Is a videotape to change beliefs and behaviors superior to a standard videotape in acute low back pain? A randomized controlled trial.
BACKGROUND
Cognitive behavioral therapy has been used successfully in acute low back pain (LBP) treatment, but the use of a cognitive behavioral videotape as an adjunct to treatment has not been studied.


OBJECTIVE
To determine outcomes for patients with acute LBP receiving a videotape designed to change beliefs and behaviors compared with a standard instructional videotape.


METHODS
Randomized controlled trial; multidisciplinary clinic in an academic setting.


METHODS
Consecutive subjects with less than 3 months of LBP. Of 224 eligible subjects, 138 participated and completed the initial questionnaires.


METHODS
Oswestry Disability Index, Pain and Impairment Relationship Scale, Fear-Avoidance Beliefs Questionnaire; medical costs related to LBP and total medical costs incurred by participants during 1 year of follow-up.


METHODS
Subjects were randomly assigned to receive a behavioral videotape or a control videotape. Other than the videotape, usual care was provided to each patient.


RESULTS
No significant differences in any outcome measures or medical costs between the two groups at 12 months. However, baseline Vermont Disability Prediction Questionnaire was significantly lower in those who completed the entire study compared with those who did not complete the study.


CONCLUSIONS
Compared with a standard instructional videotape, a behavioral videotape did not change beliefs, outcomes, or costs over 1 year. Cost-effective behavioral interventions with high patient retention rates are needed, especially for those at greatest risk of high utilization of resources.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First Street, NW, Rochester, MN 55906 USA. newcomer.karen@mayo.edu
Karen L
KL
Newcomer
Kristin S
KS
Vickers Douglas
Randy A
RA
Shelerud
Kirsten Hall
KH
Long
Brianna
B
Crawford
D000208:Acute Disease; D000328:Adult; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D015438:Health Behavior; D017048:Health Care Costs; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014743:Videotape Recording / Q000191:economics / Q000379:methods*