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

Abstract

IntroductionLow 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 analysisThe 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 disseminationThis 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 numberACTRN12617001288314.

Lifestyle and subjective musculoskeletal symptoms in young male Japanese workers: A 16-year retrospective cohort study

“…However, the studies have examined the relationship between health practices and physical health status, but not the musculoskeletal symptom outcome. Recently, changing patterns of daily life activities into a healthy lifestyle (e.g., achieve a healthy body weight, increase physical activity, develop healthy eating habits, quit smoking) has been used in interventions for low back pain ( Robson et al, 2019 ). However, it was not clarified which lifestyle changes should be prioritized.…”

Prevalence and influencing factors of low back pain among nurses in China: a systematic review and meta-analysis

“…28 Several studies identified that people with increased BMI and unhealthy lifestyles, including lack of physical activity and inappropriate diet, were more likely to suffer from chronic LBP. 36,37 A study by Li et al demonstrated that due to a high workload and less leisure time, nurses are practicing unhealthy dietary habits and inadequate physical activity, which are known significant drivers of increased BMI and LBP itself. 26 The nationwide survey is needed to uncover the significant stressors of LBP among nurses, which could provide the platform for the development of effective policy, plans, and interventions to prevent LBP and its complications among Chinese nurses.…”

The effect of smoking on back pain intensity in rehabilitated patients treated conservatively and surgically for discopathy

“…Mekhail et al (2018) presented a one-year follow-up in which current smokers reported a numerical rating scale pain score of 7.0, which is 1.93 (p < 0.001) and 1.32 (p = 0.001) points higher than those of lifelong nonsmokers and former smokers, respectively [19]. Robson et al (2019) started a study with the aim of determining the effectiveness of a Healthy Lifestyle Programme (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. The outcomes of this trial and supplementary analyses will be disseminated through publications in peerreviewed journals and conference presentations [20].…”