scholarly journals Reboot Online: A Randomized Controlled Trial Comparing an Online Multidisciplinary Pain Management Program with Usual Care for Chronic Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2385-2396 ◽  
Author(s):  
Jessica Smith ◽  
Steven G Faux ◽  
Tania Gardner ◽  
Megan J Hobbs ◽  
Mathew A James ◽  
...  

Abstract Objective Chronic pain is a prevalent and burdensome condition. Reboot Online was developed to address treatment barriers traditionally associated with accessing face-to-face chronic pain management programs. It is a comprehensive multidisciplinary online treatment program, based on an existing and effective face-to-face multidisciplinary pain program (the Reboot program). Design & Participants A CONSORT-compliant randomized controlled trial was conducted, enrolling adults who had experienced pain for three months or longer. Methods Participants were randomly allocated to either an eight-lesson multidisciplinary pain management program, Reboot Online (N = 41), or to a usual care (UC) control group (N = 39). Clinical oversight was provided by a multidisciplinary team remotely, including physiotherapists and clinical psychologists. Participants were measured at baseline, post-treatment (week 16), and three-month follow-up (week 28). Results Intention-to-treat analyses revealed that Reboot Online was significantly more effective than UC at increasing pain self-efficacy (g = 0.69) at post-treatment, and these gains were maintained at follow-up. Similarly, Reboot Online was significantly more effective than UC on several secondary measures at post-treatment and follow-up, including movement-based fear avoidance and pain-related disability, but it did not significantly reduce pain interference or depression compared with UC. Clinician input was minimal, and adherence to Reboot Online was moderate, with 61% of participants (N = 25) completing all eight lessons. Conclusions Reboot Online presents a novel approach to multidisciplinary pain management and offers an accessible, efficacious alternative and viable treatment option for chronic pain management.

Author(s):  
Mimi Tse ◽  
Yajie Li ◽  
Shuk Kwan Tang ◽  
Shamay S. M. Ng ◽  
Xue Bai ◽  
...  

Background: 80% of nursing home residents have reported chronic pain, which is often accepted by older adults as part of aging. Peer support models are being used to help individuals manage their chronic conditions and overcome the challenges of limited healthcare resources. The aims of this study were: (i) to examine the effectiveness of a 12 week peer-led pain management program (PAP) for nursing home residents and (ii) to evaluate their experiences. Methods: A cluster randomized controlled trial (RCT) was used. The 12 week pain management program was provided for the experimental group. Outcomes were measured at three time points. The participants’ satisfaction and acceptance were evaluated by a semi-structured interview after the program was completed. Results: Pain self-efficacy, pain intensity, pain interference, pain knowledge, and depression levels improved after the completion of the 12 week peer-led PAP. The pain-intensity level reported at week 12 was significantly lower in the experimental group than in the control group. Semi-structured interviews showed that the nursing home residents were satisfied with the pain education that they received. Conclusions: The 12 week peer-led PAP appeared to improve the pain-related and psychological outcome measures in nursing home residents, and the feedback on the peer-led PAP from the nursing home residents was positive.


2020 ◽  
Author(s):  
Mimi Mun Yee Tse ◽  
Yajie LI ◽  
Shuk Kwan Tang ◽  
Shamay Sheung Mei Ng ◽  
Xue Bai ◽  
...  

Abstract Background Chronic pain is common among nursing home residents and they may have difficulty seeking out pain management strategies. Due to the limitation of healthcare resources, peer support model was proved with promising effect in managing chronic conditions. Methods It is a clustered randomized controlled trial. Peer-led pain management program was provided for the experimental group. Pain situation, depression, quality of life, non-drug strategies used and pain knowledge were measured. Results Totally 262 participants joined the study. Their overall pain score was 6.36. Leg was the most frequently reported site of pain and walking ability was interfered. Depression was also reported by the participants. The score for quality of life was 32.65 for physical component and 51.58 for mental component. The mean score for pain knowledge was 46.81 out of 100. No significant difference was shown between two groups at baseline. Discussion Severe pain intensity and low self-efficacy among the participants indicated it is necessary to provide pain management programs especially for this population. The frequency with strategies applied were significantly correlated with pain intensity, pain interference, depression, and quality of life. Pain knowledge also correlated significantly with some strategies.


2017 ◽  
Vol 22 (6) ◽  
pp. 1132-1137 ◽  
Author(s):  
Masayuki Inoue ◽  
Tatsunori Ikemoto ◽  
Shinsuke Inoue ◽  
Masatoshi Nakata ◽  
Makoto Nishihara ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Regina Schultz ◽  
Jessica Smith ◽  
Jill M. Newby ◽  
Tania Gardner ◽  
Christine T. Shiner ◽  
...  

Objectives. Chronic pain causes significant disability and psychological distress, but barriers often prevent people with pain from engaging in traditional face-to-face pain management programs. Accessible, feasible, and effective alternative treatment options are needed. Methods. A prospective, feasibility pilot study was conducted to trial a novel, multidisciplinary online pain management program: the “Reboot Online” program. Twenty participants experiencing pain of at least three months duration were recruited. All participants were enrolled in the “Reboot Online” program, consisting of eight online lessons completed over 16 weeks. Lessons incorporated multidisciplinary input from medical pain specialists, physiotherapists, and psychologists. Participants were assessed at pretreatment, posttreatment, and follow-up using a suite of outcome measures examining pain, disability, catastrophising, self-efficacy, mood, and psychological distress. Results. 13 participants completed the program (65% adherence). Following treatment, the participants had significantly improved scores on measures of pain-related disability, self-efficacy, catastrophising thoughts, acceptance of pain, symptoms of depression, and general psychological distress. These findings were retained at three months posttreatment. Participants also reported high levels of acceptability and satisfaction with the program. Discussion. This study provides pilot evidence for the feasibility, acceptability, and effectiveness of an online, multidisciplinary pain program: “Reboot Online.” Future investigations will focus on conducting a randomised controlled trial of this innovative and promising treatment for chronic pain. This trial is registered with ACTRN12615000660583.


2021 ◽  
Author(s):  
Tania Gardner ◽  
Hila Haskelberg ◽  
Regina Schultz ◽  
Jill Newby ◽  
Jane Wheatley ◽  
...  

BACKGROUND Internet-based treatment programs present a solution for providing access to pain management for those unable to access clinic-based multidisciplinary pain programs. Attrition from internet interventions is a common issue. Clinician supported guidance can be an important feature in online interventions however the optimal level of therapist guidance and expertise required to improve adherence remains unclear. OBJECTIVE To evaluate whether augmenting the existing Reboot Online program with additional telephone support by a clinician, improves program adherence and effectiveness, relative to the online program alone METHODS A two-armed, CONSORT-compliant registered randomized controlled trial (RCT), with one-to-one group allocation was conducted. It compared an online multidisciplinary pain management program Reboot Online combined with telephone support (n=44), with Reboot Online alone (n=45) as the control group. Participants were recruited via online social media and existing THISWAYUP networks. The primary outcome for this study was adherence to the Reboot Online program. Adherence was quantified via three metrics; (i) completion of the program (ii) the number of participants who enrolled into the program, (iii) the number of participants who commenced the program. Data on adherence were collected automatically via the THIS WAY UP platform. Secondary measures of clinical effectiveness were also collected. RESULTS Reboot Online combined with telephone support had a positive effect on enrolment and commencement of the program compared to Reboot Online without telephone support. Significantly more participants from the Reboot Online plus telephone support group enrolled (93.2%) into the course compared to the control group (77.8%) (χ2 = 4.23, p = 0.04), Further, more participants from the intervention group commenced the course compared to the control group (90.9% versus 60.0% respectively, χ2 = 11.42, p = 0.001). Of those participants enrolled in the intervention group, 43.2% completed the course (19/44) and of those in the control group 31.1% completed the course (14/45). When considering the subgroup of those who commenced the program, there was no significant difference between the proportions of people who completed all 8 lessons in the intervention (47.5%) versus control groups (51.8%) (χ2 = 1.39, p = 0.24). CONCLUSIONS Telephone support improves participants’ registration, program commencement and engagement in early phase of the internet intervention; however, it did not appear to impact on overall course completion or efficacy. CLINICALTRIAL The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001076167), and the protocol was followed as per the registry. The study was approved by the Human Research Ethics Committee (2019/ETH08682) of St Vincent’s Hospital Sydney, Australia.


2009 ◽  
Vol 89 (10) ◽  
pp. 1016-1026 ◽  
Author(s):  
Roberta Y.W. Law ◽  
Lisa A. Harvey ◽  
Michael K. Nicholas ◽  
Lois Tonkin ◽  
Maria De Sousa ◽  
...  

Background: Stretch is commonly prescribed as part of physical rehabilitation in pain management programs, yet little is known about its effectiveness.Objective: A randomized controlled trial was conducted to investigate the effects of a 3-week stretch program on muscle extensibility and stretch tolerance in patients with chronic musculoskeletal pain.Design: A within-subject design was used, with one leg of each participant randomly allocated to an experimental (stretch) condition and the other leg randomly allocated to a control (no-stretch) condition.Patients and Setting: Thirty adults with pain of musculoskeletal origin persisting for at least 3 months were recruited from patients enrolled in a multidisciplinary pain management program at a hospital in Sydney, Australia.Intervention: The hamstring muscles of the experimental leg were stretched daily for 1 minute over 3 weeks; the control leg was not stretched. This intervention was embedded within a pain management program and supervised by physical therapists.Measurements: Primary outcomes were muscle extensibility and stretch tolerance, which were reflected by passive hip flexion angles measured with standardized and nonstandardized torques, respectively. Initial measurements were taken before the first stretch on day 1, and final measurements were taken 1 to 2 days after the last stretch. A blinded assessor was used for testing.Results: Stretch did not increase muscle extensibility (mean between-group difference in hip flexion was 1°, 95% confidence interval=−2° to 4°), but it did improve stretch tolerance (mean between-group difference in hip flexion was 8°, 95% confidence interval=5° to 10°).Conclusion: Three weeks of stretch increases tolerance to the discomfort associated with stretch but does not change muscle extensibility in patients with chronic musculoskeletal pain.


2005 ◽  
Vol 30 (5) ◽  
pp. 198-206 ◽  
Author(s):  
Elin Dysvik ◽  
Gerd Karin Natvig ◽  
Ole-Johan Eikeland ◽  
Gunilla Brattberg

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