OBJECTIVES: To examine whether the addition of motivational enhancement treatment (MET) to conventional physical therapy (PT) produces better outcomes than PT alone in people with chronic low back pain (LBP). DESIGN: A double-blinded, prospective, randomized, controlled trial. SETTING: PT outpatient department. PARTICIPANTS: Participants (N=76) with chronic LBP were randomly assigned to receive 10 sessions of either MET plus PT or PT alone. INTERVENTION: MET included motivational interviewing strategies and motivation-enhancing factors. The PT program consisted of interferential therapy and back exercises. MAIN OUTCOME MEASURES: Motivational-enhancing factors, pain intensity, physical functions, and exercise compliance. RESULTS: The MET-plus-PT group produced significantly greater improvements than the PT group in 3 motivation-enhancing factors; proxy efficacy (P<.001), working alliance (P<.001), and treatment expectancy (P=.011). Furthermore, they performed significantly better in lifting capacity (P=.015), 36-Item Short Form Health Survey General Health subscale (P=.015), and exercise compliance (P=.002) than the PT group. A trend of a greater decrease in visual analog scale and Roland-Morris Disability Questionnaire scores also was found in the MET-plus-PT group than the PT group. CONCLUSION: The addition of MET to PT treatment can effectively enhance motivation and exercise compliance and show better improvement in physical function in patients with chronic LBP compared with PT alone.
RCT Entities:
OBJECTIVES: To examine whether the addition of motivational enhancement treatment (MET) to conventional physical therapy (PT) produces better outcomes than PT alone in people with chronic low back pain (LBP). DESIGN: A double-blinded, prospective, randomized, controlled trial. SETTING: PT outpatient department. PARTICIPANTS: Participants (N=76) with chronic LBP were randomly assigned to receive 10 sessions of either MET plus PT or PT alone. INTERVENTION: MET included motivational interviewing strategies and motivation-enhancing factors. The PT program consisted of interferential therapy and back exercises. MAIN OUTCOME MEASURES: Motivational-enhancing factors, pain intensity, physical functions, and exercise compliance. RESULTS: The MET-plus-PT group produced significantly greater improvements than the PT group in 3 motivation-enhancing factors; proxy efficacy (P<.001), working alliance (P<.001), and treatment expectancy (P=.011). Furthermore, they performed significantly better in lifting capacity (P=.015), 36-Item Short Form Health Survey General Health subscale (P=.015), and exercise compliance (P=.002) than the PT group. A trend of a greater decrease in visual analog scale and Roland-Morris Disability Questionnaire scores also was found in the MET-plus-PT group than the PT group. CONCLUSION: The addition of MET to PT treatment can effectively enhance motivation and exercise compliance and show better improvement in physical function in patients with chronic LBP compared with PT alone.
Authors: Eric J Lenze; Helen H Host; Mary W Hildebrand; Nancy Morrow-Howell; Brian Carpenter; Kenneth E Freedland; Carolyn A Baum; David Dixon; Peter Doré; Leah Wendleton; Ellen F Binder Journal: J Am Med Dir Assoc Date: 2012-08-03 Impact factor: 4.669