Patient Education for Patients With Back Pain Referred to Physical Therapy

Not Applicable

Completed

Brief Summary: 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.

Detailed Description: 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.

Recruitment & Eligibility

Inclusion Criteria

Chief complaint of non-specific low back pain scheduled to receive outpatient physical therapy
age 18-60
duration of current symptoms < 8weeks
referred to physical therapy from a non-surgeon provider
no treatment received for low back pain in past year other than physician office visits.

Exclusion Criteria

Diagnosis provided by the referral source indicating a specific pathoanatomical source for LBP including fracture, spondylolesthesis, ankylosing spondylitis, radiculopathy
any red flags in the patient's general medical screening questionnaire (i.e. tumor, metabolic diseases etc.).

Arm && Interventions

Group	Intervention	Description
Education	Patient Education	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	Control	Previously scheduled physical therapy was provided with treatment at the therapist's discretion. No educational intervention was provided before beginning physical therapy

Primary Outcome Measures

Name	Time	Method
Oswestry Disability Index	6 weeks	Self-report measure of low back pain-related disability
Pain as measured by the Numeric Pain Rating Scale	6 weeks	Self-report measure of pain intensity on 0-10 rating scale

Secondary Outcome Measures

Name	Time	Method
Oswestry Disability Scale	baseline, 3 months	Self-report measure of low back pain-related disability
Numeric Pain Rating	baseline, 3 months	Self-report measure of pain intensity on 0-10 scale
Pain Catastrophizing Scale	baseline, 6 weeks, 3 months	Self-report measure of pain catastrophizing beliefs
Fear Avoidance beliefs Questionnaire	baseline, 6 weeks, 3 months	Self-report measure of fear avoidance beliefs about physical activity and work
Pain Beliefs Questionnaire	baseline, 6 weeks, 3 months	Self-report questionnaire used to measure patients' beliefs about the causes and consequences of pain with 2 subscales: organic (i.e, biomedical) and psychological.
Hospital Anxiety and Depression Scale	baseline, 6 weeks, 3 months	Self-report questionnaire assessing anxiety and depression in separate sub-scales
Global Rating of Change	6 weeks, 3 months	Self-report global rating of improvement in condition since baseline assessed on 0-15 scale
Physical Therapy Visits: Number of physical therapy episodes attended after baseline	6 weeks, 3 months	Number of physical therapy episodes attended after baseline
Treatment Self-Regulation Questionnaire	baseline, 6 weeks, 3 months	Self-report questionnaire examining motivations to attend physical therapy

Locations (1): The University of Utah Healthcare System
🇺🇸
Salt Lake City, Utah, United States