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Activity and life-role targeting rehabilitation for persistent pain: feasibility of an intervention in primary healthcare |
Gustavsson C, Nordlander J, Soderlund A |
European Journal of Physiotherapy 2018;20(3):141-151 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: The activity and life-role targeting rehabilitation programme (ALAR) promotes patient's active involvement in pain rehabilitation. PURPOSE: To explore the feasibility of ALAR applied in a primary healthcare context. MATERIALS AND METHODS: An intervention was conducted at primary healthcare centres. Patients experiencing persistent pain were randomly assigned to ALAR+MMR or multimodal pain rehabilitation (MMR). Data were collected by patient questionnaires before and after intervention (9 weeks and 1 year), medical record examination and therapist telephone interviews. RESULTS: Seventy percent of ALAR+MMR participants completed the programme (n = 24). Complete data were obtained for half of the participants (ALAR+MMR n = 15, MMR n = 17). More ALAR+MMR than MMR participants perceived that they had been participating in planning their rehabilitation. The addition of ALAR to MMR induced higher costs short term, but had favourable health-economic effects in the long term. CONCLUSIONS: The methods for delivering ALAR in primary healthcare by specially trained physio and occupational therapists were feasible. Therapists' acceptability and perceived usability of the ALAR programme was high. More ALAR+MMR than MMR participants withdrew without completing treatment. Measures to increase patients' acceptability of the ALAR programme are warranted. Flexibility in number of treatment sessions and addressing patients' self-efficacy for undertaking rehabilitation is suggested, thus emphasising a more individualised rehabilitation plan.
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