C. Oliveira1, D. Christofaro1, I. Lemes2, M. Franco3, F. Silva4, T. Damato1, R. Pinto2
1Universidade Estadual Paulista (UNESP), Physical Therapy, Presidente Prudente, Brazil, 2Universidade Federal de Minas Gerais (UFMG), Physical Therapy, Belo Horizonte, Brazil, 3Centro Universitário UNA, Physical Therapy, Belo Horizonte, Brazil, 4Universidade da Cidade de São Paulo, Physical Therapy, Sao Paulo, Brazil
Background: An increasing number of initiatives have been stimulating the practice of physical activity as a key component for treatment of chronic low back pain. However, there is still limited evidence about the effects of physical activity-based interventions on physical activity levels of people with chronic low back pain.
Purpose: To investigate whether addition of health coaching enhance the effect of exercise on pain intensity and disability of people with chronic low back pain.
Methods: This was a randomised placebo-controlled trial (NCT03200509) with concealed allocation, intention-to-treat analysis, and blinding of patients and assessors. One-hundred and sixty patients with chronic nonspecific low back pain aged between 18 and 60 years seeking care at an outpatient physiotherapy clinic. Participants in both groups received supervised group exercise therapy. Participants in the experimental group also received health coaching sessions aiming to improve physical activity and physical activity electronic feedback provided by an activity monitor. The control group received placebo health coaching and wore a placebo activity monitor. Disability was measured using the Roland Morris Disability Questionnaire (0-24), and pain intensity was measured using the 11-point Numerical Rating Scale (0-10).
Results: There were no differences between groups for reducing disability (MD = -0.1 out of 24 points, 95% CI: -1.6 to 1.4), and pain intensity (MD = -0.4 out of 10 points, 95% CI: -1.2 to 0.4) at 3-month follow-up. Similarly, there were no between-group differences in the primary outcomes at 6 and 12-month follow-up assessments.
Conclusion(s): Group exercises program and health coaching did not improve pain intensity or disability of patients with chronic low back pain compared to those patients undertaking only the group exercise program. Future studies should test if interventions having a logical sequence order (e.g., exercise and, then, health coaching) would be more effective to reduce pain and disability of patients with chronic low back pain.
Implications: Additional studies investigating the benefits of including health coaching to a group exercise program in people with chronic low back are needed before the implementation of this approach in routine clinical practice of physiotherapists.
Funding, acknowledgements: Project funded by the Sao Paulo Research Foundation-FAPESP (2014/14077-8, 2016/03826-5), and the National Council for Scientific and Technological Development-CNPQ (408712/2016-3).
Keywords: Low back pain, Physical Activity, Health Coaching
Topic: Musculoskeletal: spine
Did this work require ethics approval? Yes
Institution: São Paulo State University
Committee: Research Committee of the Sao Paulo State University
Ethics number: CAAE: 61230916.0.0000.5402
All authors, affiliations and abstracts have been published as submitted.
