Effects of Low Back Pain Knowledge-Related Education on Attitudes and Knowledge in Patients With Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Low back pain (LBP) is the leading musculoskeletal condition in burden of disease and years
      lived with disability. This high ranking is in large part due to the high prevalence of LBP.
      LBP is not only mechanically related to spinal pathophysiology (i.e., postural alterations,
      articular stiffness, or muscle weakness), but may also be influenced by psychosocial factors
      such as attitudes and beliefs. Multidisciplinary rehabilitation programs, which include
      biopsychosocial management, resulted in a better outcome. The aim of this project is to
      determine if the change in LBP-related knowledge and attitudes toward LBP are correlated with
      the change in LBP-related pain, disability, fear avoidance, and emotional states of
      depression, anxiety, and stress after three months. The second aim is to investigate the
      effect of adding LBP knowledge related education sessions to standard physical therapy
      treatment on patients' LBP knowledge, attitudes toward LBP, LBP-related pain, disability,
      fear avoidance, and emotional symptoms in comparison to standard physical therapy alone.
    

Detailed description: 
      Low back pain (LBP) is the leading musculoskeletal condition in burden of disease and years
      lived with disability. This high ranking is in large part due to the high prevalence of LBP.
      LBP is not only mechanically related to spinal pathophysiology (i.e., postural alterations,
      articular stiffness, or muscle weakness), but may also be influenced by psychosocial factors
      such as attitudes and beliefs. Multidisciplinary rehabilitation programs, which include
      biopsychosocial management, resulted in a better outcome. The aim of this project is to
      determine if the change in LBP-related knowledge and attitudes toward LBP are correlated with
      the change in LBP-related pain, disability, fear avoidance, and emotional states of
      depression, anxiety, and stress after three months. Secondly, the investigators will
      investigate the effect of adding LBP knowledge related education sessions to standard
      physical therapy treatment on patients' LBP knowledge, attitudes toward LBP, LBP-related
      pain, disability, fear avoidance, and emotional symptoms in comparison to standard physical
      therapy alone. 74 patients with LBP receiving standard physical therapy service for the first
      time will be interviewed and their knowledge and attitude about LBP will be collected at the
      baseline. After 3 months, the LBP related pain, emotional symptoms, and LBP disability will
      be collected. The patients will be allocated to "Experimental group" consist of 37 patients
      will take education sessions in addition to standard physical therapy for 12 sessions or
      "control group" consist of 37 patients take just standard physical therapy for the same
      number of sessions without education. Participants will be assessed at baseline and at 3
      months follow up. Outcome measures include Arabic version of the Back Pain Attitudes
      (Back-PAQ), Low Back Pain Knowledge (LKQ) Questionnaires, Arabic version of Oswestry
      Disability Index (ODI) to assess the function, Visual Analogue Scale for pain intensity,
      Depression Anxiety Stress Scales (DASS-21) for emotional states, and Fear-Avoidance Beliefs
      Questionnaire (FABQ) for fear avoidance beliefs. Spearman correlation coefficient r will be
      used to investigate the correlation between change in LBP knowledge and attitude, and change
      in pain, disability, fear avoidance and emotional symptoms after three months. Independent
      sample t-test will be used to compare the knowledge, attitude, VAS, ODI, FABQ, and DASS-
      between the experimental group and control group.
    

Intervention name(s): Education; Standard physical therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): A one hour educational session per week for 4 weeks. In a total of 4 sessions of education, the content based on LBP Clinical Practice Guidelines which recommended that education and counseling strategies for patients with low back pain.
Education session will be through video lecturing as a motivated tool of education for all subject who are in experimental group, this video will repeated the same in every educational session and will be sent for all participants.
The neuroscience education will be by the therapist using interactive slide show and hand-drawing images.
In addition to the education video, slide show, we will specify the education for every patient to give him all that he need, questions and details, mention his case on real spine to explore it and to determine the expected goal from what he need and what we have.; Two session physical therapy per week for 4 weeks. The physical therapy will be based on patients case.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Knowledge; Attitude; Disability; Pain