Effect of Physiotherapy in Patients Presenting to the Emergency Department With Nonspecific Lower Back Pain. A Brief Intervention Focusing on Patient Reported Outcomes
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Lower Back Pain
- Sponsor
- University Hospital, Basel, Switzerland
- Enrollment
- 126
- Locations
- 1
- Primary Endpoint
- Oswestry Disability Index (ODI)
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Physiotherapy is a long established therapy in lower back pain. It is unknown if physiotherapeutic interventions in patients presenting to the Emergency Department (ED) with nonspecific lower back pain are beneficial. The aim of this study is to assess whether patients presenting to the emergency department with non-specific low risk low back pain would benefit from a physiotherapy intervention, as compared to patients without physiotherapy intervention at time of ED presentation.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Written informed consent
- •Experiencing nonspecific lower back pain
- •Presentation to the Emergency Department (ED) of the University Hospital Basel
Exclusion Criteria
- •Inpatient disposition after ED work-up
- •"Red Flags" at time of ED-presentation:
- •Major trauma in all patients
- •Fractures leading to immobilization
- •Severe or progressive sensory alteration or weakness
- •Bladder or bowel dysfunction
- •Evidence of neurological deficit on physical examination
- •Severe chronic disease, such as metastasized cancer, palliative care
- •Epidural steroid injections in the last 3 months
- •Inability or contraindications to undergo the investigated intervention or to follow the study procedures, e.g. due to certain neurological disorders, language problems, psychological disorders, cognitive impairment, physical inability etc.
Outcomes
Primary Outcomes
Oswestry Disability Index (ODI)
Time Frame: At Day 0 and at Day 7 ± 7 days
This self-completed questionnaire contains ten topics concerning intensity of pain, lifting, ability to care for oneself, ability to walk, ability to sit, sexual function, ability to stand, social life, sleep quality, and ability to travel. Each topic category is followed by 6 statements describing different potential scenarios in the patient's life relating to the topic. The patient then checks the statement which most closely resembles their situation. Each question is scored on a scale of 0-5 with the first statement being zero and indicating the least amount of disability and the last statement is scored 5 indicating most severe disability. The scores for all questions answered are summed, then multiplied by two to obtain the index (range 0 to 100). Zero is equated with no disability and 100 is the maximum disability possible.
Secondary Outcomes
- Oswestry Disability Index (ODI)(Day 21 ± 3 days, Day 42 ± 3 days)
- Pain Numeric Rating Scale (NRS)(At Day 0, Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days)
- Adherence to therapy recommendations(At Day 7 ± 7 days)
- StarT Back Screening Tool (SBST)(Day 0, Day 7 ± 7 days, Day 42 ± 3 days)
- Feasibility of the intervention(At Day 0)
- Utilization of medical resources(At Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days)
- Ability to work(At Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days)
- Patient satisfaction(At Day 7 ± 7 days)
- Pain medication use(At Day 0, Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days)