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The purpose of this study is to evaluate patients with low back pain who are scheduled to begin physical therapy but have not yet had their first appointment to better understand their beliefs and attitudes and to evaluate the effects of an educational session about low back pain.
The investigators will conduct a randomized trial to examine the effectiveness of a patient education session provided prior to beginning physical therapy on outcomes of usual physical therapy for acute/sub-acute low back pain patients. The study compares two groups, one group will be treated with usual physical therapy with no pre-treatment education and the other group will also receive the pre-treatment. Patients will be followed after 6 weeks and 3 months. Physical therapy care is left to the discretion of the physical therapist in conjunction with the patient. Outcomes will include pain and disability, and patients attitude and believes (pain catastrophizing, fear avoidance behavior). The overall hypothesis is that the additional educational treatment may address and improve pain, disability and fear.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Education | Experimental | Patients receive an educational video about low back pain based on the Consumer Reports Choosing Wisely recommendation for patients with back pain to avoid early imaging and remain as active as possible. After the video the evaluator and patient discussed key themes from the video and the patient was able to ask any questions. Previously scheduled physical therapy then began with treatment at the therapist's discretion. |
|
| Control | Active Comparator | Previously scheduled physical therapy was provided with treatment at the therapist's discretion. No educational intervention was provided before beginning physical therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patient Education | Behavioral | An educational video was watched based on Consumer Reports Choosing Wisely patient education supporting the recommendation that imaging is not helpful early for low back pain and the best strategy is to remain as active as possible. Key themes were discussed with a physical therapist and the patient's questions were answered. |
| Measure | Description | Time Frame |
|---|---|---|
| Oswestry Disability Index | Self-report measure of low back pain-related disability | 6 weeks |
| Pain as measured by the Numeric Pain Rating Scale | Self-report measure of pain intensity on 0-10 rating scale | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Fear Avoidance beliefs Questionnaire | Self-report measure of fear avoidance beliefs about physical activity and work | baseline, 6 weeks, 3 months |
| Pain Catastrophizing Scale | Self-report measure of pain catastrophizing beliefs |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Utah Healthcare System | Salt Lake City | Utah | 84108 | United States |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D010353 | Patient Education as Topic |
| ID | Term |
|---|---|
| D006266 | Health Education |
| D011314 | Preventive Health Services |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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| Control | Other | Patients receive no additional intervention. They will begin physical therapy and receive care at the therapist's discretion. |
|
| baseline, 6 weeks, 3 months |
| Pain Beliefs Questionnaire | Self-report questionnaire used to measure patients' beliefs about the causes and consequences of pain with 2 subscales: organic (i.e, biomedical) and psychological. | baseline, 6 weeks, 3 months |
| Global Rating of Change | Self-report global rating of improvement in condition since baseline assessed on 0-15 scale | 6 weeks, 3 months |
| Physical Therapy Visits: Number of physical therapy episodes attended after baseline | Number of physical therapy episodes attended after baseline | 6 weeks, 3 months |
| Treatment Self-Regulation Questionnaire | Self-report questionnaire examining motivations to attend physical therapy | baseline, 6 weeks, 3 months |
| Hospital Anxiety and Depression Scale | Self-report questionnaire assessing anxiety and depression in separate sub-scales | baseline, 6 weeks, 3 months |
| Oswestry Disability Scale | Self-report measure of low back pain-related disability | baseline, 3 months |
| Numeric Pain Rating | Self-report measure of pain intensity on 0-10 scale | baseline, 3 months |
| D013568 |
| Pathological Conditions, Signs and Symptoms |