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The primary objective of the current research is to assess the effect of an enhanced patient-clinician relationship when compared to a limited patient-clinician relationship on measures of chronic low back pain and objective functional measures.
The second objective is to examine racialized disparities in chronic low back pain among individuals who identify as non-Hispanic Black and non-Hispanic White using a qualitative approach.
Lastly, the study team will explore relationships between psychosocial components of low back pain, pain and functional outcomes, and patient-clinician relationship measures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Limited Patient-Clinician Relationship Group | Active Comparator |
| |
| Enhanced Patient-Clinician Relationship Group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Limited Relationship | Other | In this group, participants will share information regarding their low back pain history to a clinician who is not providing eye-contact, has farther physical distance, and is not directly facing the participant. The clinician will not provide verbal affirmations or ask clarifying questions about the patient's low back pain history. Instead, more time will be spent on completion of documentation. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Number of lifts completed in 1 minute | To be measured during the 1-minute lift test, where the participant is asked to lift objects of a certain weight. | Pre-Intervention (Day 1), Post-Intervention (Day 1) |
| Change in time holding the horizontal position | To be collected during the Biering-Sorensen Test, which is a timed measure used to assess the endurance of the trunk extensor muscles. | Pre-Intervention (Day 1), Post-Intervention (Day 1) |
| Change in Trunk Flexion Range of Motion | To be measured during the Fingertip-to-floor (FTF) Test, where the participant is asked to bed forward and attempt to reach the floor with their fingertips. | Pre-Intervention (Day 1), Post-Intervention (Day 1) |
| Change in Mean Walking Speed | To be measured/assessed during the 4-meter walking test. | Pre-Intervention (Day 1), Post-Intervention (Day 1) |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analogue Scale (VAS) for Pain | VAS will be used to report pain at rest. A patient is asked to indicate his/her perceived pain intensity (most commonly) along a 100 mm horizontal line, and this rating is then measured from the left edge (=VAS score). The total score range is 0 (no pain) to 10 (worst pain imaginable); the higher the score, the worse the pain. | Pre-Intervention (Day 1), Post-Intervention (Day 1) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Angela Stolfi, PT, DPT | NYU Langone Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New York University Department of Physical Therapy, Arthur J. Nelson Human Performance Laboratory | New York | New York | 10010 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39584210 | Derived | Vorensky M, Squires A, Jones S, Sajnani N, Castillo E, Rao S. Impact of Patient-Clinician Relationships on Pain and Objective Functional Measures for Individuals with Chronic Low Back Pain: An Experimental Study. J Health Care Poor Underserved. 2024;35(4):1229-1257. doi: 10.1353/hpu.2024.a943987. |
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Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices) will be shared upon reasongle request.
Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research
The investigator who proposed to use the data will have access to the data upon reasonable request. Requests should be directed to Angela.Stolfi@nyulangone.org. To gain access, data requestors will need to sign a data access agreement
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| ID | Term |
|---|---|
| D001416 | Back Pain |
| D059350 | Chronic Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
| Enhanced Relationship | Other | A condition in which the clinician is providing enhanced relatedness with consistent eye contact, closer physical distance, facing the patient, and providing non-verbal affirmations (i.e. nodding, smiling), as the participant shares their low back pain history. The clinician will provide empathic verbal affirmations and will ask clarifying questions about the patient's low back pain history. |
|
| Pain pressure threshold | Pain pressure threshold (the degree of pressure required to produce symptoms) will be assessed using a pressure algometer. | Pre-Intervention (Day 1), Post-Intervention (Day 1) |