Abstract
BackgroundLow back pain persisting for longer than 3 months is a common and costly condition for which many current treatments have low-moderate success rates at best. Exercise is among the more successful treatments for this condition, however, the type and dosage of exercise that elicits the best results is not clearly defined. Tai chi is a gentle form of low intensity exercise that uses controlled movements in combination with relaxation techniques and is currently used as a safe form of exercise for people suffering from other chronic pain conditions such as arthritis. To date, there has been no scientific evaluation of tai chi as an intervention for people with back pain. Thus the aim of this study will be to examine the effects of a tai chi exercise program on pain and disability in people with long-term low back pain.Methods and designThe study will recruit 160 healthy individuals from the community setting to be randomised to either a tai chi intervention group or a wait-list control group. Individuals in the tai chi group will attend 2 tai chi sessions (40 minutes)/week for 8 weeks followed by 1 tai chi session/week for 2 weeks. The wait-list control will continue their usual health care practices and have the opportunity to participate in the tai chi program once they have completed the follow-up assessments. The primary outcome will be bothersomeness of back symptoms measured with a 0–10 numerical rating scale. Secondary outcomes include, self-reports of pain-related disability, health-related quality of life and global perceived effect of treatment. Statistical analysis of primary and secondary outcomes will be based on the intention to treat principle. Linear mixed models will be used to test for the effect of treatment on outcome at 10 weeks follow up. This trial has received ethics approval from The University of Sydney Human Research Ethics Committee. HREC Approval No.10452DiscussionThis study will be the first trial in this area and the information on its effectiveness will allow patients, clinicians and treatment funders to make informed choices regarding this treatment.Trial RegistrationThis trial has been registered with Australian New Zealand Clinical Trials Registry. ACTRN12608000270314
Highlights
Low back pain persisting for longer than 3 months is a common and costly condition for which many current treatments have low-moderate success rates at best
Potential participants will be screened over the phone using three standardized forms: an inclusion/ exclusion criteria sheet, a Physical Activity Readiness Questionnaire (PAR-Q) [26] and a pathology screening questionnaire
Statistical Methods Primary analysis: treatment efficacy Statistical analysis of primary and secondary outcomes will be based on the intention to treat principle
Summary
Low back pain persisting for longer than 3 months is a common and costly condition for which many current treatments have low-moderate success rates at best. A significant number of these patients develop chronic/long-term low back pain, defined as pain persisting for more than 3 months [2,3]. In Australia, it has been reported that one in ten Australians suffer from long-term low back pain [5] and it was announced in 2004 as the most prevalent and single most costly musculoskeletal disorder [6]. These data are consistent with that of other industrialized countries worldwide. In the UK and Sweden, low back pain was estimated to be the largest single cause of work absence [8]
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