Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain : a randomized clinical trial

Bagg, Matthew K.; Wand, Benedict M.; Cashin, Aidan G.; Lee, Hopin; Hübscher, Markus; Stanton, Tasha R.; O'Connell, Neil E.; O'Hagan, Edel T.; Rizzo, Rodrigo R. N.; Wewege, Michael A.; Rabey, Martin; Goodall, Stephen; Saing, Sopany; Lo, Serigne N.; Luomajoki, Hannu; Herbert, Robert D.; Maher, Chris G.; Moseley, G. Lorimer; McAuley, James H.

doi:10.1001/jama.2022.9930

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain : a randomized clinical trial
Authors:	Bagg, Matthew K. Wand, Benedict M. Cashin, Aidan G. Lee, Hopin Hübscher, Markus Stanton, Tasha R. O'Connell, Neil E. O'Hagan, Edel T. Rizzo, Rodrigo R. N. Wewege, Michael A. Rabey, Martin Goodall, Stephen Saing, Sopany Lo, Serigne N. Luomajoki, Hannu Herbert, Robert D. Maher, Chris G. Moseley, G. Lorimer McAuley, James H.
et. al:	No
DOI:	10.1001/jama.2022.9930
Published in:	JAMA: The Journal of the American Medical Association
Volume(Issue):	328
Issue:	5
Page(s):	430
Pages to:	439
Issue Date:	2-Aug-2022
Publisher / Ed. Institution:	American Medical Association
ISSN:	0098-7484 1538-3598
Language:	English
Subjects:	Adult; Exercise; Female; Humans; Male; Middle aged; Minimal clinically important difference; Neurological rehabilitation; Pain measurement; Treatment outcome; Chronic pain; Low back pain; Pain management; Physical therapy modalities; Somatosensory disorders
Subject (DDC):	617.5: Orthopaedic surgery
Abstract:	Importance: The effects of altered neural processing, defined as altering neural networks responsible for perceptions of pain and function, on chronic pain remains unclear. Objective:To estimate the effect of a graded sensorimotor retraining intervention (RESOLVE) on pain intensity in people with chronic low back pain. Design, setting and participants: This parallel, 2-group, randomized clinical trial recruited participants with chronic (>3 months) nonspecific low back pain from primary care and community settings. A total of 276 adults were randomized (in a 1:1 ratio) to the intervention or sham procedure and attention control groups delivered by clinicians at a medical research institute in Sydney, Australia. The first participant was randomized on December 10, 2015, and the last was randomized on July 25, 2019. Follow-up was completed on February 3, 2020. Interventions: Participants randomized to the intervention group (n = 138) were asked to participate in 12 weekly clinical sessions and home training designed to educate them about and assist them with movement and physical activity while experiencing lower back pain. Participants randomized to the control group (n = 138) were asked to participate in 12 weekly clinical sessions and home training that required similar time as the intervention but did not focus on education, movement, and physical activity. The control group included sham laser and shortwave diathermy applied to the back and sham noninvasive brain stimulation. Main outcomes and measures: The primary outcome was pain intensity at 18 weeks, measured on an 11-point numerical rating scale (range, 0 [no pain] to 10 [worst pain imaginable]) for which the between-group minimum clinically important difference is 1.0 point. Results: Among 276 randomized patients (mean [SD] age, 46 [14.3] years; 138 [50%] women), 261 (95%) completed follow-up at 18 weeks. The mean pain intensity was 5.6 at baseline and 3.1 at 18 weeks in the intervention group and 5.8 at baseline and 4.0 at 18 weeks in the control group, with an estimated between-group mean difference at 18 weeks of −1.0 point ([95% CI, −1.5 to −0.4]; P = .001), favoring the intervention group. Conclusions and relevance: In this randomized clinical trial conducted at a single center among patients with chronic low back pain, graded sensorimotor retraining, compared with a sham procedure and attention control, significantly improved pain intensity at 18 weeks. The improvements in pain intensity were small, and further research is needed to understand the generalizability of the findings.
URI:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346551/ https://digitalcollection.zhaw.ch/handle/11475/25708
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Appears in collections:	Publikationen Gesundheit

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Bagg, M. K., Wand, B. M., Cashin, A. G., Lee, H., Hübscher, M., Stanton, T. R., O’Connell, N. E., O’Hagan, E. T., Rizzo, R. R. N., Wewege, M. A., Rabey, M., Goodall, S., Saing, S., Lo, S. N., Luomajoki, H., Herbert, R. D., Maher, C. G., Moseley, G. L., & McAuley, J. H. (2022). Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain : a randomized clinical trial. JAMA: The Journal of the American Medical Association, 328(5), 430–439. https://doi.org/10.1001/jama.2022.9930

Bagg, M.K. et al. (2022) ‘Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain : a randomized clinical trial’, JAMA: The Journal of the American Medical Association, 328(5), pp. 430–439. Available at: https://doi.org/10.1001/jama.2022.9930.

M. K. Bagg et al., “Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain : a randomized clinical trial,” JAMA: The Journal of the American Medical Association, vol. 328, no. 5, pp. 430–439, Aug. 2022, doi: 10.1001/jama.2022.9930.

BAGG, Matthew K., Benedict M. WAND, Aidan G. CASHIN, Hopin LEE, Markus HÜBSCHER, Tasha R. STANTON, Neil E. O’CONNELL, Edel T. O’HAGAN, Rodrigo R. N. RIZZO, Michael A. WEWEGE, Martin RABEY, Stephen GOODALL, Sopany SAING, Serigne N. LO, Hannu LUOMAJOKI, Robert D. HERBERT, Chris G. MAHER, G. Lorimer MOSELEY und James H. MCAULEY, 2022. Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain : a randomized clinical trial. JAMA: The Journal of the American Medical Association [online]. 2 August 2022. Bd. 328, Nr. 5, S. 430–439. DOI 10.1001/jama.2022.9930. Verfügbar unter: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346551/

Bagg, Matthew K., Benedict M. Wand, Aidan G. Cashin, Hopin Lee, Markus Hübscher, Tasha R. Stanton, Neil E. O’Connell, et al. 2022. “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients with Chronic Low Back Pain : A Randomized Clinical Trial.” JAMA: The Journal of the American Medical Association 328 (5): 430–39. https://doi.org/10.1001/jama.2022.9930.

Bagg, Matthew K., et al. “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients with Chronic Low Back Pain : A Randomized Clinical Trial.” JAMA: The Journal of the American Medical Association, vol. 328, no. 5, Aug. 2022, pp. 430–39, https://doi.org/10.1001/jama.2022.9930.