The effectiveness of a theory-based educational intervention on promoting physical activity-related behavior in patients with chronic low back pain: a randomized controlled trial based on health center (TRA-BAC)

Aims: this study aimed to evaluate the effectiveness of a Theory of Reasoned Action (TRA) - based educational program in promoting physical activity (PA) behavior in Chronic low back pain (cLBP) patients. Methods: the Reasoned Action Theory-based Back Care program was a randomized controlled trial conducted at a Health Service Center. It compared the TRA construct's effectiveness against a control group. Eighty patients referred to Shahid Beheshti University of Medical Sciences in Tehran were randomly assigned to either the TRA-based intervention group (n=40) or the control group (n=40). Both groups completed self-reported questionnaires at baseline, 3-month, and 6-month follow-ups. Additionally, a checklist was used to assess lumbar spine range of motion test skills using the modified Schober test. Results: a significant interaction effect was observed between "group" and "test time" factors (p<0.001). A total of 77 cLBP patients were evaluated, with a mean age of 41.0 +/- 4.2 years in the intervention group and 39.0 +/- 3.5 years in the control group. While both groups initially aligned with TRA constructs (p>0.05), the intervention group demonstrated significant improvements in PA-related behavior at both 3-month (p<0.001) and 6-month (p<0.001) follow-ups. The mean score for PA behavior in the intervention group (8.4 +/- 1.1) was significantly higher compared to the control group (3.2 +/- 1.0) (p<0.001). Similarly, pain intensity was significantly lower in the intervention group (3.8 +/- 2.2) compared to the control group (4.3 +/- 3.0) (p<0.001). Furthermore, the intervention group showed a significant improvement in lumbar spine range of motion test skills (p<0.05). The lumbar spine range of motion test skills of the intervention group significantly decreased (p<0.05). Conclusions: the TRA-BAC program demonstrates promise in improving PA-related behavior and reducing pain in cLBP patients through targeted educational strategies based on the TRA framework.