Movement coaching: study protocol of a randomized controlled trial evaluating effects on physical activity and participation in low back pain patients

BMC Musculoskeletal Disorders

Ingo Froboese²  Andrea Schaller¹ 

[1] Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany;Center for Health through Sport and Movement, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany

关键词: RCT;    Multilevel approach;    Inpatient rehabilitation;    Physical activity promotion;    Low back pain;   

Others  :  1091627
DOI  :  10.1186/1471-2474-15-391

 received in 2014-09-30, accepted in 2014-11-11,  发布年份 2014

【 摘 要 】

Background

Chronic Low Back Pain is a complex syndrome with multifactorial bio-psycho-social etiology and interdependences. Thereby, physical activity seems to play an essential role regarding the prevention and rehabilitation of LBP. In consequence, physical activity and exercise therapy is an integral part of musculoskeletal rehabilitation in LBP. However, adherence to self-directed exercise and implementing a health-enhancing physical activity in daily routine after rehabilitation is a common problem for patients and only a few patients integrate health-enhancing physical activity and/or sport activities in their lifestyle. The present paper describes a comprehensive multilevel approach combining face-to-face intervention, telephone and internet aftercare (Movement Coaching). Aim of the trial presented in this study protocol is to evaluate effectiveness of Movement Coaching compared to a control intervention.

Methods/Design

The study is a prospective, single-blinded, monocenter randomized controlled trial (RCT) with three measuring points: T1 = start of inpatient rehabilitation; T2 = six months follow-up; T3 = twelve months follow-up. In total, 412 patients were recruited. The intervention involves small-group face-to-face contact during inpatient rehabilitation (two times, week 2 & 3) and telephone aftercare (week 8 & week 12 after rehabilitation) as well as internet-based aftercare (web 2.0 platform; available until six months after rehabilitation). Primary outcome is physical activity, assessed by GPAQ questionnaire. The final data collection is expected by April 2015.

Discussion

Due to the burden of physical inactivity, there is a need to develop, evaluate and disseminate approaches that are effective in promoting physical activity and especially promoting the maintenance of physical activity in relevant target groups. Considering the high prevalence and socioeconomic impact of low back pain and its multifactorial etiology, low back pain patients seem to be a relevant target group for physical activity promotion. A multilevel approach to bridge the interface of (inpatient) rehabilitation and self-directed physical activity will help to target group-specific PA promotion.

Trial registration

German Clinical Trials Register (DRKS)-ID: DRKS00004878.

【 授权许可】

   
2014 Schaller and Froboese; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Schmidt CO, Raspe H, Pfingsten M, Hasenbring M, Basler HD, Eich W, Kohlmann T: Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine 2007, 32:2005-2011.
• [2]Koch-Institut R, Raspe H: Gesundheitsberichterstattung des Bundes Heft 53 // Rückenschmerzen, Volume 53. Berlin: Robert-Koch-Inst; 2012.
• [3]Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, Castel LD, Kalsbeek WD, Carey TS: The rising prevalence of chronic low back pain. Arch Intern Med 2009, 169:251-258.
• [4]Helfenstein M, Goldenfum MA, Siena C: Occupational low back pain. Rev Assoc Med Bras 2010, 56:583-589.
• [5]Junqueira DRG, Ferreira ML, Refshauge K, Maher CG, Hopper JL, Hancock M, Carvalho MG, Ferreira PH: Heritability and lifestyle factors in chronic low back pain: Results of the Australian Twin Low Back Pain Study (The AUTBACK study). Eur J Pain 2014, 18:1410-1418.
• [6]Langevin HM, Sherman KJ: Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms. Med Hypotheses 2007, 68:74-80.
• [7]Hurwitz EL, Morgenstern H, Chiao C: Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study. Am J Public Health 2005, 95:1817-1824.
• [8]Ferreira PH, Beckenkamp P, Maher CG, Hopper JL, Ferreira ML: Nature or nurture in low back pain? Results of a systematic review of studies based on twin samples. Eur J Pain 2013, 17:957-971.
• [9]Dionne CE, von Korff M, Koepsell TD, Deyo RA, Barlow WE, Checkoway H: Formal education and back pain: a review. J Epidemiol Community Health 2001, 55:455-468.
• [10]Burton AK, Balagué F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Müller G, van der Beek AJ: How to prevent low back pain. Best Pract Res Clin Rheumatol 2005, 19:541-555.
• [11]Koes BW, van Tulder M, Lin CC, Macedo LG, McAuley J, Maher C: An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J 2010, 19:2075-2094.
• [12]van Tulder M, Becker A, Bekkering T, Breen A, del R, Maria Teresa G, Hutchinson A, Koes B, Laerum E, Malmivaara A: Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006, 15(Suppl 2):S169-S191.
• [13]German Medical Association, National Association of Statutory Health Insurance Physicians, Association of Scientific Medical Societies: National Disease Management Guideline Low back pain. Short Version. 1st edition. 2011. http://www.leitlinien.de/nvl/kreuzschmerz webcite
• [14]Völker K: Zusammenhang von körperlicher Aktivität mit physischer und psychischer Gesundheit – eine Einführung. In Gesundheit durch Bewegung fördern. Empfehlungen für Wissenschaft und Praxis. LIGA.Fokus 12. Edited by Landesinstitut für Gesundheit und Arbeit des Landes Nordrhein-Westfalen. Düsseldorf: LIGA.NRW; 2011:9-13.
• [15]World Health Organization: Global Recommendations on Physical Activity for Health. Genf: WHO Press; 2012.
• [16]Brüggemann S, Sewöster D: Bewegungstherapeutische Versorgung in der medizinischen Rehabilitation der Rentenversicherung. B & G 2010, 26:266-269.
• [17]Horst F, Adler B, Schulte-Frei B, Horst H: Orthopädisch-traumatologische Grudlagen. In Training in der Therapie. Grundlagen und Praxis. 3rd edition. Edited by Froböse I, Wilke C, Nellessen-Martens G. München: Elsevier Urban & Fischer; 2010.
• [18]World Health Organization: ICF. Internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit. Genf: WHO Press; 2005.
• [19]Schüle K, Huber G: Einleitung-Mehrdimensionalität. In Grundlagen der Sporttherapie. Edited by Schüle K, Huber G. München: Elsevier Urban & Fischer Verlag; 2004:1-9.
• [20]Pfeifer K, Sudeck G, Brüggemann S, Huber G: DGRW-Update: Bewegungstherapie in der medizinischen Rehabilitation - Wirkungen, Qualität, Perspektiven. Rehabilitation (Stuttg) 2010, 49:224-236.
• [21]Hüppe A, Raspe H: Zur Wirksamkeit von stationärer medizinischer Rehabilitation in Deutschland bei chronischen Rückenschmerzen: Zur Wirksamkeit von stationärer medizinischer Rehabilitation in Deutschland bei chronischen Rückenschmerzen: Aktualisierung und methodenkritische Diskussion einer Literaturübersicht. Rehabilitation 2005, 44:24-33.
• [22]Haaf HG: Ergebnisse zur Wirksamkeit der Rehabilitation. Rehabilitation 2005, 44:259-276.
• [23]BAR (Bundesarbeitsgemeinschaft für Rehabilitation): Praxisleitfaden-Strategien zur Sicherung der Nachhaltigkeit von Leistungen zur medizinischen Rehabilitation. Frankfurt am Main: BAR; 2008.
• [24]Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P, Methods and Processes of the CONSORT Group: Example of an extension for trials assessing nonpharmacologic treatments. Ann Intern Med 2008, 148:60-66.
• [25]Schulz KF, Altman DG, Moher D: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 2010, 1:100-107.
• [26]Achtziger A, Gollwitzer PM: Motivation und Volition im Handlungsverlauf. In Motivation und Handeln. Edited by Heckhausen J, Heckhausen H. Heidelberg: Springer-Lehrbuch; 2006:277-302.
• [27]Fuchs R: Das MoVo-Modell als theoretische Grundlage für Programme der Gesundheitsverhaltensänderung. In Aufbau eines körperlich-aktiven Lebensstils. Edited by Fuchs R, Göher W, Seelig H. Göttingen: Hogrefe Verlag; 2007:317-325.
• [28]Deci EL, Ryan RM: The “what” and “why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inq 2000, 11:227-268.
• [29]Nellessen-Martens G, Froböse I: Therapie – gemeinsames Handeln. In Training in der Therapie. Grundlagen und Praxis. 3rd edition. Edited by Froböse I, Wilke C, Nellessen-Martens G. München: Elsevier Urban & Fischer; 2010:1-13.
• [30]Armstrong T, Bull F: Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). J Public Health 2006, 14:66-70.
• [31]Bull FC, Maslin TS, Armstrong T: Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health 2009, 6:790-804.
• [32]Mittag O, Raspe H: Eine kurze Skala zur Messung der subjektiven Prognose der Erwerbstätigkeit: Ergebnisse einer Untersuchung an 4.279 Mitgliedern der Gesetzlichen Arbeiterrentenversicherung zu Reliabilität (Guttman-Skalierung) und Validität der Skala. Rehabilitation 2003, 42:169-174.
• [33]Deck R, Mittag O, Hüppe A, Muche-Borowski C, Raspe H: Index zur Messung von Einschränkungen der Teilhabe (IMET) erste Ergebnisse eines ICF-orientierten Assessmentinstruments. Praxis Klinische Verhaltensmedizin und Rehabilitation 2007, 76:113-120.
• [34]Krämer L, Fuchs R: Barrieren und Barrie renmanagement im Prozess der Sportteilnahme. Zwei neue Messinstrumente. Zeitschrift für Gesundheitspsychologie 2010, 18:170-182.
• [35]Fuchs R: Sportbezogene Konsequenzerfahrungen: Das Konstrukt und seine Messung. Freiburg: Universität Freiburg; 2013.
• [36]Kohlmann T, Raspe H: Der Funktionsfragebogen Hannover zur alltagsnahen Diagnostik der Funktionsbeeinträchtigung durch Rückenschmerzen (FFbH-R). Rehabilitation (Stuttg) 1996, 35:I-VIII.