Promoting physical activity in low back pain patients: six months follow-up of a randomised controlled trial comparing a multicomponent intervention with a low intensity intervention.
Andrea Schaller, Charalabos-Markos Dintsios, Andrea Icks and 2 others
PMID 27496696WHAT IT FOUND
Six months after rehab, Movement Coaching did not lead to higher total physical activity than a low intensity intervention.
Both groups had lower total activity at follow-up, and the Movement Coaching group had a greater decline in total, transport and workplace activity.
Key findings
01At six months, total physical activity did not differ between Movement Coaching and the low intensity intervention.
02Secondary outcomes, including workplace, transport and leisure physical activity and pain, also did not differ between groups at six months.
03From baseline to six months, both groups decreased in total physical activity, and the Movement Coaching group decreased more in total, transport and workplace activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 46% of the Movement Coaching group and 47% of the control group completed the six-month questionnaire. The analysis included 192 questionnaires, while 412 patients consented at baseline. The therapist delivering the interventions was not blinded, and patients did not know which group they were assigned to. Physical activity was measured by self-report, and the authors note that questionnaire-based activity can be overestimated, especially in low back pain patients. The study was single centre, in German inpatient orthopaedic rehabilitation, and excluded patients with cognitive disorders, poor German understanding, recent surgery, trauma-related pain or a current state-pension claim. The authors planned 372 patients, but only 192 follow-up questionnaires were analysed. The comparison was between two active interventions, not against no intervention, which may make differences harder to see.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by the German Statutory Pension Insurance Rhineland.
The easy way to misread this
Do not conclude that Movement Coaching caused the larger decline in activity or that physical activity promotion does not work. The primary outcome showed no difference between groups, the follow-up response was low, and the authors suggest self-reported activity may explain the between-group decline.