Patient Education and Motor Control Exercise Among Rural Community-dwelling Adults With Chronic Low Back Pain
Condition: Nonspecific Chronic Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Low back pain (LBP) is the leading cause of years lived with disability globally with
      increasing concern about its impact in low- and middle-income countries like those situated
      in Africa where most people are living in rural areas with limited access to health care.
      Epidemiological studies in Nigeria suggest that the burden of chronic low back pain (CLBP) in
      rural areas is greater than in urban areas, with both biomechanical and psychological factors
      being implicated. However, despite the burden of CLBP in rural Nigeria, rehabilitation
      services are lacking even at the rural primary healthcare centers due to the absence of
      physiotherapists. Current clinical practice guidelines unanimously recommend education
      including instruction on self-management options, and exercise as frontline interventions to
      help individuals with CLBP. However, the specific content of these interventions are rarely
      described. Patient education (PE) strategies incorporating both biomedical and psychosocial
      information have been shown to be beneficial for CLBP. Moreover, exercises in the form of
      motor control exercises (MCEs) have been proven to be effective for CLBP. However, RCTs
      examining the effects of PE and MCE individually or in combination among rural
      community-dwelling adults with CLBP are scarce.

      The purpose of this study is to determine the effects of PE and MCE program on selected
      clinical and psychosocial variables among rural community-dwelling adults with nonspecific
      CLBP.
    

Detailed description: 
      Participants will be recruited and assigned to one of three intervention groups that include
      PE plus MCE group, MCE group, or PE group using a block random technique based on an
      electronic randomization table generated by a computer software program. Blinded assessment
      of all outcomes will be performed at baseline, 8 weeks after randomization and at 3, 6 and 12
      months follow-up.

      Primary outcomes will be functional disability and pain intensity. Secondary outcomes will be
      quality of life, global perceived recovery, fear-avoidance beliefs, pain catastrophizing,
      back pain consequences beliefs, and physical performance (finger-floor test, repeated
      sit-to-stand test, and the 50-foot walk test) Data will be analyzed using descriptive and
      inferential (mixed-model ANOVA/linear mixed-effects model) statistics. All statistical
      analyses will be performed on IBM SPSS Statistics ver. 23.0 (IBM Co., Armonk, NY, USA) at
      alpha level of 0.05.
    

Intervention name(s): Motor Control Exercise; Patient Education
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Activation of specific muscles of the lumbopelvic region responsible for providing stability or control of posture and movement.; Education aiming to change unhelpful beliefs about LBP, decrease fear avoidance behavior and catastrophic thought, promote positive attitude, self-management, and active coping strategies.
Other intervention name(s): Specific stabilisation exercise; Cognitive Education
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Chronic Low Back Pain; Motor Control Exercise; Patient Education