title: Individual advice in addition to standard guideline care in patients with acute non-specific low back pain: a survey on feasibility among physiotherapists and patients.
abstract: The medical costs associated with low back pain (LBP) potentially pose an enormous economic burden to society. Prevention (secondary) might be beneficial when there is no definitive conclusion on the most appropriate intervention. For this purpose, individual advice focusing on modification of spinal mechanical load obtained with the 24 Hour Schedule-24HS-(an instrument for quantifying spinal mechanical load) in addition to standard care of guideline-recommendations might be effective. Naturally, this should be examined in controlled studies. Considering the costs involved carrying out a controlled study, the feasibility of 24HS-advice should be assessed first. We performed two surveys in primary care setting in 97 patients with acute (<6 weeks) non-specific LBP (who received a 24HS assessment and 24HS-advice at baseline), and 18 physiotherapists (all involved in 24HS baseline assessments). Patients and physiotherapists were first contacted by telephone after 6 months by a research assistant and requested to complete a questionnaire developed to assess feasibility. During this interview patients again completed a follow-up 24HS assessment. Eighty-eight patients and 17 physiotherapists participated in the follow-up. The median score of patients' questionnaire was 7 (interquartile range 5.9-8.3) and of physiotherapists' questionnaire 8 (interquartile range 7-8.5). Both questionnaires exceeded the criteria for feasibility, which we had previously set at seven or higher (out of 10). Subsequently, 24HS-advice was considered feasible for use in primary care healthcare providers and patients with LBP. In patients, the absence of LBP during the follow-up period and in physiotherapists 'lack of time' were identified as factors that could potentially threaten the feasibility in 24HS-advice.
authors.affiliation: Department of General Practice, Erasmus University, Rotterdam, The Netherlands. ewp.bakker@zonnet.nl
authors.forename: Eric W P
authors.initials: EW
authors.lastname: Bakker
authors.forename: Arianne P
authors.initials: AP
authors.lastname: Verhagen
authors.forename: Emiel
authors.initials: E
authors.lastname: van Trijffel
authors.forename: Cees
authors.initials: C
authors.lastname: Lucas
authors.forename: Hans J C M F
authors.initials: HJ
authors.lastname: Koning
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D010808:Physical Examination / Q000379:methods; D026741:Physical Therapy Modalities; D011320:Primary Health Care / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult