Chronic Low Back Pain Rehabilitation in Primary Care: an RCT

NCT ID: NCT02220543

Last Updated: 2017-08-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-08-31

Study Completion Date

2017-08-31

Brief Summary

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The aim of this study is to evaluate the effectiveness and cost-effectiveness of a new primary care intervention "Back on Track" as compared to usual primary care in patients with non-specific chronic low back pain in which disability levels are moderate and the role of psychosocial factors to this disability is at maximum low (classified as WPN2).

Detailed Description

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Conditions

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Low Back Pain Chronic Pain Musculoskeletal Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Back on Track intervention

Back on Track intervention is a biopsychosocial primary care intervention

Group Type EXPERIMENTAL

Back on Track intervention

Intervention Type OTHER

Biopsychosocial primary care intervention based on multidisciplinary pain rehabiliation programs. The Back on Track intervention comprises 4 individual sessions and 8 group sessions.

Primary care as usual

Intervention Type OTHER

Regular physical therapy in primary care. Physical therapists are recommended by their profession (the Royal Dutch Society for Physical Therapy) to work according to a profession-specific guideline for the treatment of patients with low back pain in primary care settings. Maximally 12 individual sessions (30 minutes each) for a maximum of 8 weeks.

Primary care as usual

Primary care as usual comprises maximally 12 individual regular physical therapy sessions for a maximum of 8 weeks.

Group Type ACTIVE_COMPARATOR

Back on Track intervention

Intervention Type OTHER

Biopsychosocial primary care intervention based on multidisciplinary pain rehabiliation programs. The Back on Track intervention comprises 4 individual sessions and 8 group sessions.

Primary care as usual

Intervention Type OTHER

Regular physical therapy in primary care. Physical therapists are recommended by their profession (the Royal Dutch Society for Physical Therapy) to work according to a profession-specific guideline for the treatment of patients with low back pain in primary care settings. Maximally 12 individual sessions (30 minutes each) for a maximum of 8 weeks.

Interventions

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Back on Track intervention

Biopsychosocial primary care intervention based on multidisciplinary pain rehabiliation programs. The Back on Track intervention comprises 4 individual sessions and 8 group sessions.

Intervention Type OTHER

Primary care as usual

Regular physical therapy in primary care. Physical therapists are recommended by their profession (the Royal Dutch Society for Physical Therapy) to work according to a profession-specific guideline for the treatment of patients with low back pain in primary care settings. Maximally 12 individual sessions (30 minutes each) for a maximum of 8 weeks.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Chronic low back pain; defined as pain between scapulae and gluteal region, whether or not with radiation towards one or both legs, present for at least three months.
* Presence of contributing social and psychological factors, however not complex (WPN2 classification)
* Age between 18 and 65 year
* Sufficient knowledge of the Dutch language
* Acceptance towards the biopsychosocial approach instead of biomedical approach

Exclusion Criteria

* Chronic low back pain attributable to e.g. infection, tumour, osteoporosis, fracture, structural deformation, inflammatory process, radicular syndrome or cauda equina syndrome
* Pregnancy
* Any suspicion of an (underlying) psychiatric disease, for which psychiatric treatment is better suited, according to the expert opinion of the consultant in rehabilitation medicine.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Adelante, Centre of Expertise in Rehabilitation and Audiology

OTHER

Sponsor Role collaborator

The Province of Limburg

UNKNOWN

Sponsor Role collaborator

CZ Fonds

OTHER

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ivan PJ Huijnen, Dr.

Role: PRINCIPAL_INVESTIGATOR

Maastricht University

Locations

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Fysiotherapie Giessen-Ploemen

Bunde, Limburg, Netherlands

Site Status

Fysiohof

Maastricht, Limburg, Netherlands

Site Status

Fysio Zuyd Caberg

Maastricht, Limburg, Netherlands

Site Status

Fysiotherapiepraktijk Yvonne Janss

Maastricht, Limburg, Netherlands

Site Status

ICM Fysio

Maastricht, Limburg, Netherlands

Site Status

Fysiotherapie Breuers

Margraten, Limburg, Netherlands

Site Status

Fysiotherapie Abbink

Ulestraten, Limburg, Netherlands

Site Status

Fysio Valkenburg

Valkenburg, Limburg, Netherlands

Site Status

Countries

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Netherlands

References

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Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000 Apr;85(3):317-332. doi: 10.1016/S0304-3959(99)00242-0.

Reference Type BACKGROUND
PMID: 10781906 (View on PubMed)

Lindstrom I, Ohlund C, Eek C, Wallin L, Peterson LE, Fordyce WE, Nachemson AL. The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavioral approach. Phys Ther. 1992 Apr;72(4):279-90; discussion 291-3. doi: 10.1093/ptj/72.4.279.

Reference Type BACKGROUND
PMID: 1533941 (View on PubMed)

Leeuw M, Goossens MEJB, van Breukelen GJP, de Jong JR, Heuts PHTG, Smeets RJEM, Koke AJA, Vlaeyen JWS. Exposure in vivo versus operant graded activity in chronic low back pain patients: results of a randomized controlled trial. Pain. 2008 Aug 15;138(1):192-207. doi: 10.1016/j.pain.2007.12.009. Epub 2008 Feb 1.

Reference Type BACKGROUND
PMID: 18242858 (View on PubMed)

Lamb SE, Hansen Z, Lall R, Castelnuovo E, Withers EJ, Nichols V, Potter R, Underwood MR; Back Skills Training Trial investigators. Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. Lancet. 2010 Mar 13;375(9718):916-23. doi: 10.1016/S0140-6736(09)62164-4. Epub 2010 Feb 25.

Reference Type BACKGROUND
PMID: 20189241 (View on PubMed)

Macedo LG, Smeets RJ, Maher CG, Latimer J, McAuley JH. Graded activity and graded exposure for persistent nonspecific low back pain: a systematic review. Phys Ther. 2010 Jun;90(6):860-79. doi: 10.2522/ptj.20090303. Epub 2010 Apr 15.

Reference Type BACKGROUND
PMID: 20395306 (View on PubMed)

Brunner E, De Herdt A, Minguet P, Baldew SS, Probst M. Can cognitive behavioural therapy based strategies be integrated into physiotherapy for the prevention of chronic low back pain? A systematic review. Disabil Rehabil. 2013 Jan;35(1):1-10. doi: 10.3109/09638288.2012.683848. Epub 2012 May 21.

Reference Type BACKGROUND
PMID: 22607157 (View on PubMed)

van Erp RMA, Huijnen IPJ, Koke AJA, Abbink FE, den Hollander M, Smeets RJEM. Development and content of the biopsychosocial primary care intervention 'Back on Track' for a subgroup of people with chronic low back pain. Physiotherapy. 2017 Jun;103(2):160-166. doi: 10.1016/j.physio.2016.04.004. Epub 2016 May 11.

Reference Type DERIVED
PMID: 27641497 (View on PubMed)

van Erp RM, Huijnen IP, Verbunt JA, Smeets RJ. A biopsychosocial primary care intervention (Back on Track) versus primary care as usual in a subgroup of people with chronic low back pain: protocol for a randomised, controlled trial. J Physiother. 2015 Jul;61(3):155. doi: 10.1016/j.jphys.2015.03.003. Epub 2015 Apr 23.

Reference Type DERIVED
PMID: 25922158 (View on PubMed)

Other Identifiers

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14-3-019

Identifier Type: -

Identifier Source: org_study_id

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