None listed
Conditions
Brief summary
This pilot study aims to determine the feasibility of running a larger, multi-centre randomised controlled trial comparing the effectiveness of the UPLIFT program as a treatment for persistent back pain when compared to usual physiotherapy care. Primary outcomes: feasibility (recruitment, retention, intervention delivery) and acceptability (patient satisfaction and semi-structured interviews). Secondary outcomes: Clinical efficacy and cost effectiveness of the UPLIFT program compared to usual care physiotherapy. Participants will include patients aged over 18 years who have been referred to the Gold Coast University Hospital Neurosurgical Screening Clinic (NSC) service with low back pain of >6 months’ duration. 60 participants (30 per group). UPLIFT was developed in response to a need for alternative treatment modalities for people with persistent low back pain at Gold Coast University Hospital. A large cohort study indicated the UPLIFT program to be effective for managing this population. Another advantage is that it is delivered in a group-based format which increases cost effectiveness, by increasing the consumer to clinician ratio. The UPLIFT model of care could become the standard model of care for this cohort of patients state-wide in Queensland and even nationally. The UPLIFT program has been part of standard practice within the Gold Coast University Hospital Neurosurgical Screening Service for the past four years, with no adverse events occurring within this time. The proposed research project involves no changes to standard practice, except participants will be required to complete additional questionnaires imposing an additional but small imposition on their time. The requirement of completing additional questionnaires is also explained in the informed consent procedure. Given the trial involves people experiencing persistent pain, there is a possibility that participants will experience a transient increase in symptoms following exercise, however this possibility is no greater than what occurs with usual care. Experienced clinicians with expertise in managing this population group are leading this project and delivering the UPLIFT program (Experimental group) and physiotherapy care (Control group).
Interventions
Participants allocated to the intervention group will participate in the UPLIFT program. UPLIFT is a 5-week program consisting of weekly 90-minute group sessions that combine education (60 Minutes) followed by exercise (30 Minutes). Sessions take place in the allied health outpatient clinic at thenGold Coast University Hospital, utilizing a meeting room for the education and an adjacent exercise gym room for the exercise. The education is delivered in a group setting. Group sizes are between 8
Participants allocated to the intervention group will participate in the UPLIFT program. UPLIFT is a 5-week program consisting of weekly 90-minute group sessions that combine education (60 Minutes) followed by exercise (30 Minutes). Sessions take place in the allied health outpatient clinic at thenGold Coast University Hospital, utilizing a meeting room for the education and an adjacent exercise gym room for the exercise. The education is delivered in a group setting. Group sizes are between 8 to 10 participants including 2 physiotherapists and an "expert" patient. Each education session targets a different theme: 1) pain neuroscience; 2) activity pacing; 3) flare-up management; 4) acceptance; and 5) adopting healthy lifestyle behaviors (including sleep hygiene and movement). UPLIFT incorporates motivational interviewing techniques allowing participants to undertake appropriate cognitive and experiential processing of the program’s content. The 'expert" patient is a volunteer peer mentor who has successfully completed UPLIFT. They assist in facilitating the program by sharing their own experience with participants during the group sessions. The mentors are given three hours of face-to-face training by the program’s lead physiotherapists on the program’s content, communication skills (ie motivational interviewing techniques and coaching principles) and self-care strategies. Lessons are open and conversational, rather than didactic. UPLIFT’s interactive delivery style aims to improve participants’ knowledge, which underpins behavior change. Patients in the UPLIFT program are considered active partners in their rehabilitation, aiming to reconceptualize their understanding of pain, develop active coping strategies to self-manage LBP, and re-engage in value-based activities. Participants' attendance is recorded in a participation log maintained by the research assistant. The exercise component of the program is patient directed , in line with the capacity, interest and resources of the patient. Each patient will choose from a number of available cardiovascular ( walking, cycling, rowing ergometer) and strength exercises. In addition, Tai Chi, yoga and stretching is included. The program is delivered by 2 physiotherapists with a minimum of 5 years clinical experience in musculoskeletal practice.
Sponsors
Office for Research Governance and Development, Gold Coast University Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: 1) Adults aged 18–70 years; 2) persistent LBP ( that is pain in the region between the iliac crests and the ribs that has been present for greater than 3 months); and 3) sufficient English language skills to complete questionnaires and comprehend/participate in interactive education sessions within the UPLIFT program.
Exclusion criteria
Exclusion criteria: 1) Contraindications for exercise; 2) recent spinal surgery; 3) active inflammatory conditions (such as rheumatoid arthritis); and 4) neurological conditions.
Outcome results
None listed