Chronic Lower Back Pain
Conditions
Keywords
Chronic Lower Back Pain, Manual Therapy, Cognitive Behavioral Therapy
Brief summary
This pilot study will evaluate the feasibility of having a non-behavioral health provider deliver a combination of manual therapy (MT) and cognitive behavioral therapy for pain (CBT-p). In addition, we will evaluate differences in outcomes in patients undergoing the combined intervention of CBT-p and MT and those undergoing MT alone.
Detailed description
Given that this is a pilot study we will use simple descriptive statistics for patient characteristics, including age, sex, BMI and baseline scores on outcome measures. In addition we will assess the inter-rater reliability of the scoring of the delivery of the CBT-p by the two trained practitioners utilizing kappa statistics. We will perform data analyses using SPSS.
Interventions
Manual Therapy Arm
Combination of manual therapy and cognitive behavioral therapy for pain.
Sponsors
Study design
Eligibility
Inclusion criteria
* 18 to 69 years of age with CLBP who are * high risk for poor prognosis based on SBST * currently undergoing chiropractic care.
Exclusion criteria
* Contraindications to either MT or CBT-p. * Patients who are currently undergoing CBT-p * who have been treated for substance abuse in the past year.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale | Baseline and 6 weeks post baseline (immediately post intervention) | The VAS is a patient completed analogue measure that evaluates pain intensity on a 100 mm long horizontal line, which is anchored at each end with a statement representing the extremes of the dimension being measured. In this case the left hand side reads, no pain and the right hand side reads worst pain possible. The VAS scale utilized will assess pain at the current time. The VAS has been established as a reliable, valid and generalizable measure that can be administered in a wide range of clinical and experimental settings. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PROMIS Global Health Scale (GHS) | Baseline and 6 weeks post baseline (immediately post intervention) | Health outcomes assessment has advanced to a point where generic health-related quality of life (HRQL) measures are often used to examine the health status of populations and the effects of medical interventions. Generic HRQL profile measures, such as the SF-36 Health Survey, provide multiple health domains scores (e.g., physical function, mental health, pain, vitality, etc.), but not an overall index score. Patient reported outcome measurement information system has developed a quality of life tool that provides an overall index score for quality of life. The main advantage of the PROMIS measures over other static health status measures is that the PROMIS domain item banks and scores allow flexibility in administration using either targeted short forms or computerized adaptive testing. This form has recently been validated in comparison to the EuroQual. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient Satisfaction Questionnaire | Baseline and post intervention | Cherkin et al, in the evaluation of a physician education program developed a patient satisfaction questionnaire which was found to be reliable and valid. The questionnaire utilized in this study will incorporate these same questions. Additional questions to be included focus on the burden of the data collection activities, and suggestions for subject recruitment. |
Countries
United States