Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial

Introduction Low back pain is one of the most common and burdensome chronic conditions worldwide. Lifestyle factors, such as excess weight, physical inactivity, poor diet and smoking, are linked to low back pain chronicity and disability. There are few high-quality randomised controlled trials that...

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Main Authors: Steven J Kamper, Emma K Robson, Simon Davidson, Priscilla Viana da Silva, Amanda Williams, Rebecca K Hodder, Hopin Lee, Alix Hall, Connor Gleadhill, Christopher M Williams
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/9/e029290.full
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author Steven J Kamper
Emma K Robson
Simon Davidson
Priscilla Viana da Silva
Amanda Williams
Rebecca K Hodder
Hopin Lee
Alix Hall
Connor Gleadhill
Christopher M Williams
author_facet Steven J Kamper
Emma K Robson
Simon Davidson
Priscilla Viana da Silva
Amanda Williams
Rebecca K Hodder
Hopin Lee
Alix Hall
Connor Gleadhill
Christopher M Williams
author_sort Steven J Kamper
collection DOAJ
description Introduction Low back pain is one of the most common and burdensome chronic conditions worldwide. Lifestyle factors, such as excess weight, physical inactivity, poor diet and smoking, are linked to low back pain chronicity and disability. There are few high-quality randomised controlled trials that investigate the effects of targeting lifestyle risk factors in people with chronic low back pain.Methods and analysis The aim of this study is to determine the effectiveness of a Healthy Lifestyle Program (HeLP) for low back pain targeting weight, physical activity, diet and smoking to reduce disability in patients with chronic low back pain compared with usual care. This is a randomised controlled trial, with participants stratified by body mass index, allocated 1:1 to the HeLP intervention or usual physiotherapy care. HeLP involves three main components: (1) clinical consultations with a physiotherapist and dietitian; (2) educational resources; and (3) telephone-based health coaching support for lifestyle risk factors. The primary outcome is disability (Roland Morris Disability Questionnaire) at 26 weeks. Secondary outcomes include pain intensity, weight, quality of life and smoking status. Data will be collected at baseline, and at weeks 6, 12, 26 and 52. Patients with chronic low back pain who have at least one health risk factor (are overweight or obese, are smokers and have inadequate physical activity or fruit and vegetable consumption) will be recruited from primary or secondary care, or the community. Primary outcome data will be analysed by intention to treat using linear mixed-effects regression models. We will conduct three supplementary analyses: causal mediation analysis, complier average causal effects analysis and economic analysis.Ethics and dissemination This study was approved by the Hunter New England Research Ethics Committee (Approval No 17/02/15/4.05), and the University of Newcastle Human Research Ethics Committee (Ref No H-2017-0222). Outcomes of this trial and supplementary analyses will be disseminated through publications in peer-reviewed journals and conference presentations.Trial registration number ACTRN12617001288314.
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spelling doaj-art-5a3d37fd9f9e4ee796482cf38b3fa7d02024-11-28T16:50:08ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-029290Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trialSteven J Kamper0Emma K Robson1Simon Davidson2Priscilla Viana da Silva3Amanda Williams4Rebecca K Hodder5Hopin Lee6Alix Hall7Connor Gleadhill8Christopher M Williams96 Allied Health Department, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia1 School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia1 School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia3 Centre for Pain, Health and Lifestyle, Sydney, New South Wales, AustraliaClinical Sciences, Murdoch Children’s Research Institute, Parkville, Victoria, AustraliaSchool of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia7 IQVIA, London, UKSchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia1 School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia3 Centre for Pain, Health and Lifestyle, Sydney, New South Wales, AustraliaIntroduction Low back pain is one of the most common and burdensome chronic conditions worldwide. Lifestyle factors, such as excess weight, physical inactivity, poor diet and smoking, are linked to low back pain chronicity and disability. There are few high-quality randomised controlled trials that investigate the effects of targeting lifestyle risk factors in people with chronic low back pain.Methods and analysis The aim of this study is to determine the effectiveness of a Healthy Lifestyle Program (HeLP) for low back pain targeting weight, physical activity, diet and smoking to reduce disability in patients with chronic low back pain compared with usual care. This is a randomised controlled trial, with participants stratified by body mass index, allocated 1:1 to the HeLP intervention or usual physiotherapy care. HeLP involves three main components: (1) clinical consultations with a physiotherapist and dietitian; (2) educational resources; and (3) telephone-based health coaching support for lifestyle risk factors. The primary outcome is disability (Roland Morris Disability Questionnaire) at 26 weeks. Secondary outcomes include pain intensity, weight, quality of life and smoking status. Data will be collected at baseline, and at weeks 6, 12, 26 and 52. Patients with chronic low back pain who have at least one health risk factor (are overweight or obese, are smokers and have inadequate physical activity or fruit and vegetable consumption) will be recruited from primary or secondary care, or the community. Primary outcome data will be analysed by intention to treat using linear mixed-effects regression models. We will conduct three supplementary analyses: causal mediation analysis, complier average causal effects analysis and economic analysis.Ethics and dissemination This study was approved by the Hunter New England Research Ethics Committee (Approval No 17/02/15/4.05), and the University of Newcastle Human Research Ethics Committee (Ref No H-2017-0222). Outcomes of this trial and supplementary analyses will be disseminated through publications in peer-reviewed journals and conference presentations.Trial registration number ACTRN12617001288314.https://bmjopen.bmj.com/content/9/9/e029290.full
spellingShingle Steven J Kamper
Emma K Robson
Simon Davidson
Priscilla Viana da Silva
Amanda Williams
Rebecca K Hodder
Hopin Lee
Alix Hall
Connor Gleadhill
Christopher M Williams
Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial
BMJ Open
title Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial
title_full Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial
title_fullStr Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial
title_full_unstemmed Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial
title_short Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial
title_sort healthy lifestyle program help for low back pain protocol for a randomised controlled trial
url https://bmjopen.bmj.com/content/9/9/e029290.full
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