title: Integrating Mobile health and Physical Activity to reduce the burden of Chronic low back pain Trial (IMPACT): a pilot trial protocol.
abstract: BACKGROUND
  It is well recognised that low back pain is a significant public health problem and engagement in moderate levels of physical activity is associated with positive outcomes. Conservative active care, such as exercise, is effective in reducing pain and disability associated with chronic low back pain. However, a rapid decline in clinical outcomes is commonly seen after discharge from treatment.
  
  
  METHODS
  We will conduct a randomised controlled trial to investigate the effectiveness of a mobile health supported physical activity intervention (compared to standard care) in care-seeking, pain and disability in people with chronic low back pain after discharge from treatment. We will recruit 68 patients with chronic low back pain following discharge from an outpatient hospital program, who will be randomly allocated to the physical activity intervention (n = 34) or the standard care group (n = 34) and monitored for 6 months. The physical activity intervention will involve a physical activity advice booklet, a face-to-face health coaching session and 12 fortnightly follow-up telephone-based health coaching sessions. This intervention will be supported by provision of a specifically designed web app and a physical activity monitoring device (FitBit). The standard care group will receive the physical activity advice booklet only.
  
  
  CONCLUSIONS
  This pilot trial will investigate a new model to prevent clinical decline in people following conservative treatment for chronic low back pain. If proven to be effective, this approach will constitute a major advance in the management of low back pain. Chronic patients who experience recurrent pain and disability after treatment are prone to seek additional care in the form of physiotherapy, medication, emergency department attendance, specialist consultation or spinal surgery. This model aims to maintain functional levels and reduce care-seeking empowering patients to self-manage their low back pain by offering them a contemporary patient-centred physical activity program with the support of mobile health technology. The outcomes of this trial will have immediate implications for clinical practice.
  
  
  BACKGROUND
  ACTRN12615000189527 (26-02-2015).
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 1825, Australia. abar3926@uni.sydney.edu.au.
authors.forename: Anita B
authors.initials: AB
authors.lastname: Amorim
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 1825, Australia.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Pappas
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 1825, Australia.
authors.forename: Milena
authors.initials: M
authors.lastname: Simic
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.|Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Manuela L
authors.initials: ML
authors.lastname: Ferreira
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Tiedemann
authors.affiliation: Physiotherapy Department, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Jennings
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 1825, Australia.
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Ferreira
mesh_terms: D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D017281:Cost of Illness; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D009043:Motor Activity; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D016037:Single-Blind Method; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome