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Chronic Low Back Pain: A Multidisciplinary Approach (CLBP-HUVH)

15 juni 2015 uppdaterad av: Hospital Universitari Vall d'Hebron Research Institute

A Multidisciplinary Approach to Treat and Rehabilitate Patients With Chronic Low Back Pain

Introduction: Non-specific chronic low back pain (CLBP) is one of the most frequent causes for patient disability and a general recurrent cause for medical consultation with high costs to public health. From rehabilitative medicine, physiotherapy is commonly offered. Although this treatment is aimed to reduce disability, pain severity and pain-related anxiety-depressive symptoms, many patients report partial improvement and recurrent intensive and disabling pain episodes. Therefore, a new approach in the treatment and rehabilitation of this pathology that takes into account psychosocial aspects that might be modulating pain is necessary.

Material and methods: This project aims to assess the efficacy of two complementary interventions to standard physical therapy, such as relaxation techniques and cognitive-behavioral intervention, to improve health-related quality of life (HRQoL) among patients with CLBP. It is hypothesized that groups receiving these complementary interventions will significantly improve their adherence to physiotherapy and the control of their pain and, ultimately, these aspects will facilitate a decreasing of pain intensity and better HRQoL.

For these purposes, a pre-post longitudinal design will be carried out, with follow-up assessments at 6 and 12 months in a sample of 66 participants. This sample will be divided into: control group (physiotherapy), intervention group 1 (physiotherapy and relaxation techniques-sophrology) and intervention group 2 (physiotherapy and cognitive-behavioral intervention).

Expected impact: Study results are not available yet. However, if working hypotheses are confirmed, a multidisciplinary model of care for CLBP will be empirically justified. This approach is expected to benefit HRQoL among these patients implying a significant short-mid term reduction of public health costs.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

66

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Spanien
      • Barcelona, Spanien, 08035
        • Hospital Universitari Vall d'Hebron Institut de Recerca Vall d'Hebron

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

30 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Non-specific chronic (> 6 months of evolution) low back pain diagnosis
  • Ability to read and speak in Spanish

Exclusion Criteria:

  • Addictive behaviors (DAST-10 > 3, alcoholism, drug addiction or other drug abuse)
  • Psychiatric contraindications (BDI > 15 or other severe psychiatric disorder not stabilized)
  • Neurological impairment
  • No mental competence (MEC < 23)
  • Fibromyalgia and/or chronic fatigue

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Stödjande vård
  • Tilldelning: Randomiserad
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: TAU
Control group. Treatment as usual (TAU): Physiotherapy program for CLBP.
Övrig: Physiotherapy
Physical therapy exercise program for CLBP patients. Its goal is to reduce pain and improve patients' health-related quality of life, functional capacity and well-being.
Andra namn:
  • Behandling som vanligt (TAU)
Experimentell: Intervention 1 Relaxation techniques-sophrology
Intervention group 1: TAU + relaxation techniques-sophrology program.
Övrig: Physiotherapy
Physical therapy exercise program for CLBP patients. Its goal is to reduce pain and improve patients' health-related quality of life, functional capacity and well-being.
Andra namn:
  • Behandling som vanligt (TAU)
Övrig: Intervention 1
Relaxation techniques-sophrology consists of a set of physical and relaxation exercises that include breathing methods, visualization, modification of states of consciousness, etc. with the goal to enhance balance between body and mind to improve health-related quality of life, reduce pain and foster patients' well-being.
Andra namn:
  • Relaxation techniques-sophrology
Experimentell: Intervention 2 Cognitive-behavioral therapy
Intervention group 2: TAU + cognitive-behavioral therapy.
Övrig: Physiotherapy
Physical therapy exercise program for CLBP patients. Its goal is to reduce pain and improve patients' health-related quality of life, functional capacity and well-being.
Andra namn:
  • Behandling som vanligt (TAU)
Beteende: Intervention 2
Cognitive-behavioral therapy (in combination with motivational interviewing principles) is aimed to facilitate psychological adjustment and self-management of CLBP with the ultimate goal of increasing patients' health-related quality of life and well-being.
Andra namn:
  • KBT

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
The SF-12v2 Health Status Questionnaire (change is being assessed)
Tidsram: Baseline, 6 and 12 months
The SF-12 measures health-related quality of life including items from various domains both physical and psychological.
Baseline, 6 and 12 months

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
VAS for Self-perceived Pain
Tidsram: Baseline, 6 and 12 months
Visual Analogue Scale to rate self-perceived pain. Recall period: last 4 weeks.
Baseline, 6 and 12 months
Oswestry-15 Disability Index
Tidsram: Baseline, 6 and 12 months
The Oswestry Disability Index (aka: Oswestry Low Back Pain Disability Questionnaire) is a time-tested outcome assessment tool that is used to measure a patient's impairment and quality of life (i.e., how badly the pain has affected their life).
Baseline, 6 and 12 months

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
LISAT-8
Tidsram: Baseline, 6 and 12 months
The LISAT is a domain-specific measure of life satisfaction, which corresponds to Box E (subjective evaluations and reactions; life satisfaction) of Dijker's Model.
Baseline, 6 and 12 months
STAI
Tidsram: Baseline, 6 and 12 months
The State-Trait Anxiety Inventory (STAI) is a commonly used measure of trait and state anxiety. It can be used in clinical settings to screen anxiety and to distinguish it from depressive syndromes.
Baseline, 6 and 12 months
BDI-13
Tidsram: Baseline, 6 and 12 months
The Beck Depression Inventory (BDI) is a 13-item (short-form), self-report rating inventory that measures characteristic attitudes and symptoms of depression.
Baseline, 6 and 12 months
PSQI
Tidsram: Baseline, 6 and 12 months
The Pittsburgh Sleep Quality Index (PSQI) assesses sleep quality during the previous month.
Baseline, 6 and 12 months
CAD
Tidsram: Baseline and 12 months
The CAD (Cuestionario para el Afrontamiento al Dolor) is a coping questionnaire to chronic pain developed in a Spanish sample.
Baseline and 12 months
TAS-20
Tidsram: Baseline and 12 months
The Toronto Alexithymia Scale (TAS) 20-item is one of the most commonly used measures of alexithymia (people who have trouble identifying and describing emotions and who tend to minimise emotional experience and focus attention externally).
Baseline and 12 months
PSS-14
Tidsram: Baseline and 12 months
The Perceived Stress Scale (PSS) is a 14-item questionnaire that measures the degree to which life events are considered stressful.
Baseline and 12 months
DUKE-11
Tidsram: Baseline and 12 months
The DUKE 11-item social support questionnaire measures an individual's perception of the amount and type of personal social support. The original instrument included 14 items, grouped into 4 subscales: Quantity of Support, Confidant Support, Affective Support, and Instrumental Support.
Baseline and 12 months
VAS for patient satisfaction with treatment received
Tidsram: Baseline, 6 and 12 months
Visual Analogue Scale to rate patients' satisfaction with treatment, attention received and outcomes.
Baseline, 6 and 12 months
Medical and demographics
Tidsram: Baseline
Medical (medical and psychopathological history, physical exploration of LBP and possible substance abuse or other toxic habits such as alcohol or tobacco) and demographics (age, gender, immediate family network, education, job and SES) of patients are collected according to standard procedures.
Baseline

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Hospital Universitari Vall d'Hebron Research Institute

Utredare

  • Huvudutredare: Carmina Castellano-Tejedor, PhD, Hospital Universitari Vall d'Hebron - Institut de Recerca Vall d'Hebron
  • Studierektor: Elisa Barnola-Serra, MD, Hospital Vall d'Hebron
  • Studiestol: Gemma Costa-Requena, MsC, Hospital Vall d'Hebron
  • Studiestol: Pilar Lusilla-Palacios, MD, PhD, Hospital Vall d'Hebron
  • Studiestol: Alex Ginés-Puertas, Hospital Universitario Vall d'Hebron - Parc Sanitari Pere i Virgili
  • Studiestol: Laura Camprubí-Roca, Hospital Universitario Vall d'Hebron - Parc Sanitari Pere i Virgili
  • Studiestol: Mª Lluisa Torrent-Bertran, MD, Hospital Vall d'Hebron
  • Studiestol: Ana Palacios-González, Hospital Universitario Vall d'Hebron - Parc Sanitari Pere i Virgili
  • Studiestol: Tamara Biedermann-Villagra, MD, Hospital Vall d'Hebron

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

  • Group of pain for patients with chronic low back pain: A multidisciplinary intervention. Lusilla-Palacios, P, Castellano-Tejedor, C, Barnola-Serra, E, Ramos-Rondón, C, Biedermann-Villagra, T, Torrent-Bertran, M.L, Costa-Requena, G, Camprubí-Roca, L, Palacios-González, A, Cuxart-Fina, A, Ginés-Puertas, A, Bosch-Graupera, A. Poster communication on the 21th European Congress of Psychiatry, Nice, France, 25-29/05/2010.
  • Castellano-Tejedor, C., Costa-Requena, G., Lusilla-Palacios, P., Biedermann-Villagra, T., Barnola-Serra, E. Calidad del sueño en pacientes con lumbalgia crónica inespecífica. Rehabilitación 48(4): 219-225, 2014. DOI: 10.1016/j.rh.2014.05.003
  • Castellano-Tejedor, C., Costa-Requena, G., Lusilla-Palacios, P., Barnola-Serra, E. Calidad de vida en pacientes con dolor lumbar crónico: efectos de un programa de intervención multidisciplinar a los 6 meses de seguimiento. Comunicació tipus pòster presentada a les II Jornades BiblioPro del Parc de Recerca Biomédica de Barcelona, Barcelona 19 de febrer de 2015.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 mars 2013

Primärt slutförande (Faktisk)

1 november 2014

Avslutad studie (Faktisk)

1 januari 2015

Studieregistreringsdatum

Först inskickad

11 november 2013

Först inskickad som uppfyllde QC-kriterierna

19 november 2013

Första postat (Uppskatta)

25 november 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

16 juni 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

15 juni 2015

Senast verifierad

1 juni 2015

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CLBP-PT_ATR_274-2012

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