Kaiser Permanente Washington Health Research Institute, Seattle, WA.
Department of Epidemiology, University of Washington, Seattle, WA.
J Altern Complement Med. 2020 Mar;26(3):176-189. doi: 10.1089/acm.2019.0438. Epub 2020 Feb 3.
(TC) has been found effective for improving chronic low back pain (cLBP). However, such studies did not include adults over 65 years of age. This study was designed to evaluate the feasibility and acceptability of TC in this population compared with Health Education (HE) and with Usual Care (UC). Feasibility randomized controlled trial. Participants were recruited from Kaiser Permanente Washington and classes took place in a Kaiser facility. Adults 65 years of age and older with cLBP. Twenty-eight participants were randomized to 12 weeks of TC followed by a 24-week tapered TC program, 12 were assigned to a 12-week HE intervention and 17 were assigned to UC only. Feasibility and acceptability were determined by recruitment, retention and 12-, 26-, and 52-week follow-up rates, instructor adherence to protocol, class attendance, TC home practice, class satisfaction, and adverse events. Fifty-seven participants were enrolled in two cohorts of 28 and 29 during two 4-month recruitment periods. Questionnaire follow-up completion rates ranged between 88% and 93%. Two major class protocol deviations were noted in TC and none in HE. Sixty-two percent of TC participants versus 50% of HE participants attended at least 70% of the classes during the 12-week initial intervention period. Weekly rates of TC home practice were high among class attendees (median of 4.2 days) at 12 weeks, with fewer people practicing at 26 and 52 weeks. By 52 weeks, 70% of TC participants reported practicing the week before, with a median of 3 days per week and 15 min/session. TC participants rated the helpfulness of their classes significantly higher than did HE participants, but the groups were similarly likely to recommend the classes. The TC intervention is feasible in this population, while the HE group requires modifications in delivery.
(TC)已被证明可有效改善慢性下腰痛(cLBP)。然而,这些研究并未纳入 65 岁以上的成年人。本研究旨在评估 TC 在该人群中的可行性和可接受性,与健康教育(HE)和常规护理(UC)相比。 可行性随机对照试验。 参与者从 Kaiser Permanente Washington 招募,课程在 Kaiser 设施中进行。 65 岁及以上患有 cLBP 的成年人。 28 名参与者随机分配到为期 12 周的 TC 治疗,然后进行 24 周的 TC 递减治疗方案,12 名参与者分配到为期 12 周的 HE 干预组,17 名参与者仅分配到 UC 组。 通过招募、保留以及 12 周、26 周和 52 周的随访率、讲师对方案的依从性、出勤率、TC 家庭练习、课程满意度和不良事件来确定可行性和可接受性。 在两个为期 4 个月的招募期内,共有 57 名参与者分两批参加了 28 人和 29 人的研究。问卷调查的随访完成率在 88%至 93%之间。在 TC 中注意到了 2 个主要的课程方案偏差,而在 HE 中则没有。在 12 周的初始干预期间,至少参加了 70%的课程的 TC 参与者占 62%,而参加了 HE 课程的参与者占 50%。在 12 周时,参加课程的人每周进行 TC 家庭练习的频率很高(中位数为 4.2 天),而在 26 周和 52 周时则较少。到 52 周时,70%的 TC 参与者报告在之前一周进行了练习,中位数为每周 3 天,每次 15 分钟。TC 参与者对课程的帮助程度的评价明显高于 HE 参与者,但两组对课程的推荐率相似。 TC 干预在该人群中是可行的,而 HE 组需要在交付方式上进行修改。