Primary care Musculoskeletal Diseases Recurrent and chronic back pain
Conditions
Interventions
Alexander Technique (AT) factor:
1. Normal management (control):
This group provides a realistic comparator, particularly for the economic component of the trial (so that the marginal costs of the i
are members of STAT
and have at least 3 years post qualification experience. The aim in the longer course of lessons is to provide a much more comprehensive course in line with STAT?s recommendations for a new pupil. Up
Sponsors
University of Southampton (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. The entry criteria are similar to the UK BEAM trial to facilitate comparison, except for this trial all patients have chronic or recurrent pain 2. The population will be aged 18 to 65 who presented in primary care with low back pain more than 3 months previously, who currently score 4 or more on the Roland Scale and have had back pain for 3 weeks (ie to exclude short-lived recurrence) 3. Participants will need to be fluent in English and able to read and write (to complete the outcome measures)
Exclusion criteria
Exclusion criteria: 1. Previous experience of AT 2. The over 65s (serious spinal pathology more likely) 3. Clinical indicators of serious spinal pathology 4. Current nerve root pain (below knee in dermatomal distribution) or previous spinal surgery (outcome may be very different, and groups too small to analyse) 5. History of psychosis or major alcohol abuse (difficulty completing outcomes) 6. Perceived inability to walk 100 metres (exercise difficult) 7. Exercising for 30 min three times a week or above 8. Pregnancy 9. Pending litigation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary analysis will be an analysis of covariance for a factorial study at 3 months and 1 year for the principal outcomes between groups (Rowland score; days of back pain). | — |
Secondary
| Measure | Time frame |
|---|---|
| Controlling for potentially confounding baseline values and for cluster effects, and transforming data as appropriate. Although we are not expecting interaction between factors we will assess interaction and if significant will report outcomes for groups seperately. This trial will detect large interactions, but if smaller non-significant interactions looked likely they would have to be the subject of further study. If significant and multiple cluster effects are demonstrated a multi-level modelling approach will be used. Secondary analysis will assess the prognostic value of clinical and psychological variables at baseline in predicting outcome at 1 year. The economic evaluation will take the form of a cost-consequence analysis and if appropriate a cost-effectiveness and cost-utility analysis. | — |
Countries
United Kingdom
Outcome results
None listed