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Sponsors and Collaborators: |
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) University of Florida |
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Information provided by: | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
ClinicalTrials.gov Identifier: | NCT00373867 |
Low back pain is a very common problem and the most common cause of job-related disability. While some occurrences of low back pain disappear within a couple of days, other occurrences take much longer to resolve or lead to more serious conditions. The purpose of this study is to determine the effectiveness of two behavioral types of therapy in reducing future disability in people who are receiving physical therapy for low back pain and tend to fear and avoid pain.
Condition | Intervention |
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Low Back Pain |
Behavioral: Standard physical therapy Behavioral: Graded exercise Other: Graded exposure |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Investigator, Outcomes Assessor), Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Behavioral Interventions for Low Back Pain |
Enrollment: | 108 |
Study Start Date: | January 2006 |
Estimated Study Completion Date: | March 2008 |
Estimated Primary Completion Date: | March 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Standard: Active Comparator
Standard treatment-based classification physical therapy
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Behavioral: Standard physical therapy
Treatment-based classification physical therapy
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Graded exercise: Active Comparator
Treatment-based classification physical therapy plus graded exercise
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Behavioral: Graded exercise
Graded exercise increases an individual's tolerance to activity over time
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Graded exposure: Experimental
Treatment-based classification physical therapy plus graded exposure
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Other: Graded exposure
Graded exposure places the individual in fearful situations and gradually increases their exposure to such situations.
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Psychosocial factors, such as fear and avoidance, appear to play a role in the development of long-term disability from low back pain. The Fear-Avoidance Model of Exaggerated Pain Perception (FAMEPP) is a biopsychosocial model that attempts to explain how and why some individuals develop a more substantial psychological component to their low back pain problem than do others. FAMEPP suggests that an individual's pain-related fear and avoidance are the most important factors in determining whether long-term disability will result from an episode of low back pain. For example, FAMEPP suggests that individuals with high pain-related fear and avoidance are likely to use an avoidance response to low back pain, leading to both physical and psychological consequences. In contrast, individuals with low pain-related fear and avoidance are likely to use a confrontation type of response to low back pain and gradually return to their normal social and physical functioning.
Treatment based on FAMEPP involves two specific behavioral interventions that encourage people to confront their low back pain. The first intervention, graded exposure, places the individual in fearful situations and gradually increases their exposure to such situations. The second intervention, graded exercise, increases an individual's tolerance to activity over time. The purpose of this pilot study is to determine the effectiveness of graded exposure and graded exercise, when combined with traditional physical therapy, in reducing future disability in adults with low back pain who tend to fear and avoid pain.
Participants in this study will be randomly assigned to one of three groups:
The number of treatment sessions will vary, depending on how a participant is improving. At Week 4 and Month 6, all participants will be evaluated with a pain symptom assessment and questionnaires on pain intensity, pain-related disability, fear-avoidance beliefs, overreaction to pain, and physical impairment. There will be no other follow-up visits for this study.
Ages Eligible for Study: | 15 Years to 60 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, Florida | |
Shands Rehabilitation at the University of Florida | |
Gainesville, Florida, United States, 32610 |
Principal Investigator: | Steven Z. George, PT, PhD | University of Florida |
Responsible Party: | University of Florida ( Steven George ) |
Study ID Numbers: | R03 AR051128 |
Study First Received: | September 6, 2006 |
Last Updated: | September 3, 2008 |
ClinicalTrials.gov Identifier: | NCT00373867 |
Health Authority: | United States: Federal Government |
Secondary prevention Physical therapy Fear-avoidance beliefs Disability |
Signs and Symptoms Neoplasm Metastasis Neurologic Manifestations |
Low Back Pain Pain Back Pain |
Nervous System Diseases |