Exploring booster session attendance, prescription, and outcomes in adults with chronic low back pain: Secondary analysis of a randomized clinical trial.

INTRODUCTION

Booster sessions are a potential method for maintaining self-management behaviors and treatment effects in people with chronic low back pain (LBP). However, few studies have examined booster prescription or outcomes in people with LBP.

OBJECTIVE

(1) Compare booster prescription for two exercise-based treatments for low back pain (LBP) in a randomized clinical trial (RCT) where the number of boosters prescribed was based on self-management program independence, (2) Determine if there are variables that predict who will require >1 booster, (3) Explore the effects of boosters on pain and function in people who required >1 booster.

DESIGN

Secondary analysis of a RCT in which participants were randomized to motor skill training (MST), MST+Boosters (MST+B), strength and flexibility exercise (SFE), or SFE+B.

SETTING

Academic research setting.

PARTICIPANTS

76 participants with chronic LBP assigned to receive boosters.

INTERVENTIONS: This secondary analysis focuses only on the MST+B and SFE+B groups. Both groups received 6 visits of MST or SFE and six months later received up to 3 boosters. The number of boosters was based on self-management program independence at the first booster. Those who required >1 booster were not able to independently perform their program at the first booster.

MAIN OUTCOME MEASURES: Booster attendance and prescription, pain (Numeric Pain Rating Scale), function (modified Oswestry Disability Questionnaire).

RESULTS

There was not a significant difference between MST+B and SFE+B in returning for the initial booster, χ 2 (1)=1.76, p=0.185. SFE+B were more likely to require >1 booster than MST+B; β =2.39, p <0.001. No participant-specific factors we examined were statistically related to needing >1 booster.

CONCLUSION

MST+B participants were less likely to require additional boosters. No additional participant-specific factors we examined were associated with needing additional boosters. Qualitatively, attending additional booster sessions did not appear to change pain or function in the current sample.