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Sports medicine highlights from other journals

Griffin SA, et al. Br J Sports Med 2017;51:1566. doi:10.1136/bjsports-2017-098066 IncreasIng recreatIonal physIcal actIvIty In patIents wIth chronIc low back paIn: a pragmatIc controlled clInIcal trIal Journal of orthopaedic & sports physical therapy. 2017;47:57–66 Chronic low back pain (CLBP) treatment guidelines recommend introducing and maintaining physical activity because it improves function, speeds return to work and prevents future pain in patients. But it’s hard to get patients to do it! This paper encourages us to consider behaviour-change theory (enhanced transtheoretical model intervention (ETMI)). This intervention was designed to enhance reassurance, and tackle any fear of movement through an overarching approach that matched the patients' readiness to engage in change. Disability was the primary outcome of this multicentre, prospective, controlled trial, that used this model versus usual physiotherapy for CLBP. The study group included 189 patients who had CLBP for more than 3 months. At 12 months, the ETMI group (n=94) demonstrated significant improvements in disability in comparison to the control group (n=95). The difference in reduction in group averages on the Roland Morris Disability Questionnaire was 2.7, indicating that the change was clinically meaningful. Significantly more people in the ETMI group (n=79, 84.0%) achieved a reduction greater than 30% in disability scores from baseline than in the control group. What does this mean? Further consideration and focus is required on the barriers to physical activity with patients with CLBP, and it may be pertinent for clinicians to consider various forms of behaviour change theory to address these.