Movement coaching: study protocol of a randomized controlled trial evaluating effects on physical activity and participation in low back pain patients

Background: Chronic Low Back Pain is a complex syndrome with multifactorial bio-psycho-social etiology and interdependences. Thereby, physical activity seems to play an essential role regarding the prevention and rehabilitation of LBP. In consequence, physical activity and exercise therapy is an integral part of musculoskeletal rehabilitation in LBP. However, adherence to self-directed exercise and implementing a health-enhancing physical activity in daily routine after rehabilitation is a common problem for patients and only a few patients integrate health-enhancing physical activity and/or sport activities in their lifestyle. The present paper describes a comprehensive multilevel approach combining face-to-face intervention, telephone and internet aftercare (Movement Coaching). Aim of the trial presented in this study protocol is to evaluate effectiveness of Movement Coaching compared to a control intervention. Methods/Design: The study is a prospective, single-blinded, monocenter randomized controlled trial (RCT) with three measuring points: T1 = start of inpatient rehabilitation; T2 = six months follow-up; T3 = twelve months follow-up. In total, 412 patients were recruited. The intervention involves small-group face-to-face contact during inpatient rehabilitation (two times, week 2 & 3) and telephone aftercare (week 8 & week 12 after rehabilitation) as well as internet-based aftercare (web 2.0 platform; available until six months after rehabilitation). Primary outcome is physical activity, assessed by GPAQ questionnaire. The final data collection is expected by April 2015. Discussion: Due to the burden of physical inactivity, there is a need to develop, evaluate and disseminate approaches that are effective in promoting physical activity and especially promoting the maintenance of physical activity in relevant target groups. Considering the high prevalence and socioeconomic impact of low back pain and its multifactorial etiology, low back pain patients seem to be a relevant target group for physical activity promotion. A multilevel approach to bridge the interface of (inpatient) rehabilitation and self-directed physical activity will help to target group-specific PA promotion.