{Reference Type}: Journal Article
{Title}: Embedded motivational interviewing combined with a smartphone application to increase physical activity in people with sub-acute low back pain: a cluster randomised controlled trial.
{Author}: Holden J;O'Halloran P;Davidson M;Breckon J;Rahayu W;Monfries M;Taylor NF;
{Journal}: Braz J Phys Ther
{Volume}: 28
{Issue}: 4
{Year}: 2024 Jun 16
{Factor}: 4.762
{DOI}: 10.1016/j.bjpt.2024.101091
{Abstract}: <B>BACKGROUND: </B>Moderately vigorous physical activity (PA) may be beneficial for people with sub-acute low back pain (LBP), but may initially be painful for patients and challenging for physical therapists to facilitate.<BR><B>OBJECTIVE: </B>This study investigated motivational interviewing (MI) delivered by physical therapists and a smartphone app for increasing PA in people with LBP.<BR><B>METHODS: </B>A mixed methods cluster randomised controlled trial involving 46 adults with LBP in Melbourne, Australia. Participants attended weekly 30-min physical therapy consultations for 6 weeks. Experimental group physical therapists were taught to embed MI into consultations and patients were provided with a self-directed app. The primary outcome was accelerometer-derived moderately vigorous PA. Secondary outcomes were LBP disability (Oswestry Disability Index), functional capacity (Patient Specific Functional Scale), and self-efficacy (Pain Self-Efficacy Questionnaire). Between-group differences were analysed by ANCOVA post-intervention.<BR><B>RESULTS: </B>There was no statistically significant difference between the experimental group and control group for PA. Between-group differences in LBP disability (MD= 19.4 units, 95% CI: 8.5, 30.3), functional capacity (primary MD= -4.1 units, 95% CI: -6.9, -1.3; average MD= -3.1, 95% CI: -4.9, -1.2) and self-efficacy (MD -11.3 units, 95%CI -20.2, -2.5) favoured the control group with small to moderate effect sizes. There were low levels of overall engagement with the app.<BR><B>CONCLUSIONS: </B>The embedded MI intervention was no more beneficial than physical therapy alone for PA and was associated with poorer LBP disability, function, and self-efficacy. The effectiveness of embedding MI and a smartphone app into usual care for LBP was not supported.