Effects of brief self-exercise education on the management of chronic low back pain: A community-based, randomized, parallel-group pragmatic trial

Abstract

Objective

This study aimed to develop and assess additional effects of brief self-exercise education (brief-See) for individuals with chronic low back pain (CLBP). The brief-See comprised 100-minute consultation, individualized self-exercise program, and direct short teaching.

Methods

We conducted a 6-month, community-based, randomized, parallel-group trial in a community setting, and allocated into a brief-See or material-based education alone. Pain intensity (NRS, numeric rating scale), functional limitation (RDQ, Roland-Morris disability questionnaire), self-efficacy (PSEQ, pain self-efficacy questionnaire), and quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at 4, 12, and 24 weeks after the initial consultation.

Results

The brief-See did not show additional improvement over material-based education on the NRS, but it did on the RDQ, PSEQ, and EQ-5D; the estimated mean group differences in changes from the baseline were −2.1 (–3.5 to −0.7, p = .005) on the RDQ, 6.9 (1.7–12.1, p = .010) on the PSEQ, and 0.07 (0.02–0.12, p = .004) on the EQ-5D.

Conclusion

The 100 minutes’ education program could be more acceptable, and restores functional limitation, self-efficacy, and quality of life in addition to the effects of material-based education. This has the potential to contribute to the management of CLBP in a community.

Keywords:

• Brief intervention
• chronic low back pain
• community-based intervention
• exercise therapy
• randomized controlled trial

Acknowledgements

The authors thank all the CIRCS investigators, all the staff at Ikawa town office, especially in Yuriko Minato, Nozomi Yasuda, Yomishi Suzuki, and Tamon Saito, Mayor of Ikawa Town, and all the participants in this study. We also appreciate the public health nurses, engineers of the computer processing unit, nurses, and nutritionists, and clinical laboratory technologists in the Osaka Center for Cancer and Cardiovascular Disease Prevention. The authors also appreciate Professor Tomoyuki Kawada (Nippon Medical School) for his understanding and support.

CIRCS investigators

The CIRCS has been led by Yoshio Komachi (Professor Emeritus of University of Tsukuba), Minoru Iida, Hideki Ozawa, the late Takashi Shimamoto (Professor Emeritus of University of Tsukuba), the late Masamitsu Konishi (Professor Emeritus of Ehime University), and Yoshinori Ishikawa. The present investigators of CIRCS are as follows: Hiroyasu Iso, Hironori Imano, Renzhe Cui, Isao Muraki, Hiroyuki Noda, and Hiroshige Jinnouchi (Osaka University), Masahiko Kiyama, Takeo Okada, Yuji Shimizu, Mina Hayama-Terada, and Yasuhiko Kubota (Osaka Center for Cancer and Cardiovascular Disease Prevention), Tomoko Sankai, Kazumasa Yamagishi, Mitsumasa Umesawa, and Mizuki Sata (University of Tsukuba), Isao Koyama and Masakazu Nakamura (National Cerebral and Cardiovascular Center), Isao Saito (Oita University), Koutatsu Maruyama (Ehime University), Shinichi Sato (Chiba Prefectural Institute of Public Health), Takeshi Tanigawa and Ai Ikeda (Juntendo University), Tetsuya Ohira and Masanori Nagao (Fukushima Medical University), and Akihiko Kitamura (Tokyo Metropolitan Geriatric Medical Center).

Conflict of interest

None.

Additional information

Funding

This study was supported in part by the Japan Small- and Medium-Sized Enterprise Welfare Foundation (FULLHAP), and Grants-in-Aid for Scientific [Research A, 26253043].