The Integration of Coping Strategies after Spine Surgery: a pilot trial
In addition to exercise, do behaviour change interventions or care coordination interventions improve pain levels, coping ability, disability, insomnia, anxiety and depression levels in individuals with borderline abnormal or abnormal anxiety and/or depression prior to spine surgery?
Queensland University of Technology
80 participants
Jun 30, 2020
Interventional
Conditions
Summary
This research will provide insight into whether post-operative support interventions – other than physical therapy alone – can improve acute and long-term outcomes in spinal surgery patients. In addition to this, the study strives to determine whether an intervention must be behaviorally informed in order to improve patient outcomes. In addition to a CS and BCC arm, a control arm has been included in the study design as previous interventions in this area of research have found minimal variation between the BCC and corresponding intervention (which was not a control intervention), raising the question, are clinician support and BCC effective in comparison to standard treatment?
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Interventions
This study is a randomised controlled trial whereby patients will be allocated to one of three treatment arms; two intervention arms and one control arm. The two intervention arms include: 1. Behaviour Change Counselling (BCC) and exercise 2. Clinician Support (CS) and exercise The control arm includes: 1. Exercise Behaviour Change Counselling (BCC) A Changing Behaviour through Physical Therapy (CBPT) manual will be used by the researcher to deliver the CBPT intervention to participants. The participants will also receive a modified copy of this material. This intervention will be delivered via teleconference, weekly for the first six weeks following surgery. Each teleconference session will take approximately 30 minutes. Follow-up visits will occur 6 weeks and 6 months following surgery. The CBPT resource is available on request and was designed by the Vanderbilt University Medical Center and John Hopkins University. It's official title is the Spine Surgery Recovery Program - Changing Behaviour through Physical Therapy (CBPT). A summary of the content addressed in the guide is listed below. Week 1: Setting activity goals and walking goals, recognizing what makes pain and stress better and worse, introduction to deep breathing as a coping mechanism Week 2: Re-setting activity goals and walking goals, evaluating success with deep breathing, introducing distraction techniques Week 3: Re-setting activity goals and walking goals, evaluating success of distraction techniques, learning how to balance negative thoughts with positive thoughts Week 4: Re-setting activity goals and walking goals, evaluating success of balancing negative and positive thoughts, recognising differences in underactive and overactive activity types and introducing pacing strategies to avoid excessive activity in those who are overactive, introducing sleeping tips (if applicable) Week 5: Re-setting activity goals and walking goals, evaluating success with pacing strategies, recognising the benefits of the program over the past 4 weeks, discussing how to manage any setbacks Week 6: Re-setting activity goals and walking goals, develop a recovery plan centered around activity levels, walking frequency, relaxation time, distraction techniques, pacing and using positive thoughts in everyday activity. In addition, participants will be required to report to the reseracher their Rate of Perceived Exertion (RPE) whilst completing structured walking and their exercises. Clinician Support Clinician Support is a pre-determined set of questions will be used by the clinician who delivers this intervention to participants. The following questions are asked to patients in the clinician support intervention: 1. How do you feel you are coping after surgery/ this week? 2. What is your activity like since surgery/ this week? 3. How many times this week have you completed your exercises at home? 4. How many times this week have you completed your exercises with a physiotherapist or exercise physiologist? 5. Are you back at work (if applicable)? If not, when do you plan on going back to work? 6. What type of help are you getting from your family and /or friends? 7. What are you doing now/ this week to help with your recovery? 8. Do you have any concerns with your recovery that you would like to discuss with me? The clinician support intervention will be delivered via teleconference weekly, for six weeks following surgery. The intervention delivery will take approximately 10 minutes and follow-up visits will occur 6 weeks, 6 months and 12 months after surgery. In addition, participants will be required to report to the reseracher their Rate of Perceived Exertion (RPE) whilst completing structured walking and their exercises. The telehealth sessions for patients in the BCC or CS interventions will be delivered by an Exercise Physiologist with training in Motivational Interviewing (MI). Information regarding the types of exercise prescribed to participants can be found in section 'Comparator/ control treatment'.
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ACTRN12619001579189