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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_10 | Pages 5 - 5
1 May 2017
Marley J McDonough S Tully M Bunting B O'Hanlon J Porter-Armstrong A
Full Access

Background

Chronic musculoskeletal pain increases an individual's risk of developing many chronic diseases and the risk of all-cause early mortality. There is irrefutable evidence supporting the role of physical activity (PA) in reducing these risks. Sustaining changes to PA behaviours is challenging and efforts are needed to understand the barriers and facilitators of change. Understanding these factors is a vital step in developing behaviour change interventions.

Objectives

Explore barriers and facilitators to engaging in PA in adults accessing pain services.

Explore barriers and facilitators to promoting PA by healthcare professionals, exercise professionals and charity staff/expert patients.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_2 | Pages 16 - 16
1 Feb 2015
Campbell C Kerr D McDonough S Murphy M Tully M
Full Access

Background and purpose

To identify methods used to measure free living sedentary behaviour in people with back pain and review the validity and reliability of identified measures.

Methods

Databases including CINAHL, EMBASE, MEDLINE, AMED, PsycINFO, SPORTDiscus and the Sedentary Behaviour and Research Network website (www.sedentarybehaviour.org) were searched for relevant published articles up to June 2014. Studies which measured sedentary behaviour in people with back pain were included. Quality of the included studies was assessed using the Newcastle Ottawa Scale. The Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) Checklist was used to assess psychometric properties.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_I | Pages 6 - 6
1 Jan 2012
O'Connor S Tully M Ryan B Baxter G Bradley J McDonough S
Full Access

Aims/background

Current treatment recommendations advocate various exercise modalities for people with chronic Low Back Pain (cLBP)1. Walking appears to represent an inexpensive and readily accessible activity for a range of individuals, including those who were previously sedentary. However, the effectiveness of such interventions are uncertain in cLBP.

Methods

A systematic review was undertaken to examine the effectiveness of walking interventions across a range of chronic musculoskeletal pain conditions, including LBP. Six electronic databases were searched for relevant studies. Data for pain and self reported function were extracted and where appropriate, results were pooled and analysed using RevMan (v.5).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_I | Pages 8 - 8
1 Jan 2012
Hurley D Eadie J Tully M van Mechelen W Boreham C McDonough S Lonsdale C Daly L
Full Access

Background and purpose

Sleep disturbance is a prevalent symptom in people with chronic low back pain (CLBP >12 weeks), but there is currently no knowledge of the effectiveness of physiotherapy for this problem. This study evaluated the feasibility of a randomised controlled trial (RCT) exploring the effects of physiotherapy on sleep disturbance in CLBP [Current controlled trial ISRCTN 54009836].

Methods

A sample of 60 consenting patients with CLBP [23 M, 37 F; mean (SD) age = 44.93 (13.41) years] were recruited in Beaumont Hospital, Dublin and randomly allocated to one of three groups [supervised exercise class (SEC), walking programme (WP) and usual physiotherapy (UP)] in a concealed manner. The main outcomes were sleep quality, functional disability, pain, and quality of life at baseline, 3 and 6 months.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 489 - 489
1 Nov 2011
McDonough S Hunter R Tully M Walsh D Dhamija S McCann S Liddle S Glasgow P Paterson C Gormley G Hurley D Delitto A Park J Bradbury I Baxter G
Full Access

Background and Purpose: Current clinical guidelines recommend supervised exercise as a first-line treatment in the management of low back pain (LBP). To date studies have not used objective forms of measuring changes in free-living physical activity (FLPA). The aim of this study was to compare FLPA between two groups who received either supervised exercise and auricular acupuncture (EAA) or exercise alone (E).

Methods: 51 patients with non-specific LBP [mean±SD=42.8±12.4 years] wore an accelerometer for 7 days at baseline, end of the intervention (week 8) and follow up (week 25). FLPA variables were extracted: % time (hours) spent in postures; daily step count and cadence. Data were analysed using SPSS (v15). Repeated measures ANCOVA were performed using a mixed linear model.

Results: There was no difference in daily step count between the two groups at any time point (E, mean±SD, week 1, 8197±2187; week 8, 8563±2438, week 25, 8149±2800; EAA, mean±SD, week 1, 8103±1942; week 8, 8010±2845, week 25, 8139±1480, p=0.9) or cadence. No differences in postures were noted, apart from time sitting/lying which was shorter at week 25 in the E group (p=0.006).

Conclusions & Implications: Supervised exercise classes, with or without acupuncture, do not produce changes in FLPA in the short term or longer term in people with LBP. This suggests more effective ways should be sought to encourage the patient to incorporate activity into their daily lives. These findings have informed the design of two walking intervention trials for LBP patients.

Conflict of Interest: None

Sources of Funding: Research and Development Office, Northern Ireland, Strategic Priority Fund, Department of Employment and Learning, Northern Ireland.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 235 - 235
1 Mar 2010
O’Donoghue G van Mechelen W Tully M Moffett JK Daly L Boreham C McDonough S Hurley D
Full Access

Background & Purpose: Clinical guidelines support physical activity for people with chronic low back pain (CLBP); walking is an ideal form of physical activity as it is easy to do, requires no special skills and is achievable by virtually all ages with little risk of injury but there are no current evidence-based structured walking programmes (WP) for this population. The purpose of this study was to develop a WP for CLBP patients in preparation for a proposed randomized controlled trial.

Methods: An 8-week structured WP was developed using Intervention Mapping (IM) principles:

literature review,

4 focus groups (n=18 CLBP patients),

Physiotherapist Interviews (n=4), and then pilot-tested in a consenting sample of 10 CLBP patients [n=5 male, 5 female; mean (SD)= 50.5 (12.6) years], who completed the 10-metre Shuttle Walk Test, Oswestry Disability Index, NRS, Euro-Qol, Fear Avoidance, Back Beliefs, International Physical Activity and Self-Efficacy Questionnaires, at baseline and 8-week follow-up, and wore the activPAL™ accelerometer for 7 days pre and post intervention.

Results: Both the CLBP patients and physiotherapists interviewed endorsed walking as a suitable form of physical activity, and identified possible barriers as fear avoidance, exacerbation of pain, behavioural change, motivation, time, personal safety and adverse weather. The pilot study found 90% compliance with the WP. Descriptive analysis of change scores showed improvements at 8-weeks in all self reported outcomes and objectively measured physical activity and functional capacity.

Conclusion: Intervention Mapping was successfully used to develop a WP intervention for chronic LBP, the efficacy of which is being evaluated in a randomized controlled trial.