Veterans walk to beat back pain: study rationale, design and protocol of a randomized trial of a pedometer-based Internet mediated intervention for patients with chronic low back pain

Krein, Sarah L.; Metreger, Tabitha; Kadri, Reema; Hughes, M. E.; Kerr, Eve A.; Piette, John D.; Kim, Hyungjin Myra; Richardson, Caroline R.

doi:10.1186/1471-2474-11-205

Cited by 28 publications

(34 citation statements)

References 76 publications

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“…In addition, a number of studies describe a variety of pedometer-driven walking research protocols for adults with low back pain [42,43] designed to assess the effects on pain-related disability and functional interference.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of studies using pedometers as an intervention for musculoskeletal diseases

Mansi

Milosavljevic

Baxter

et al. 2014

BMC Musculoskelet Disord

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BackgroundPhysical activity (PA) plays an important role in the prevention and management of a number of chronic conditions. Aim: to investigate the evidence for effectiveness of pedometer-driven walking programs to promote physical activity among patients with musculoskeletal disorders (MSDs).MethodA comprehensive systematic review was performed using 11 electronic databases up to 20 February 2014. Keywords and MeSH terms included “musculoskeletal disorders”, “walking”, and “pedometer”. Randomized controlled trials, published in English, that examined the effects of a pedometer-based walking intervention to increase physical activity levels and improve physical function and pain in patients with musculoskeletal disorders were included.ResultOf the 1996 articles retrieved, seven studies ranging in date of publication from 1998 to 2013 met the inclusion criteria, allowing data extraction on 484 participants with an age range of 40 to 82 years. Interventions lasted from 4 weeks to 12 months and the results across studies showed significant increases in step count (p < 0.05) following the intervention. Across these studies, there was a mean increase in PA of 1950 steps per day relative to baseline. Four studies reported improved scores for pain and/or physical function at the intervention completion point relative to controls.ConclusionThis study provides strong evidence for the effectiveness of pedometer walking interventions in increasing PA levels for patients with MSDs. Our findings suggest that a combination of interventions is likely to be the most effective strategy to maximize health benefits in the short term. Further research should include larger sample sizes, and longer intervention durations are required to support the role of pedometer walking interventions as a long term intervention for management of musculoskeletal disorders.

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Section: Introductionmentioning

confidence: 99%

A systematic review of studies using pedometers as an intervention for musculoskeletal diseases

Mansi

Milosavljevic

Baxter

et al. 2014

BMC Musculoskelet Disord

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“…The design, rationale, and main results for the primary study are described in detail elsewhere [21][22]. Briefly, we recruited patients with back pain from one VA healthcare system.…”

Section: Study Population and Data Collectionmentioning

confidence: 99%

Opioid use and walking among patients with chronic low back pain

et al. 2016

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Abstract-This study examined the effect of a walking intervention on step counts among patients with chronic back pain who report opioid use. Data were collected as part of a randomized trial to reduce back-pain-related disability. Participants (n = 118 usual care, 111 intervention) were Veterans receiving care within one healthcare system. Step counts were collected at baseline, 6 mo, and 12 mo via an uploading pedometer. Self-reported opioid use was collected by survey. More than 40% (n = 99) of participants reported opioid use at baseline. After adjustment, the predicted mean step count for baseline opioid users assigned to the intervention increased by more than 1,200 steps compared with a reduction of nearly 400 steps for those assigned to usual care (between-group difference = 1,625 steps, p = 0.004). Among nonopioid users, there was no change for those in the intervention (16 steps) and an increase of about 660 steps for those assigned to usual care (between-group difference = 683 steps, p = 0.17). These data show that patients taking opioids may engage in walking to help manage their back pain. This finding emphasizes the importance of encouraging the use of alternative pain management strategies for these patients.Clinical Trial Registration: ClinicalTrials.gov; "Veterans Walk to Beat Back Pain": NCT00694018; https:// clinicaltrials.gov/ct2/show/NCT00694018

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“…This includes patient beliefs and attitudes that contribute to poor pain outcomes (e.g., pain-related fear of movement, low perceived control over pain, lower self-efficacy in coping with pain), which African Americans are more likely to hold [1, 21, 22]. …”

Section: Introductionmentioning

confidence: 99%

“…Second, proactive telephone outreach (in which a counselor reaches out to patients to offer them the intervention, rather than requiring the patients to seek out care) can address environmental barriers that lead to lower levels of utilization of care among African Americans [19]. Third, pedometer-based walking programs are effective at increasing walking for various groups [20, 21], including African Americans [22–25]. Fourth, making an action plan (specifying when, where, and how the behavior will be performed) increases the likelihood that individuals will perform intended behaviors and overcome psychological and environmental barriers [24, 25].…”

Section: Introductionmentioning

confidence: 99%

Taking ACTION to reduce pain: ACTION study rationale, design and protocol of a randomized trial of a proactive telephone-based coaching intervention for chronic musculoskeletal pain among African Americans

Bhimani

Cross²,

Taylor

et al. 2017

BMC Musculoskelet Disord

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BackgroundRates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race.Methods/DesignThe primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain. Participants assigned to the intervention will receive a telephone counselor delivered pedometer-mediated walking intervention that incorporates action planning and motivational interviewing. The intervention will consist of 6 telephone counseling sessions over an 8–10 week period. Participants randomly assigned to Usual Care will receive an informational brochure and a pedometer. The primary outcome is chronic pain-related physical functioning, assessed at 6 months, by the revised Roland and Morris Disability Questionnaire, a measure recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). We will also examine whether the intervention improves other IMMPACT-recommended domains (pain intensity, emotional functioning, and ratings of overall improvement). Secondary objectives include examining whether the intervention reduces health care service utilization and use of opioid analgesics and whether key contributors to racial/ethnic disparities targeted by the intervention mediate improvement in chronic pain outcomes Measures will be assessed by mail and phone surveys at baseline, three months, and six months. Data analysis of primary aims will follow intent-to-treat methodology.DiscussionWe will tailor our intervention to address key contributors to racial pain disparities and examine the effects of the intervention on important pain treatment outcomes for African Americans with chronic musculoskeletal pain.Trial registrationClinicalTrials.gov: NCT01983228. Registered 6 November 2013.

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Veterans walk to beat back pain: study rationale, design and protocol of a randomized trial of a pedometer-based Internet mediated intervention for patients with chronic low back pain

Cited by 28 publications

References 76 publications

A systematic review of studies using pedometers as an intervention for musculoskeletal diseases

A systematic review of studies using pedometers as an intervention for musculoskeletal diseases

Opioid use and walking among patients with chronic low back pain

Taking ACTION to reduce pain: ACTION study rationale, design and protocol of a randomized trial of a proactive telephone-based coaching intervention for chronic musculoskeletal pain among African Americans

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