Effects of behavioural exercise therapy on the effectiveness of a multidisciplinary rehabilitation for chronic non-specific low back pain: Study protocol for a randomised controlled trial

BMC Musculoskeletal Disorders

Klaus Pfeifer¹  Christian Hentschke¹  Wolfgang Geidl¹  Stefan Peters¹  Jana Hofmann¹ 

[1] Institute of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstr. 123b, D-91058 Erlangen, Germany

关键词: Physical activity;    Self-management;    Multidisciplinary rehabilitation;    Behavioural exercise therapy;    Exercise therapy;    Chronic non-specific low back pain;   

Others  :  1133446
DOI  :  10.1186/1471-2474-14-89

 received in 2013-01-30, accepted in 2013-02-28,  发布年份 2013

【 摘 要 】

Background

In Germany, a multidisciplinary rehabilitation named “behavioural medical rehabilitation” (BMR) is available for treatment of chronic low back pain (clbp). A central component of BMR is standard exercise therapy (SET), which is directed mainly to improve physical fitness. There is a need to address psychosocial factors within SET and therefore to improve behavior change with a focus on the development of self-management skills in dealing with clbp. Furthermore, short-term effectiveness of BMR with a SET has been proven, but the impact of a behavioural exercise therapy (BET) for improvement of the long-term effectiveness of BMR is unclear.

Methods/design

To compare the effectiveness of two exercise programs with different approaches within BMR on the effects of BMR a prospective randomized controlled trial (RCT) in two rehabilitation centres will be performed. 214 patients aged 18–65 with clbp will be, based on an "urn randomisation"-algorithm, randomly assigned to a BMR with SET (function-oriented, n=107) and BMR with BET (behaviour-oriented, n=107). Both exercise programs have a mean duration of 26 hours in three weeks and are delivered by a limited number of not-blinded study therapists in closed groups with six to twelve patients who will be masked regarding study group. The main differences of BET lie in its detailed manualised program with a theory-based, goal-orientated combination of exercise, education and behavioural elements, active participation of patients and consideration of their individual preferences and previous experiences with exercise. The primary outcome is functional ability assessed with the Hannover Functional Ability Questionnaire directly before and after the rehabilitation program, as well as a six and twelve-month follow-up.

Discussion

This RCT is designed to explore the effects of BET on the effectiveness of a BMR compared to a BMR with SET in the management of patients with clbp. Methodological challenges arise from conducting a RCT within routine health care as well as from ensuring high treatment integrity. Findings of this study might contribute to a better understanding of the mechanism of action of BMR and the special effects of BET and may be used to improve the quality of these interventions in routine care, therefore reducing the burden to patients with disabling clbp.

Trial registration

Current controlled trials NCT01666639

【 授权许可】

   
2013 Hofmann et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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