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Macedo L, Di Pelino S, Santos VS, Richardson J, MacDermid J, Hancock M, Battie MC, Saragiotto BT, Hayden JA, Rushton A, Packham T, Freman M, Bray S, Griffin M, Hladysh G, Miller P, Attwell S. Implementation of back to living well, a community-based program for the tertiary prevention of low back pain: a study protocol. BMC Musculoskelet Disord 2024; 25:593. [PMID: 39068385 PMCID: PMC11283700 DOI: 10.1186/s12891-024-07712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND The current literature supports the effectiveness of exercise, education, and self-management interventions for the long-term management of persistent low back pain. However, there is significant uncertainty about the implementation of interventions related to barriers, facilitators, and patient's preferences. This study will evaluate the Back to Living Well program implementation from a participant and organizational perspective. More specifically we address the following objectives: 1) identify program barriers and facilitators from participants' perspectives, 2) identify factors related to program, personal and contextual factors that contribute to negative and positive outcomes, and outcome trajectories, 3) identify factors influencing participants' selection of an in-person or e-health program, and 4) evaluate program specific barriers and facilitators from the organization and care delivery perspectives. METHODS This study will utilize a mixed-method convergent design including a longitudinal cohort strand and a longitudinal qualitative interview strand. The RE-AIM framework will be used to assess program implementation. Participants (n = 90, 1:1: in person or virtual) who choose to register in the program as well as staff (n = 10 to 15) involved in the delivery of the program will be invited to participate. Participants will participate in a 12-week physical activity, education, and self-management program. Implementation outcomes will be measured at 3-, 6-, 12-months, and six months after the end of the follow-ups. Interview scripts and directed content analysis will be constructed based on the Theoretical Domains Framework and the Neuromatrix Model of Pain, Theoretical Domains Framework. Staff interviews will be constructed and analyzed using the Consolidated Framework for Implementation Research. Participants will also complete pain, disability, quality of life and psychological questionnaires, wear an activity tracker at all time points, and complete weekly pain and activity limitation questions using a mobile application. DISCUSSION The study results will provide evidence to inform potential future implementation of the program. An effective, appropriately targeted, and well implemented exercise program for the long-term management (i.e., tertiary prevention) of LBP could minimize the burden of the condition on patients, the health care system and society. TRIAL REGISTRATION ClinicalTrials.gov NCT05929846. This (Registration Date: July 3 2023) study has been approved by the Hamilton Integrated Research Ethics Board Project ID#15,354.
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Affiliation(s)
- Luciana Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
| | | | - Veronica Souza Santos
- School of Rehabilitation Science, McMaster University and Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Sao Paulo, Brazil
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | | | | | | | - Bruno T Saragiotto
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | | | | | - Tara Packham
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Matt Freman
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Steven Bray
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Meridith Griffin
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | | | - Pat Miller
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Montgomery G, Tobias JH, Paskins Z, Khera TK, Huggins CJ, Allison SJ, Abasolo D, Clark EM, Ireland A. Daily Pain Severity but Not Vertebral Fractures Is Associated With Lower Physical Activity in Postmenopausal Women With Back Pain. J Aging Phys Act 2024; 32:428-437. [PMID: 38527456 DOI: 10.1123/japa.2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/24/2023] [Accepted: 12/13/2023] [Indexed: 03/27/2024]
Abstract
Back pain lifetime incidence is 60%-70%, while 12%-20% of older women have vertebral fractures (VFs), often with back pain. We aimed to provide objective evidence, currently lacking, regarding whether back pain and VFs affect physical activity (PA). We recruited 69 women with recent back pain (age 74.5 ± 5.4 years). Low- (0.5 < g < 1.0), medium- (1.0 ≤ g < 1.5), and high-impact (g ≥ 1.5) PA and walking time were measured (100 Hz for 7 days, hip-worn accelerometer). Linear mixed-effects models assessed associations between self-reported pain and PA, and group differences (VFs from spine radiographs/no-VF) in PA. Higher daily pain was associated with reduced low (β = -0.12, 95% confidence interval, [-0.22, -0.03], p = .013) and medium-impact PA (β = -0.11, 95% confidence interval, [-0.21, -0.01], p = .041), but not high-impact PA or walking time (p > .11). VFs were not associated with PA (all p > .2). Higher daily pain levels but not VFs were associated with reduced low- and medium-impact PA, which could increase sarcopenia and falls risk in older women with back pain.
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Affiliation(s)
- Gallin Montgomery
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jon H Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Zoe Paskins
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Tarnjit K Khera
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Cameron J Huggins
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sarah J Allison
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
- Department of Nutrition, Food & Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Daniel Abasolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Emma M Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alex Ireland
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
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Pottkotter K, Hazlett M, Mansfield CJ, Rethman K, Fritz JM, Quatman-Yates CC, Briggs MS. Understanding social determinants of health and physical therapy outcomes in patients with low back pain: A scoping review. Musculoskeletal Care 2024; 22:e1888. [PMID: 38747557 DOI: 10.1002/msc.1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Low back pain (LBP) is the number one cause of disability worldwide; however, it is not clear how social determinants of health (SDOH) impact care management and outcomes related to physical therapy (PT) services for patients with LBP. OBJECTIVE The purposes of this scoping review are to examine and assimilate the literature on how SDOH and PT care relate to non-specific LBP outcomes and identify gaps in the literature to target for future research. METHODS Data were extracted from eight electronic databases from January 2011 to February 2022. Reviewers independently screened all studies using the PRISMA extension for scoping review guidelines. Data related to study design, type of PT, type of non-specific LBP, patient demographics, PT intervention, SDOH, and PT outcomes were extracted from the articles. RESULTS A total of 30,523 studies were screened, with 1961 articles undergoing full text review. Ultimately, 76 articles were identified for inclusion. Sex and age were the most frequent SDOH examined (88% and 78% respectively) followed by education level (18%). Approximately half of the studies that examined age, sex, and education level identified no effect on outcomes. The number of studies examining other factors was small and the types of outcomes evaluated were variable, which limited the ability to pool results. CONCLUSIONS Sex and age were the most frequent SDOH examined followed by education level. Other factors were evaluated less frequently, making it difficult to draw conclusions. Study design and heterogeneity of determinants and outcomes were barriers to examining the potential impact on patients with LBP.
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Affiliation(s)
- Kristy Pottkotter
- The Ohio State University Wexner Medical Center, Ambulatory Rehabilitation, Columbus, Ohio, USA
- The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, Columbus, Ohio, USA
| | - Miriam Hazlett
- The Ohio State University School of Health and Rehabilitation Sciences, Columbus, Ohio, USA
| | - Cody J Mansfield
- The Ohio State University Wexner Medical Center, Ambulatory Rehabilitation, Columbus, Ohio, USA
- The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, Columbus, Ohio, USA
- The Ohio State University School of Health and Rehabilitation Sciences, Columbus, Ohio, USA
| | - Katherine Rethman
- The Ohio State University Wexner Medical Center, Ambulatory Rehabilitation, Columbus, Ohio, USA
- The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, Columbus, Ohio, USA
| | - Julie M Fritz
- College of Health, The University of Utah, Salt Lake City, Utah, USA
| | - Catherine C Quatman-Yates
- The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, Columbus, Ohio, USA
- The Ohio State University School of Health and Rehabilitation Sciences, Columbus, Ohio, USA
| | - Matthew S Briggs
- The Ohio State University Wexner Medical Center, Ambulatory Rehabilitation, Columbus, Ohio, USA
- The Ohio State University Wexner Medical Center, Sports Medicine Research Institute, Columbus, Ohio, USA
- The Ohio State University School of Health and Rehabilitation Sciences, Columbus, Ohio, USA
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA
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Haddas R, Botros M, D'Agostino CR, Jablonski J, Ramirez G, Vasalos K, Thirukumaran C, Rubery PT. The effect of a workplace wellness program on disability, function and pain in healthcare providers workers with low back pain-outcomes of 3040 academic health center employees. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4405-4419. [PMID: 37875680 DOI: 10.1007/s00586-023-07971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 09/22/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE (1) Identification of musculoskeletal risk factors for healthcare providers suffering low back pain (LBP) and the creation of risk profiles for those individuals and (2) analyze the impact of a workplace wellness program on healthcare providers who suffer from low back pain. METHODS A total of 3040 employees at an academic healthcare center underwent a computer-adaptive survey of health-related quality of life (HRQOL), biometric tests, and a disability and functional movement assessment as part of the workplace wellness program (WWP). Clinical interventions with a rehabilitation specialist were offered to employees identified as at risk for low back pain. Data collected were analyzed using descriptive methods and multivariable regressions to address the study objectives. RESULTS Of the 3040 healthcare providers enrolled in this study, 77% identified with non-specific LBP with greater weakness, numbness, reduced flexibility, and physical activity. The major predictive risk factors for LBP were Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference score, PROMIS fatigue, previous work injury, flexibility, numbness, PROMIS social function, level of education, and BMI. Healthcare providers with LBP who completed the WWP improved in most dimensions of HRQOL and disability and functional outcomes. CONCLUSIONS A high proportion of healthcare providers suffer from LBP as a result of the nature of their work. Disability and functional outcomes measurements and PROMIS results quantitatively assess healthcare providers with LBP. Organizations can develop injury mitigation programs to target employees at high risk of LBP using the risk factors we identify. Completion of the WWP was associated with improvements in disability, HRQOL and functional measures.
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Affiliation(s)
- Ram Haddas
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA.
| | - Mina Botros
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
| | - Charles R D'Agostino
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
| | - Justin Jablonski
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
| | - Gabriel Ramirez
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
| | - Kostantinos Vasalos
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
| | - Caroline Thirukumaran
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
| | - Paul T Rubery
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY, 14642, USA
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Kalın AS, Aytur YK. Physical activity levels of individuals with chronic musculoskeletal disorders: Their relationship with barriers and facilitators. Musculoskeletal Care 2023; 21:797-805. [PMID: 36876649 DOI: 10.1002/msc.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Individuals with chronic musculoskeletal disorders (MSD) often avoid physical activity (PA) and exercise although these are the key factors in managing their condition and pain. OBJECTIVES To determine the PA levels of individuals with chronic MSD and their relationship with barriers and facilitators. DESIGN Three hundred and five subjects with five MSD groups; fibromyalgia, myofascial pain, osteoarthritis, periarticular regional pain and degenerative spine problems were included in the study. The visual analogue scale was used to assess pain, the Hospital Anxiety and Depression Scale to assess emotional impact, and the Nottingham Health Profile (NHP) to assess quality of life. PA levels were categorised by the International Physical Activity Questionnaire-Short Form. Perceived barriers and facilitators for PA/exercise were determined by questionnaire. RESULTS 66 (21.6%) were male, 239 (78.4%) were female. 196 (64.3%) of the subjects were physically inactive, 94 (31.1%) low-active, and 15 (4.6%) sufficiently active. The most frequently reported barriers for PA/exercise were fatigue/feeling too tired (72.1%), pain (66.2%), and lack of motivation/willingness (54.4%). The most frequently reported facilitators were the desire to be in good health (72.8%), enjoying exercise (59.7%), and the desire to keep fit and lose weight (59%). CONCLUSION The level of PA in individuals with MSD was quite low. Identifying the underlying causes of PA is important since PA/exercise is beneficial for musculoskeletal health. Yet, barriers and facilitators for PA were revealed for this study population. Identifying and understanding these barriers and facilitators would facilitate the individualised PA/exercise programs for both clinical practice and research.
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Affiliation(s)
- Ayse Sevim Kalın
- Department of Physical Medicine and Rehabilitation, Dağkapı State Hospital, Diyarbakır, Turkey
| | - Yesim Kurtais Aytur
- Department of Physical Medicine and Rehabilitation, Ankara University, Faculty of Medicine, Ankara, Turkey
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Zhong G, Yin X, Li J, Li X, Zhang Q. Acupoint catgut embedding for chronic low back pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e32409. [PMID: 36595995 PMCID: PMC9803487 DOI: 10.1097/md.0000000000032409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The treatment of acupoint catgut embedding (ACE) effective and safe for patients with chronic low back pain (CLBP) is not yet known. This systematic review will objectively and systematically evaluate the efficacy and safety of ACE in CLBP according to the existing evidence. METHODS The protocol of this systematic review and meta-analyses has been registered in PROSPERO with the registration number CRD42019142256. The following electronic databases from inception to November 29, 2022 will be searched: PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang Data and Chinese Science Journal Database. Randomised controlled clinical(RCTs) using ACE to treat CLBP will be included. Outcomes will include pain intensity, instrument with assessment function and disability, quality-of-life, and costs. Adverse events will be reported for safety assessment. By screening the titles, abstracts, and full texts, two independent reviewers will select studies, extract data, and assess study quality. Data synthesis, sensitivity analysis, subgroup analysis and risk of bias assessment will be conducted using RevmanV.5.3 software. The Grading of Recommendations Assessment, Development and Evaluation system will be used to assess the quality ofthe evidence. RESULTS The efficacy and safety of ACE in the treatment of CLBP has not yet been determined. CONCLUSION This systematic review will objectively and systematically evaluate the efficacy and safety of ACE in CLBP according to the existing evidence, which can give high level clinical recommendations to improve patient care and clinical outcomes.
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Affiliation(s)
- Guofu Zhong
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Xiuju Yin
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingyi Li
- Shunde Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaohui Li
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiang Zhang
- Shenzhen Hospital of Beijing University of Chinese Medicine, Guangdong, China
- * Correspondence: Qiang Zhang, Department of Respiratory, Shenzhen Hospital of Beijing University of Chinese Medicine, Shenzhen, Guangdong 518172, China. (e-mail: )
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Ho-A-Tham N, Struyf N, Ting-A-Kee B, de Almeida Mello J, Vanlandewijck Y, Dankaerts W. Physical activity, fear avoidance beliefs and level of disability in a multi-ethnic female population with chronic low back pain in Suriname: A population-based study. PLoS One 2022; 17:e0276974. [PMID: 36315484 PMCID: PMC9621425 DOI: 10.1371/journal.pone.0276974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/18/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is an important cause for reduced daily physical activity (PA) and loss of quality of life, especially in women. In Suriname, a middle-income country in South America, the relationship between PA and CLBP is still unknown. AIMS To assess the level of PA in women with CLBP of different ethnicity, and to identify whether fear avoidance beliefs (FAB), disability, co-occurring musculoskeletal pain sites and various sociodemographic and lifestyle factors were associated with self-reported PA. METHODS A cross-sectional community-based house-to-house survey was conducted between April 2016 and July 2017. The survey followed the Community Oriented Program for Control of Rheumatic Diseases methodology. Selection criteria were being female of Asian-Surinamese, African-Surinamese or of Mixed ethnicity and aged 18 or older, living in an urban area, and reporting CLBP. Data was collected on PA, FAB, disability, co-occurring musculoskeletal pain sites, CLBP intensity and sociodemographic and lifestyle factors. RESULTS Urban adult women with current CLBP (N = 210) were selected. Nearly 57% of the population met the WHO recommendation on PA, with work-related PA as the largest contributor to total self-reported PA. Most women showed low FAB scores (FABQ-Work ≤34 (96.2%) and FABQ-PA ≤14 (57.6%)) and low disability levels (Oswestry Disability Index ≤20 (62.4%)). An inverse association between total PA and FABQ-Work (OR = 0.132, CI: 0.023; 0.750) was found. In contrast, total PA had a significant, positive association with disability (OR = 2.154, CI: 1.044; 4.447) and workload (OR = 2.224, CI: 1.561; 3.167). All other variables showed no association with total PA. CONCLUSION This was the first study in Suriname reporting that 43.3% of urban adult women with CLBP were physically inactive. Total self-reported PA is influenced by FABQ-Work, average to heavy workload and moderate to severe disability. In this study, PA-Work was the major contributor to total PA. Therefore, future longitudinal studies should evaluate different types and aspects of PA in relation to CLBP management.
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Affiliation(s)
- Nancy Ho-A-Tham
- Department of Physiotherapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Niels Struyf
- Department of Physiotherapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Beverly Ting-A-Kee
- Department of Pathology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | | | - Yves Vanlandewijck
- Department of Rehabilitation Sciences, Research Group of Adapted Physical Activity and Psychomotor Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Wim Dankaerts
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Thackeray A, Waring J, Hoogeboom TJ, Nijhuis-van Der Sanden MWG, Hess R, Fritz JM, Conroy MB, Fernandez ME. Implementing a Dutch Physical Therapy Intervention Into a U.S. Health System: Selecting Strategies Using Implementation Mapping. Front Public Health 2022; 10:908484. [PMID: 35899163 PMCID: PMC9309571 DOI: 10.3389/fpubh.2022.908484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCoach2Move is a person-centered physical therapy intervention that has demonstrated success in changing physical activity behaviors among older adults in the Netherlands. In this manuscript, we describe how we developed an implementation plan for Coach2move in a U.S. population and healthcare system using Implementation Mapping.MethodsWe established an implementation planning team of researchers, patients, and clinicians. The Consolidated Framework for Implementation Research provided an overall structure for consideration of the context for implementation. Implementation Mapping guided the planning process. The implementation planning team worked sequentially through the five tasks of Implementation Mapping (1) Identify needs, program adopters and implementers; (2) Identify adoption and implementation outcomes, performance objectives, determinants, and matrices of change; (3) Choose theoretical models and implementation strategies; (4) Produce implementation protocols; (5) Evaluate implementation outcomes. In this manuscript, we identify our evaluation plan but not results as data collection is ongoing.ResultsClinic managers and physical therapists were identified as program adopters and implementors. Performance objectives necessary steps to achieving implementation outcomes were linked to Coach2Move fidelity indicators with implementation by the physical therapist. These included delivery of person-centered care, motivational interviewing, meaningful goal setting, shared decision-making in planning, and systematic monitoring and follow-up. Determinants linked to these performance objectives included knowledge, outcome expectations, skills and self-efficacy, and perceived norms. Implementation strategies were selected based on a review of methods effective for influencing these determinants. This resulted in four primary strategies (1) educational meetings and dynamic training, (2) peer-assessment meetings, (3) changing the electronic health record template, and (4) reminders and prompts. Measures of intervention acceptability, appropriateness, and feasibility will be collected after training and early in implementation. Fidelity and effectiveness measures will be collected over the next 12-months.ConclusionImplementation mapping provided a systematic process for identifying what physical therapists would need to implement Coach2Move with fidelity. The result was a matrix linking behavioral determinants and performance objectives. These matrices of change allowed for systematic identification and tailoring of implementation strategies to the needs of our population and setting. The process was acceptable to diverse stakeholders, facilitated communication across stakeholders.
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Affiliation(s)
- Anne Thackeray
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Anne Thackeray
| | - Jackie Waring
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Thomas J. Hoogeboom
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Rachel Hess
- Division of Health System Innovation and Research, Population Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Julie M. Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Molly B. Conroy
- Department of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Maria E. Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
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Bilterys T, Van Looveren E, Mairesse O, Nijs J, Meeus M, Ickmans K, Cagnie B, Goubert D, Willaert W, De Pauw R, Danneels L, Moens M, Malfliet A. Predictors for physical activity and its change after active physical therapy in people with spinal pain and insomnia: Secondary analysis of a randomized controlled trial. Braz J Phys Ther 2022; 26:100456. [PMID: 36372043 PMCID: PMC9661644 DOI: 10.1016/j.bjpt.2022.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/22/2022] [Accepted: 10/19/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In healthy people and people with nonspecific chronic spinal pain (nCSP) and/or insomnia, participation in physical activity on a regular basis has several physical and psychological health benefits. However, people with chronic conditions often tend to reduce physical activity participation which can lead to deconditioning over time. Currently, there are no known predictors for an (in)active lifestyle (before and after physical therapy treatment) in people with chronic spinal pain and comorbid insomnia. OBJECTIVE To examine predictors of pre-treatment moderate-to-vigorous physical activity (MVPA) and to examine determinants for a change in MVPA in response to 14-weeks of active physical therapy treatment in people with nonspecific chronic spinal pain (nCSP) and comorbid insomnia. METHODS Baseline data and post-treatment data were analyzed for 66 participants. A linear multiple regression analysis was conducted to examine which factors predict MVPA at baseline. Linear mixed-effects modeling was used to identify determinants for change in MVPA in response to an active physical therapy treatment. RESULTS Physical fatigue (b = -0.9; 95%CI: -1.59, -0.15), less limitations in functioning as a result of emotional problems (b = 0.1; 95%CI: 0.03, 0.10), mental fatigue (b = -1.0; 95%CI: -1.67, -0.43), lower general sleep quality (b= 0.7; 95%CI: 0.22, 1.17), and body mass index (b = -0.5; 95%CI: -0.93, -0.16) were significant predictors of baseline MVPA. The regression model explained 33.3% of the total variance in baseline MVPA. The change of MVPA in response to the treatment ranged from a decrease of 17.5 to an increase of 16.6 hours per week. No determinants for change in MVPA after treatment could be identified. CONCLUSION People with nCSP and comorbid insomnia are more likely to engage in MVPA if they report, at baseline, lower sleep quality, fewer limitations in functioning resulting from emotional problems, lower body mass index, as well as less physical and mental fatigue.
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Affiliation(s)
- Thomas Bilterys
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium,Pain in Motion International Research Group
| | - Eveline Van Looveren
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium,Pain in Motion International Research Group
| | - Olivier Mairesse
- Brain, Body and Cognition, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium,Sleep Laboratory and Unit for Clinical Chronobiology, Bregman University Hospital, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Pain in Motion International Research Group,Department of Physical Medicine and Physcal Therapy, University Hospital Brussels, Brussels, Belgium,Department of Health and Rehabilitation, Unit of Physical Therapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden. University of Gothenburg Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium,Pain in Motion International Research Group,Department of Rehabilitation Sciences and Physical Therapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Pain in Motion International Research Group,Department of Physical Medicine and Physcal Therapy, University Hospital Brussels, Brussels, Belgium,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Dorien Goubert
- Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Ward Willaert
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium,Pain in Motion International Research Group
| | - Robby De Pauw
- Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Maarten Moens
- Pain in Motion International Research Group,Department of Neurosurgery and Radiology, University Hospital Brussels, Brussels, Belgium,Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium,Stimulus research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Pain in Motion International Research Group,Department of Physical Medicine and Physcal Therapy, University Hospital Brussels, Brussels, Belgium,Research Foundation Flanders (FWO), Brussels, Belgium.,Corresponding author at: Pain in Motion, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
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10
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Areerak K, Waongenngarm P, Janwantanakul P. Factors associated with exercise adherence to prevent or treat neck and low back pain: A systematic review. Musculoskelet Sci Pract 2021; 52:102333. [PMID: 33529988 DOI: 10.1016/j.msksp.2021.102333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/10/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Much attention has been paid to the evaluation of the efficacy of exercise therapy or increasing physical activity with the aim to prevent or alleviate neck and low back pain. However, exercise adherence is necessary for the effective management of neck and low back pain. OBJECTIVE We aimed to systematically review randomized controlled trials and cohort studies to gain insights into the factors associated with adherence to exercise or physical activity programs to prevent or treat neck pain and low back pain. METHOD Publications were systematically searched from 1980-December 2019 in several databases. The following key words were used: neck pain or low back pain paired with exercise or physical activity and adherence or compliance. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. Quality of evidence was assessed and rated according to GRADE guidelines. RESULTS Nine randomized controlled trials and eight cohort studies were included in this review. Randomized controlled trials indicated moderate-quality evidence for the association between exercise adherence and self-efficacy. Cohort studies showed moderate-quality evidence for the association between exercise adherence and education level. CONCLUSIONS Literature investigating factors associated with exercise adherence to prevent or treat neck and low back pain was heterogeneous. Few factors were found to be associated with exercise adherence. More studies are needed before any firm conclusions can be reached.
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Affiliation(s)
- Kantheera Areerak
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand.
| | - Pooriput Waongenngarm
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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11
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Lansing JE, Ellingson LD, DeShaw KJ, Cruz-Maldonado G, Hurt TR, Meyer JD. A qualitative analysis of barriers and facilitators to reducing sedentary time in adults with chronic low back pain. BMC Public Health 2021; 21:215. [PMID: 33499812 PMCID: PMC7836448 DOI: 10.1186/s12889-021-10238-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/14/2021] [Indexed: 02/08/2023] Open
Abstract
Background Sedentary time (SED) is associated with many detrimental health outcomes, yet little is known about what factors influence one’s ability to reduce SED. Even less is known about these factors in specific patient populations for whom high levels of SED may influence symptoms, such as those with chronic low back pain (cLBP). The purpose of this study was to qualitatively explore participants’ perceptions of factors that influenced their ability to reduce SED across an 8-week intervention to reduce SED in adults with cLBP and elevated depressive symptoms. Methods Three months after a theory-based intervention to break up and reduce sitting, semi-structured interviews explored factors that influenced reducing SED. Three researchers independently coded each conversation. Codes were charted and mapped with participants reviewing their own transcripts and the merged codes. The research team then defined key themes. Factors that were perceived to either facilitate behavior change or acted as barriers were identified and thematized as positive or negative determinants. Results Common barriers for reducing SED included environmental constraints, opposing social norms, and productivity; these barriers were frequently encountered in the workplace. Common facilitators for reducing SED included habit development, self-monitoring tools, restructuring the physical environment, and social accountability. Notably, back pain was not a frequently reported barrier or facilitator for reducing SED. Conclusion This sample of patients with cLBP and elevated depressive symptoms had similar determinants for reducing SED as previously reported in non-patient populations and did not appear to need strategies specific to dealing with chronic pain. Since work-related social norms and environmental factors were perceived as significant barriers to sitting less, workplace interventions that provide standing desks, offer standing meetings rooms, and/or institution-wide standing breaks may help reduce SED at work. The use of an activity monitor with sitting reminders and education regarding how to use the reminders as external cues to develop new sitting habits may also aid in adoption and adherence to this behavior change across settings. Developing coping plans and restructuring physical environments were perceived as successful strategies for overcoming social and environmental barriers. Future interventions targeting SED reductions may benefit from incorporating these strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10238-5.
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Affiliation(s)
- Jeni E Lansing
- Department of Kinesiology, Iowa State University, Ames, IA, USA.
| | - Laura D Ellingson
- Division of Health and Exercise Science, Western Oregon University, Monmouth, OR, USA
| | | | | | - Tera R Hurt
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - Jacob D Meyer
- Department of Kinesiology, Iowa State University, Ames, IA, USA
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12
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Spencer L, Fary R, McKenna L, Jacques A, Lalor J, Briffa K. The relationship between breast size and aspects of health and psychological wellbeing in mature-aged women. WOMEN'S HEALTH (LONDON, ENGLAND) 2020; 16:1745506520918335. [PMID: 32419664 PMCID: PMC7235664 DOI: 10.1177/1745506520918335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/12/2019] [Accepted: 03/02/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Increases in breast size with age are common but have not been widely examined as a factor that could affect the health and psychological wellbeing of mature-aged women. The purpose of this study was to examine the relationships between breast size and aspects of health and psychological wellbeing in mature-aged women. METHODS This was a cross-sectional study of mature-aged women (⩾40 years). Breast size (breast size score) was determined from self-reported bra size and was examined against health-related quality of life (Medical Outcomes Study Short-Form 36 and BREAST-Q), body satisfaction (numerical rating scale), breast satisfaction (BREAST-Q), physical activity levels (Human Activity Profile), the presence of upper back pain and breast and bra fit perceptions. RESULTS Two hundred sixty-nine women (40-85 years) with bra band sizes ranging from 8 to 26 and bra cup sizes from A to HH participated. The mean (standard deviation) breast size score of 7.7 (2.7) was equivalent to a bra size of 14DD. Increasing breast size was associated with significantly lower breast-related physical wellbeing (p < 0.001, R2 = 0.043) and lower ratings of body (p = 0.002, R2 = 0.024) and breast satisfaction (p < 0.001, R2 = 0.065). Women with larger breasts were more likely to be embarrassed by their breasts (odds ratio: 1.49, 95% confidence interval: 1.31 to 1.70); more likely to desire a change in their breasts (odds ratio: 1.55, 95% confidence interval: 1.37 to 1.75) and less likely to be satisfied with their bra fit (odds ratio: 0.84, 95% confidence interval: 0.76 to 0.92). Breast size in addition to age contributed to explaining upper back pain. For each one-size increase in breast size score, women were 13% more likely to report the presence of upper back pain. CONCLUSION Larger breast sizes have a small but significant negative relationship with breast-related physical wellbeing, body and breast satisfaction. Larger breasts are associated with a greater likelihood of upper back pain. Clinicians considering ways to improve the health and psychological wellbeing of mature-aged women should be aware of these relationships.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Robyn Fary
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Jennifer Lalor
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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13
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Storm V. [Fear avoidance beliefs, pain-related self-efficacy, and subjective work ability among back pain patients : A pilot study with voluntary subjects]. Schmerz 2019; 33:312-319. [PMID: 31041528 DOI: 10.1007/s00482-019-0371-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Work-related fear avoidance beliefs play an important role when considering subjective work ability among people with back pain. Pain-related self-efficacy is known as a predictor for physical activity and subjective work ability. OBJECTIVES The present longitudinal study aims to investigate the relationships between work-related fear avoidance beliefs, pain-related self-efficacy, and subjective work ability among back pain patients. MATERIALS AND METHODS A total of 93 people with back pain (M = 35.58 years, SD = 13.45; range: 18-69) were assessed at baseline and 4 weeks later. Of the participants, 54.83% (n = 51) were female. Data analysis was performed with SPSS 25 using descriptive statistics and multiple regression methods. RESULTS Work-related fear avoidance beliefs were negatively related with subjective work ability at baseline. Pain-related self-efficacy moderated this relationship. The relationship was stronger at low and medium levels of pain-related self-efficacy. The moderation effect was not found when considering subjective work ability after 4 weeks. CONCLUSION Work-related fear avoidance beliefs among back pain patients seem to be important for subjective work ability in the short term. This especially holds true when patients have low self-efficacy beliefs. The investigated constructs should be emphasized in the patient-centered therapy. Longitudinal studies with larger samples and more frequent follow-ups should be investigated in future studies.
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Affiliation(s)
- Vera Storm
- Institut für Sportwissenschaften, Abteilung Sportpsychologie, Universität Münster, Horstmarer Landweg 62b, 48149, Münster, Deutschland.
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