Evidence map›Paper›PMID 35392935›Full record

ArticleChiropractic & manual therapies2022

GLA:D® Back Australia: a mixed methods feasibility study for implementation.

Matthew Fernandez, Anika Young, Alice Kongsted, Jan Hartvigsen, Christian Barton, Jason Wallis, Peter Kent, Greg Kawchuk, Hazel Jenkins, Mark Hancock and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chiropractic & manual therapies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Matthew FernandezSchool of Health, Medical and Applied Sciences, Central Queensland University, Brisbane, Australia. m.fernandez@cqu.edu.au.ORCID 0000-0002-9802-0573
Anika YoungDepartment of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
Alice KongstedDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Jan HartvigsenDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Christian BartonLa Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Jason WallisCentre for Allied Health Research and Education, Cabrini Health, Melbourne, Australia.
Peter KentDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Greg KawchukDepartment of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Hazel JenkinsDepartment of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
Mark HancockDepartment of Health Sciences, Macquarie University, Sydney, Australia.
Simon D FrenchDepartment of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPractice-based guidelines recommend patient education and exercise as first-line care for low back pain (LBP); however, these recommendations are not routinely delivered in practice. GLA:D® Back, developed in Denmark to assist clinicians to implement guideline recommendations, offers a structured education and supervised exercise program for people with LBP in addition to a clinical registry to evaluate patient outcomes. In this study we evaluated the feasibility of implementing the GLA:D® Back program in Australia. We considered clinician and patient recruitment and retention, program fidelity, exploring clinicians' and patients' experiences with the program, and participant outcome data collection.

methodsClinicians (chiropractors and physiotherapists) were recruited and participated in a 2-day GLA:D® Back training course. Patients were eligible to participate if they had persistent or recurrent LBP. Feasibility domains included the ability to: (1) recruit clinicians to undergo training; (2) recruit and retain patients in the program; (3) observe program fidelity; and (4) perceive barriers and facilitators for GLA:D® Back implementation. We also collected data related to: (5) clinician confidence, attitudes, and behaviour; and (6) patient self-reported outcomes related to pain, disability, and performance tests.

resultsTwenty clinicians (8 chiropractors, 12 physiotherapists) participated in the training, with 55% (11/20) offering GLA:D® Back to their patients. Fifty-seven patients were enrolled in the program, with 67% (38/57) attending the final follow-up assessment. Loss to follow up was mainly due to the effects of the COVID-19 pandemic. We observed program fidelity, with clinicians generally delivering the program as intended. Interviews revealed two clinician themes related to: (i) intervention acceptability; and (ii) barriers and facilitators to implementation. Patient interviews revealed themes related to: (i) intervention acceptability; and (ii) program efficacy. At 3 months follow-up, clinicians demonstrated high treatment confidence and biomedical orientation. Patient outcomes trended towards improvement.

conclusionGLA:D® Back implementation in Australia appears feasible based on clinician recruitment, program acceptability and potential benefits for patient outcomes from the small sample of participating clinicians and patients. However, COVID-19 impacted patient recruitment, retention, and data collection. To scale-up GLA:D® Back in private and public settings, further work is warranted to address associated barriers, and to leverage facilitators.

Indexed as

COVID-19Low Back PainPhysical TherapistsExercise TherapyFeasibility StudiesHumansPandemicsExerciseFeasibilityImplementationLow back painPatient educationSelf-management

Identifiers

PMID35392935
PMCPMC8989099

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.