treatment for older people with low back pain is more effective for improving physical activity and reducing use of health care services compared to usual discharge from treatment. It will be a randomised pilot clinical trial, single-blind, parallel, three-arm pilot study with 1:1:1 allocation ratio. Adults over the age of 50 years who have completed a course of physiotherapy, chiropractic or General practitioner treatment for their chronic low back pain will be included. Participants will be randomised either to Individual-Only Group, Buddy-Assisted Group or Control Group. Our hypothesis is that participants from the health coaching groups will present a greater mean daily number of steps at 3 and 6 months post-randomisation than people who continue with usual discharge care. Our secondary hypothesis is that participants who are randomised to the Buddy-Assisted Group will present a higher mean daily number of steps than participants who are randomised to the Individual-Only Group.
Interventions
Individual-Only Group – Patients will have a phone session with a member of the study team, who will explain the intervention and register them with the Get Healthy Service (GHS). Following registration participants will then receive up to 13 confidential coaching sessions over 6 months which will be provided on a tapered schedule with coaches from the GHS. All sessions will be delivered via phone with a primary aim to increase physical activity levels, but participants may decide with their coa
Individual-Only Group – Patients will have a phone session with a member of the study team, who will explain the intervention and register them with the Get Healthy Service (GHS). Following registration participants will then receive up to 13 confidential coaching sessions over 6 months which will be provided on a tapered schedule with coaches from the GHS. All sessions will be delivered via phone with a primary aim to increase physical activity levels, but participants may decide with their coaches to have other health-related goals (i.e. diet, alcohol consumption related goals) if they wish. Participants will decide with the coaches their goals and the time and dates of the sessions that best suit them. The coaches will not influence the choice of the participants and they may choose any physical activity goal they want, which may be to go for a walk once a week for 30 minutes, go for a swim twice per week for 40 minutes, etc. The coaching sessions will be provided by allied health care professionals (such as dietitians or exercise physiologists) who have been trained in health coaching. The anticipated duration of the sessions is of approximately 20 minutes. Attendance at the sessions will be recorded by the health coaches. Physical activities, individual and combined goals and their achievement will be recorded via weekly online diaries and monitored by the health coach during the coaching sessions. The health coach will be there to provide health information, assistance with goal setting and help maintaining motivation. Buddy-Assisted Group – Patients and their exercise buddies will have a first phone session with a member of the study team, who will explain how the intervention will be delivered, how to maximise the power of the buddies, how each partner can have a positive effect on each other’s behaviour, decide on their combined goal and discuss how they can track their combined goal. The anticipated duration of this session is of approximately 20-30 minutes. Then only the patient (not the buddy) will be registered in the GHS system and will receive up to 13 confidential coaching sessions over 6 months being provided on a tapered schedule with coaches of the GHS. As for the Individual-Only Group, coaches will be nurses and allied health professionals who have been trained in health coaching. The participant and buddy will exercise together at least once per week for 30 minutes. Examples of their combined exercise might be to go for a walk together for 30 minutes once per week, or go bowling together once a week for 30 minutes, etc.
Sponsors
Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Be over the age of 50 years and having been recently discharged from treatment for non-specific low back pain (LBP) • Have non-specific LBP for at least 3 months and greater than or equal to 2/10 in average pain intensity on the 11-point numeric rating scale for the past week • Be engaged in less than 300 minutes of total volume of light and moderate physical activity per week • To have an exercise-buddy willing to exercise together at least once per week for 30 minutes or more • To have adequate hearing and eyesight and independent ambulatory status
Exclusion criteria
• Have specific spinal conditions using the recommended criteria from the clinical practice guideline by the American College of Physicians and the American Pain Society • Participate in any vigorous sport activities (such as jogging, competitive tennis, vigorous swimming, etc) • Have had any spinal, hip or knee surgery within last 12 months • Have had recent corticosteroid injections in the spine (in the past 4 weeks) • Have evidence of radiculopathy and nerve root compromise (2 out of 3 positive tests for myotome, dermatomes, reflexes) • Have lumbar neurogenic claudication (i.e. pain, numbness and/or fatigue in the legs that is worse in standing or walking and alleviated during flexion/sitting, or being told by a doctor they have it) • Have LBP caused by involvement in a road traffic accident in the last 12 months or ongoing litigation • Have any comorbid condition that would prevent active participation in performing exercises at home or increasing physical activity levels – any heart or vascular conditions that would prevent the individual from exercising – told by a doctor • Have any known disease and/or signs or symptoms assessed with the Adult Pre-Exercise Screening System that represent higher risk of having an adverse event due to exercise (i.e. an unexpected event that occurs as a consequence of an exercise session, resulting in ill health, physical harm or death to an individual) • Have a diagnosis of fibromyalgia or a systematic arthritic condition • Have cognitive impairment, assessed by the Physiotherapist as being unable to follow instructions and understand the consent form • History of unexpected falls in the previous 12 months, defined as “an unexpected loss of balance resulting in coming to rest on the floor, the ground, or an object below the knee level"
Outcome results
None listed