Acceptability of a 12-week movement program (Motum) to address functional outcomes in people with chronic non-specific low back pain: a mixed methods pilot study

Introduction

Chronic non-specific low back pain (CNSLBP) is a major cause of disability globally. Due to the multifactorial nature of CNSLBP, non-pharmacological management such as exercise therapy, has been recommended as a first-line treatment. This pilot study examined the acceptability and clinical impact of a novel physiotherapist-led movement-based intervention for people with CNSLBP.

Methods

A mixed-methods study design was used. Twenty-nine adults with CNSLBP were allocated to a 12-week movement-based program (Motum) or waitlist control. The intervention comprised 12 sessions based on fundamental movement patterns and motor control principles. The primary outcome was acceptability and secondary measures were balance, pain, function, self-efficacy and kinesiophobia. Semi-structured interviews explored participants experiences of the intervention.

Results

The intervention was acceptable to participants with all sub-domains (affective attitude, perceived effectiveness, intervention coherence, opportunity costs, self-efficacy, and ethicality) scoring ‘highly acceptable’ (p < .001), except burden which scored ‘acceptable’ (p < .02). The intervention demonstrated large positive changes for improving fear avoidance of movement (Hedges g = .92) and balance (g = 1.04) and smaller positive effects on pain and function (g = .62) and self-efficacy (g = .23), compared to controls. Themes emerging from qualitative data with 10 participants were: 1) acceptability of program structure; 2) positive impacts attributed to the intervention; and 3) barriers to engagement.

Conclusion

Motum was an acceptable intervention and demonstrated positive impacts across a range of clinical outcomes. While these findings are encouraging, further research through mature study designs (such as randomised controlled trials) are required to substantiate these findings.