Feasibility of a multidisciplinary group videoconferencing approach for chronic low back pain: a randomized, open-label, controlled, pilot clinical trial (EN-FORMA).

Autor: Garreta-Catala I; Orthopedic Surgery and Traumatology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain. iago.garreta@bellvitgehospital.cat., Planas-Balagué R; Rehabilitation and Physical Medicine Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Abouzari R; Rehabilitation and Physical Medicine Department, Delta del Llobregat Primary Care Center, Barcelona, El Prat de Llobregat, Spain., Carnaval T; Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, IDIBELL, Barcelona University, Barcelona, Spain., Nolla JM; Rheumatology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Videla S; Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, IDIBELL, Barcelona University, Barcelona, Spain.; Clinical Research Support Unit, Clinical Pharmacology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Agulló-Ferré JL; Orthopedic Surgery and Traumatology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2023 Aug 09; Vol. 24 (1), pp. 642. Date of Electronic Publication: 2023 Aug 09.
DOI: 10.1186/s12891-023-06763-6
Abstrakt: Background: Low back pain is a common condition that becomes even more prevalent with aging. A non-pharmacological multidisciplinary approach for chronic non-specific low back pain (CNSLBP) has been recommended, but integrating different healthcare professionals is challenging. A multidisciplinary group videoconferencing approach (MGVA) can be helpful. Our aim was to provide evidence on MGVA's feasibility in managing CNSLBP and its impact on clinical practice.
Methods: We conducted an open-label, randomized, controlled, parallel-group pilot clinical trial with CNSLBP patients irresponsive to conservative treatment. Patients between 18 and 67 years of age were randomly assigned (1:1) to either Standard-of-Care + MGVA (experimental group) or Standard-of-Care alone (control group). MGVA consisted of integrated sessions for physical rehabilitation/physiotherapy, psychology, and social work treatments. The control group received standard clinical practice treatment. The feasibility was assessed by the number of study procedures completed to at least 80% as planned. The impact on clinical practice was evaluated by the number of patients who changed their status from "candidate" to "non-candidate" to low back surgery as the treatment of choice for CNSLBP. The SF-36, Oswestry Disability Index, and TMMS-24 questionnaires were used. We performed a whole population-based descriptive analysis.
Results: We included 20 patients, but only 18 were randomized (2 withdrew consent before randomization). The mean (SD) age was 53.1 (5.9) years, and mostly women (13/18); 7 were actively employed. In the experimental group, 6/9 (67%, 95%CI:35-88%) patients attended at least 80% of the scheduled procedures, while in the control group, 8/9 (89%, 95%CI:57-98%) did. Additionally, 1 out of 4 (25%) patients in the experimental group changed their status from "candidate" for low back surgery to "non-candidate". None of the 2 patients in the control group did so. We found differences between groups in the SF-36 mental health component (p-value:0.061), Oswestry Disability Index (p-value:0.032), and TMMS-24 Repair component (p-value:0.014) at the end of the trial favoring MGVA.
Conclusions: The multidisciplinary group videoconferencing approach to managing chronic non-specific low back pain was feasible, suggesting overall beneficial effects on patients' health and could play a role in changing a patient's status from "candidate" to "non-candidate" for surgery.
Trial Registration: NCT05093543 (ClinicalTrials.gov), first registered in 26/10/2021.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje