The primary objective of this parallel-group randomized controlled trial was to compare the effect of two different approaches to delivering a 10-week self-management program for cMSKDs on pain-related disabilities: standard self-management and supported self-management. Secondary outcomes included pain severity, kinesiophobia, catastrophizing, and pain self-efficacy.
A total of 108 adults with cMSKDs were assessed and randomly assigned to one of two groups: 1) self-management group (without healthcare provider support) or 2) supported self-management group (same program along with two additional 30-minute counseling sessions with a physiotherapist and a 60-minute group session led by a peer with cMSKD). Outcomes were reassessed at 10 and 26 weeks, with primary (pain-related disability) and secondary (pain severity, kinesiophobia, catastrophizing, and pain self-efficacy) outcomes measured at each time point. The effects of both delivery methods were compared using repeated measures ANOVA, with effect sizes determined by partial eta-squared (η²p). So far, 57 participants completed the program and were evaluated at 10 weeks, and 36 participants completed the 26-week assessment. Analyses were only performed on participants who completed the 10-week evaluation (n=57).
The mean age of the 57 participants was 37.2 years (SD = 15.5), comprising 40 women and 17 men. All participants had experienced pain for over 3 months, with 79% reporting pain lasting more than one year. At 10 weeks, no time x group interaction effect was found for the primary (P = 0.05; η²p: 0.008) or secondary outcomes (P > 0.270; η²p 0.023), indicating that both groups progressed similarly during the 10-week intervention period. However, a significant time effect was observed, reflecting improvement across all outcomes following the programs: pain-related disability (P = 0.010; η²p = 0.116), pain severity (P = 0.043; η²p: 0.072), kinesiophobia (P 0.001; η²p: 0.312), catastrophizing (P 0.001; η²p: 0.284), and pain self-efficacy (P = 0.005; η²p: 0.136). No group effect was detected.
Our preliminary data suggest that adding two counseling sessions with a physiotherapist and a peer-led group session did not result in better immediate outcomes at the end of the program. However, both self-management approaches effectively improved pain-related outcomes. The impact may become more evident over the long term, and the 26-week analyses could yield different results.
This free and easily accessible online self-management program could be relevant as a complement to physiotherapy interventions or for those awaiting treatment or living in areas where access to a healthcare provider is challenging.
chronic pain
musculoskeletal disorders
