Telephone coaching can increase activity levels for people with non-chronic low back pain: a randomised trial

QuestionDoes the addition of telephone coaching to usual physiotherapy care improve activity for people with non-chronic low back pain and low to moderate recovery expectations?DesignRandomised trial with concealed allocation and intention-to-treat analysis.ParticipantsPeople attending the physiotherapy department of a public hospital for treatment within eight weeks of onset of non-specific low back pain. Eligible participants had low to moderate recovery expectations, defined as a response of 7 or less to the question ‘How certain are you that you will return to all of your usual activities one month from today?’ on a scale from 0 (not certain at all) to 10 (completely certain).InterventionFive sessions of telephone coaching by a physiotherapist trained in health coaching techniques in addition to usual physiotherapy compared to usual physiotherapy alone.Outcome measuresThe Patient Specific Functional Scale, Oswestry Disability Index, Pain Self Efficacy Questionnaire, and recovery expectation were measured at baseline, 4, and 12 weeks.Results30 participants were recruited, with 26 completing all measures at 12 weeks. There were no significant differences between groups at 4 weeks. After 12 weeks the coaching group improved significantly more than the control group on two 10-point scales: the Patient Specific Functional Scale (mean difference 3.0 points, 95% CI 0.7 to 5.4) and recovery expectation (mean difference 3.4 points, 95% CI 1.1 to 5.7). Estimates of effect sizes were moderate to large in favour of the intervention.ConclusionThe addition of telephone health coaching to usual physiotherapy care for people with non-chronic non-specific low back pain led to clinically important improvements in activity and recovery expectation.