scholarly journals Effectiveness of a biopsychosocial e-learning intervention on the clinical judgements of medical students and GP trainees regarding future risk of disability in patients with chronic lower back pain: study protocol for a randomised controlled trial

BMJ Open ◽  
2016 ◽  
Vol 6 (5) ◽  
pp. e010407 ◽  
Author(s):  
Christopher P Dwyer ◽  
Hannah Durand ◽  
Pádraig MacNeela ◽  
Bronagh Reynolds ◽  
Robert M Hamm ◽  
...  
Keyword(s):  
Back Pain ◽  
Medical Students ◽  
Randomised Controlled Trial ◽  
Lower Back Pain ◽  
Controlled Trial ◽  
Chronic Lower Back Pain ◽  
Lower Back ◽  
E Learning ◽  
Future Risk ◽  
Randomised Controlled

scholarly journals Study protocol for a randomised controlled trial on the effect of local analgesia for pain relief after minimal invasive sacroiliac joint fusion: the ARTEMIS study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056204
Author(s):  
Sem M M Hermans ◽  
Jorm M Nellensteijn ◽  
Henk van Santbrink ◽  
Rob Knoef ◽  
Mattheus K Reinders ◽  
...  
Keyword(s):  
Back Pain ◽  
Postoperative Pain ◽  
Randomised Controlled Trial ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Controlled Trial ◽  
Lower Back ◽  
Joint Fusion ◽  
Randomised Controlled ◽  
Sacroiliac Joint Fusion

IntroductionChronic lower back pain is a common report in the general population. A dysfunctional sacroiliac joint (SIJ) is estimated to be responsible for one in five patients with lower back pain. Minimally invasive sacroiliac joint fusion (MISJF) is a surgical procedure to treat SIJ dysfunction. During the procedure, the SIJ is stabilised by implants inserted percutaneously under fluoroscopy guidance. Postoperatively, patients often report a lot of pain, which contributes to patients taking high doses of painkillers (opioids for example,) and preventing early mobilisation. In several orthopaedic procedures, intraoperative infiltration of the wound bed results in decreased consumption of analgesics, earlier mobilisation and shorter hospitalisation time. The aim of this study is to investigate the effectiveness of intraoperative SIJ infiltration with analgesia in reducing postoperative pain after MISJF.Methods and analysisWe will perform a two-centre, prospective, double-blind, randomised controlled trial to determine whether SIJ infiltration with 1.5–5 cc bupivacaine 0.50% is superior to 1.5–5 cc placebo (NaCl 0.9%) in reducing postoperative pain in patients after MISJF, and to determine whether bupivacaine significantly reduces opioid use in the direct postoperative period. Patients will be randomised with 1:1 allocation for either bupivacaine (intervention) or placebo SIJ infiltration. Postoperative pain will be measured by the Visual Analogue Scale pain score at entry and exit recovery, 2, 4, 6, 24 and 48 hours postoperatively.Ethics and disseminationThis is the first trial that investigates the effectiveness of intraoperative SIJ infiltration with bupivacaine 0.50% in reducing postoperative pain after MISJF. If intraoperative SIJ infiltration with bupivacaine 0.50% proves to be effective, this might have important clinical implications, such as postoperative analgesics (opioids for example,) consumption, earlier mobilisation and potentially shorter hospitalisation time.Trial registration numberNL9151.

Effects of Biopsychosocial Education on the Clinical Judgments of Medical Students and GP Trainees Regarding Future Risk of Disability in Chronic Lower Back Pain: A Randomized Control Trial

Pain Medicine ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 939-950
Author(s):  
Christopher P Dwyer ◽  
Pádraig MacNeela ◽  
Hannah Durand ◽  
Laura L O’Connor ◽  
Chris J Main ◽  
...  
Keyword(s):  
Back Pain ◽  
Medical Students ◽  
Educational Intervention ◽  
Lower Back Pain ◽  
Clinical Judgment ◽  
Chronic Lower Back Pain ◽  
Attitudes And Beliefs ◽  
Clinical Judgments ◽  
Positive Effects ◽  
Lower Back

Abstract Background Chronic lower back pain (CLBP) is a major health care burden and often results in workplace absenteeism. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions informed by the flags approach, which integrates cognitive and behavioral approaches via identification of biopsychosocial barriers to recovery, have resulted in reduced pain-related work absences and increased return to work for individuals with CLBP. However, research indicates that physicians’ adherence to biopsychosocial guidelines is low. Objective The current study examined the effects of a flags approach–based educational intervention on clinical judgments of medical students and general practitioner (GP) trainees regarding the risk of future disability of CLBP patients. Design Randomized controlled trial (trial registration number: ISRCTN53670726). Setting University classroom. Subjects Medical students and GP trainees. Methods Using 40 fictional CLBP cases, differences in clinical judgment accuracy, weighting, and speed (experimental N = 32) were examined pre- and postintervention, as were flags approach knowledge, pain attitudes and beliefs, and empathy, in comparison with a no-intervention control group (control N = 31). Results Results revealed positive effects of the educational intervention on flags approach knowledge, pain-related attitudes and beliefs, and judgment weighting of psychologically based cues; results are discussed in light of existing theory and research. Conclusions Short flags approach–based educational video interventions on clinical judgment-making regarding the risk of future disability of CLBP patients may provide opportunities to gain biopsychosocial knowledge, overcome associated attitude barriers, and facilitate development of clinical judgment-making more aligned with psychological cues.

Treatment of Chronic Lower Back Pain: Study Protocol of a Comparative Effectiveness Study on Yoga, Eurythmy Therapy, and Physiotherapeutic Exercises

2017 ◽  
Vol 25 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Arndt Büssing ◽  
Désirée Poier ◽  
Thomas Ostermann ◽  
Matthias Kröz ◽  
Andreas Michalsen
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Controlled Trial ◽  
Self Regulation ◽  
Chronic Lower Back Pain ◽  
Disability Score ◽  
Satisfaction Scale ◽  
Visual Analog Scales ◽  
Lower Back

Background: We aim to compare the effectiveness of 3 active interventions, i.e., yoga, eurythmy therapy, and physiotherapeutic exercise, on chronic lower back pain. Methods: In this randomized controlled trial over 16 weeks (8 weeks of intervention, 8 weeks of follow-up), data of individuals with chronic lower back pain will be analyzed. Interventions are implemented as group sessions (75 min) once per week. Participants receive a manual for home-based practice and are assessed before and at the end of the 8-week intervention period, and at the end of an 8-week follow-up period. Standardized questionnaires are: the Roland-Morris Disability Score, visual analog scales measuring intensity of pain, the Brief Multidimensional Life Satisfaction Scale, the Perceived Stress Scale, the Inner Correspondence with the Practices questionnaire, the Freiburg Mindfulness Questionnaire, the General Self-Efficacy Scale, a self-regulation questionnaire, the Internal Coherence Scale, a pain diary (registering the need of analgesic medication), and a questionnaire on the patients' expectation that the interventions will be effective in reducing pain and how strong this reduction might be (2 single items), etc. Discussion: This large multicenter study will provide evidence on the effectiveness of 3 contrasting movement-orientated treatments that share some similarities but differ in essential details: yoga, eurythmy therapy, and physiotherapeutic exercises. It will provide important data on non-pharmacological options to treat lower back pain in a large group of affected individuals.

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