Promoting physical activity in low back pain patients: six months follow-up of a randomised controlled trial comparing a multicomponent intervention with a low intensity intervention

Objective: To assess a comprehensive multicomponent intervention against a low intensity intervention for promoting physical activity in chronic low back pain patients. Design: Randomised controlled trial. Setting: Inpatient rehabilitation and aftercare. Subjects: A total of 412 patients with chronic low back pain. Interventions: A multicomponent intervention (Movement Coaching) comprising of small group intervention (twice during inpatient rehabilitation), tailored telephone aftercare (twice after rehabilitation) and internet-based aftercare (web 2.0 platform) versus a low level intensity intervention (two general presentations on physical activity, download of the presentations). Main measures: Physical activity was measured using a questionnaire. Primary outcome was total physical activity; secondary outcomes were setting specific physical activity (transport, workplace, leisure time) and pain. Comparative group differences were evaluated six months after inpatient rehabilitation. Results: At six months follow-up, 92 participants in Movement Coaching (46 %) and 100 participants in the control group (47 %) completed the postal follow-up questionnaire. No significant differences between the two groups could be shown in total physical activity (P = 0.30). In addition to this, workplace (P = 0.53), transport (P = 0.68) and leisure time physical activity (P = 0.21) and pain (P = 0.43) did not differ significantly between the two groups. In both groups, physical activity decreased during the six months follow-up. Conclusions: The multicomponent intervention was no more effective than the low intensity intervention in promoting physical activity at six months follow-up. The decrease in physical activity in both groups is an unexpected outcome of the study and indicates the need for further research.