Education of Municipality-based Physiotherapists in Managing Disabling Low Back Pain - an Observational Study
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 200
- 试验地点
- 1
- 主要终点
- Disability
研究概览
简要总结
A consistent theme in the modern-day healthcare system is the difficulty of transferring research knowledge into clinical practice. Recently, it has been pointed out that this is a barrier for providing care that is evidence-based which may partly explain the growing burden of low back pain.
Low back pain, as all other musculoskeletal pain conditions is multidimensional where biomedical and psychological factors need to be accounted for, as well as the patient's social context. From the healthcare provider perspective, this requires skills that often goes beyond the basic training where clinicians need to be able to assess and manage the multiple domains in a patient-centered manner.
In Denmark, people living with disabling low back pain can be referred to a municipality-based rehabilitation program. This study seeks to investigate whether providing physiotherapists an evidence-based educational course on the management of low back pain will change patient-related outcomes. Likewise, we will investigate potential barriers and facilitators for implementing the skills the physiotherapists acquire in clinical practice.
If the project shows a favorable effect, it will allow for upscaling the intervention within and across municipalities. Moreover, a positive outcome may provide indications of what type of continuing education resources should be made available to help clinicians better manage complicated low back pain problems.
详细描述
Schedule of procedures and assessments
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All participating physiotherapists will recruit eligible patients (N=100) who are asked to fill out project-specific questionnaires (see procedures) at the start and at the end of the rehabilitation program.
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The participating physiotherapists will undergo a 13-day educational intervention (see description below under intervention) focusing on management of low back pain within an individualized multidimensional framework.
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Point 1 is repeated on an additional 100 patients who undergo rehabilitation after the physiotherapists have completed the course
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Participating physiotherapists will be evaluated on the background of a competency checklist which is scored by clinical supervisors connected to the study. The checklist will be scored after watching a video recording of a patient consultation performed by the physiotherapist in focus. The checklist covers 6 domains: Subjective and objective assessment, cognitive-functional therapy intervention, style of communication, patient's unhelpful pain behavior, and an overall assessment
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •referred to municipality care from the Spine Clinic of Southern Denmark
- •Between 18-65 years
- •Speaks and comprehends Danish
- •A score over 40 on the Orebro Musculoskeletal Pain Questionnaire
- •Low back pain as dominating cause for referral
排除标准
- •A current diagnosis of psychiatric illness that precludes participation in rehabilitation
- •A neurologic disorder or other disease that may affect the ability to participate in a municipality based rehabilitation program
- •A neurological deficits related with radiographically confirmed lumbar spinal stenosis or radicular pain correlating with the clinical presentation
- •Recent (within 6 months) history of a stabilizing operation of the low back
结局指标
主要结局
Disability
时间窗: At baseline and 3 months after starting rehabilitation
Change in disability measured on the Roland Morris Disability Questionnaire between baseline and follow up. Questionnaire designed to capture disability in low back pain patients (0-24 where 0 = no loss of function and 24 = complete loss of function)
次要结局
- Sick leave from work(At baseline and 3 months after starting rehabilitation)
- Pain intensity(At baseline and 3 months after starting rehabilitation)
- Patient Assessment of Transitions in Healthcare(3 months after starting rehabilitation)
- Emotional and cognitive functioning(At baseline and 3 months after starting rehabilitation)
研究者
Thorvaldur Skuli Palsson
Head of research,
Aalborg University Hospital