Addition of MoodGYM to physical treatments for chronic low back pain: A randomized controlled trial

M. John Petrozzi, Andrew Leaver, Paulo H. Ferreira, Sidney M. Rubinstein, Mairwen K. Jones, Martin G. Mackey

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Low back pain (LBP) is prevalent, costly and disabling. A biopsychosocial treatment approach involving physical and cognitive behavioural therapy (CBT) is recommended for those with chronic LBP. It is not known if online psychological coaching tools might have a role in the secondary prevention of LBP related disability. To assess the effectiveness of an internet-delivered psychological program (MoodGYM) in addition to standard physical treatment in patients with chronic non-specific LBP at medium risk of ongoing disability. Methods: A multisite randomized controlled trial was conducted with 108 participants (aged mean 50.4 ± 13.6 years) with chronic LBP attending one of six private physiotherapy or chiropractic clinics. Disability (Roland Morris Disability Questionnaire) and self-efficacy (Patient Self-Efficacy Questionnaire), were assessed at baseline, post-treatment (8-weeks) with follow-up at six- and twelve-months. Participants were randomized into either the intervention group, MoodGYM plus physical treatments, or the control group which received physical treatments alone. Results: No statistically significant between group differences were observed for either disability at post-treatment (Effect size (standardised mean difference) 95% CI) RMD - 0.06 (- 0.45,0.31), 6-months RMD 0.01 (- 0.38,0.39) and 12-months - 0.20 (- 0.62,0.17) or self-efficacy at post-treatment PSEQ 0.06 (- 0.31,0.45), 6-months 0.02 (- 0.36,0.41) and 12-months 0.21 (- 0.16,0.63). Conclusion: There was no additional benefit of an internet-delivered CBT program (MoodGYM) to physical treatments in those with chronic non-specific LBP at medium risk of ongoing disability measured at post-treatment, or at 6 and 12 months. Trial registration: This trial was prospectively registered with Australian New Zealand Clinical Trials Registry Number (ACTRN) 12615000269538.

Original languageEnglish
Article number54
Pages (from-to)1-12
Number of pages12
JournalChiropractic and Manual Therapies
Volume27
Issue number1
DOIs
Publication statusPublished - 25 Oct 2019

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Low Back Pain
Randomized Controlled Trials
Self Efficacy
Therapeutics
Cognitive Therapy
Internet
Psychology
Chiropractic
Secondary Prevention
New Zealand
Registries
Clinical Trials
Control Groups

Keywords

  • Chiropractic
  • Chronic non-specific LBP
  • Disability
  • MoodGYM
  • Secondary psychosocial prevention
  • Self-efficacy

Cite this

Petrozzi, M. John ; Leaver, Andrew ; Ferreira, Paulo H. ; Rubinstein, Sidney M. ; Jones, Mairwen K. ; Mackey, Martin G. / Addition of MoodGYM to physical treatments for chronic low back pain : A randomized controlled trial. In: Chiropractic and Manual Therapies. 2019 ; Vol. 27, No. 1. pp. 1-12.
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title = "Addition of MoodGYM to physical treatments for chronic low back pain: A randomized controlled trial",
abstract = "Background: Low back pain (LBP) is prevalent, costly and disabling. A biopsychosocial treatment approach involving physical and cognitive behavioural therapy (CBT) is recommended for those with chronic LBP. It is not known if online psychological coaching tools might have a role in the secondary prevention of LBP related disability. To assess the effectiveness of an internet-delivered psychological program (MoodGYM) in addition to standard physical treatment in patients with chronic non-specific LBP at medium risk of ongoing disability. Methods: A multisite randomized controlled trial was conducted with 108 participants (aged mean 50.4 ± 13.6 years) with chronic LBP attending one of six private physiotherapy or chiropractic clinics. Disability (Roland Morris Disability Questionnaire) and self-efficacy (Patient Self-Efficacy Questionnaire), were assessed at baseline, post-treatment (8-weeks) with follow-up at six- and twelve-months. Participants were randomized into either the intervention group, MoodGYM plus physical treatments, or the control group which received physical treatments alone. Results: No statistically significant between group differences were observed for either disability at post-treatment (Effect size (standardised mean difference) 95{\%} CI) RMD - 0.06 (- 0.45,0.31), 6-months RMD 0.01 (- 0.38,0.39) and 12-months - 0.20 (- 0.62,0.17) or self-efficacy at post-treatment PSEQ 0.06 (- 0.31,0.45), 6-months 0.02 (- 0.36,0.41) and 12-months 0.21 (- 0.16,0.63). Conclusion: There was no additional benefit of an internet-delivered CBT program (MoodGYM) to physical treatments in those with chronic non-specific LBP at medium risk of ongoing disability measured at post-treatment, or at 6 and 12 months. Trial registration: This trial was prospectively registered with Australian New Zealand Clinical Trials Registry Number (ACTRN) 12615000269538.",
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Addition of MoodGYM to physical treatments for chronic low back pain : A randomized controlled trial. / Petrozzi, M. John; Leaver, Andrew; Ferreira, Paulo H.; Rubinstein, Sidney M.; Jones, Mairwen K.; Mackey, Martin G.

In: Chiropractic and Manual Therapies, Vol. 27, No. 1, 54, 25.10.2019, p. 1-12.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Addition of MoodGYM to physical treatments for chronic low back pain

T2 - A randomized controlled trial

AU - Petrozzi, M. John

AU - Leaver, Andrew

AU - Ferreira, Paulo H.

AU - Rubinstein, Sidney M.

AU - Jones, Mairwen K.

AU - Mackey, Martin G.

PY - 2019/10/25

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N2 - Background: Low back pain (LBP) is prevalent, costly and disabling. A biopsychosocial treatment approach involving physical and cognitive behavioural therapy (CBT) is recommended for those with chronic LBP. It is not known if online psychological coaching tools might have a role in the secondary prevention of LBP related disability. To assess the effectiveness of an internet-delivered psychological program (MoodGYM) in addition to standard physical treatment in patients with chronic non-specific LBP at medium risk of ongoing disability. Methods: A multisite randomized controlled trial was conducted with 108 participants (aged mean 50.4 ± 13.6 years) with chronic LBP attending one of six private physiotherapy or chiropractic clinics. Disability (Roland Morris Disability Questionnaire) and self-efficacy (Patient Self-Efficacy Questionnaire), were assessed at baseline, post-treatment (8-weeks) with follow-up at six- and twelve-months. Participants were randomized into either the intervention group, MoodGYM plus physical treatments, or the control group which received physical treatments alone. Results: No statistically significant between group differences were observed for either disability at post-treatment (Effect size (standardised mean difference) 95% CI) RMD - 0.06 (- 0.45,0.31), 6-months RMD 0.01 (- 0.38,0.39) and 12-months - 0.20 (- 0.62,0.17) or self-efficacy at post-treatment PSEQ 0.06 (- 0.31,0.45), 6-months 0.02 (- 0.36,0.41) and 12-months 0.21 (- 0.16,0.63). Conclusion: There was no additional benefit of an internet-delivered CBT program (MoodGYM) to physical treatments in those with chronic non-specific LBP at medium risk of ongoing disability measured at post-treatment, or at 6 and 12 months. Trial registration: This trial was prospectively registered with Australian New Zealand Clinical Trials Registry Number (ACTRN) 12615000269538.

AB - Background: Low back pain (LBP) is prevalent, costly and disabling. A biopsychosocial treatment approach involving physical and cognitive behavioural therapy (CBT) is recommended for those with chronic LBP. It is not known if online psychological coaching tools might have a role in the secondary prevention of LBP related disability. To assess the effectiveness of an internet-delivered psychological program (MoodGYM) in addition to standard physical treatment in patients with chronic non-specific LBP at medium risk of ongoing disability. Methods: A multisite randomized controlled trial was conducted with 108 participants (aged mean 50.4 ± 13.6 years) with chronic LBP attending one of six private physiotherapy or chiropractic clinics. Disability (Roland Morris Disability Questionnaire) and self-efficacy (Patient Self-Efficacy Questionnaire), were assessed at baseline, post-treatment (8-weeks) with follow-up at six- and twelve-months. Participants were randomized into either the intervention group, MoodGYM plus physical treatments, or the control group which received physical treatments alone. Results: No statistically significant between group differences were observed for either disability at post-treatment (Effect size (standardised mean difference) 95% CI) RMD - 0.06 (- 0.45,0.31), 6-months RMD 0.01 (- 0.38,0.39) and 12-months - 0.20 (- 0.62,0.17) or self-efficacy at post-treatment PSEQ 0.06 (- 0.31,0.45), 6-months 0.02 (- 0.36,0.41) and 12-months 0.21 (- 0.16,0.63). Conclusion: There was no additional benefit of an internet-delivered CBT program (MoodGYM) to physical treatments in those with chronic non-specific LBP at medium risk of ongoing disability measured at post-treatment, or at 6 and 12 months. Trial registration: This trial was prospectively registered with Australian New Zealand Clinical Trials Registry Number (ACTRN) 12615000269538.

KW - Chiropractic

KW - Chronic non-specific LBP

KW - Disability

KW - MoodGYM

KW - Secondary psychosocial prevention

KW - Self-efficacy

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