TTM-based motivational counselling does not increase physical activity of low back pain patients in a primary care setting--A cluster-randomized controlled trial.
OBJECTIVE
To investigate the effectiveness of a TTM-based motivational counselling approach by trained practice nurses to promote physical activity of low back pain patients in a German primary care setting.


METHODS
Data were collected in a cluster-randomized controlled trial with three study arms via questionnaires and patient interviews at baseline and after 6 and 12 months. We analysed total physical activity and self-efficacy by using random effect models to allow for clustering.


RESULTS
A total of 1378 low back pain patients, many with acute symptoms, were included in the study. Nearly 40% of all patients reported sufficient physical activity at baseline. While there were significant improvements in patients' physical activity behaviour in all study arms, there was no evidence for an intervention effect.


CONCLUSIONS
The outcome may be explained by insufficient performance of the practice nurses, implementation barriers caused by the German health care system and the heterogenous sample.


CONCLUSIONS
Given the objective to incorporate practice nurses into patient education, there is a need for a better basic training of the nurses and for a change towards an organizational structure that facilitates patient-nurse communication. Counselling for low back pain patients has to consider more specificated aims for different subgroups.
Leonhardt
Corinna
C
Institute for Medical Psychology, University of Marburg, Germany. cleonhar@med.uni-marburg.de
Keller
Stefan
S
Chenot
Jean-François
JF
Luckmann
Judith
J
Basler
Heinz-Dieter
HD
Wegscheider
Karl
K
Baum
Erika
E
Donner-Banzhoff
Norbert
N
Pfingsten
Michael
M
Hildebrandt
Jan
J
Kochen
Michael M
MM
Becker
Annette
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D015444:Exercise; D005194:Family Practice; D005260:Female; D005858:Germany; D006801:Humans; D017116:Low Back Pain / Q000451:nursing / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D010349:Patient Compliance; D017064:Process Assessment, Health Care; D012044:Regression Analysis