Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial

Abstract Background Exercise for the prevention of low back pain recurrences is recommended, but under-researched. The effectiveness and cost-effectiveness of a walking program for preventing low back pain recurrence remains unknown. This a priori statistical analysis plan describes the methods of a...

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Main Authors: Natasha C. Pocovi, Petra L. Graham, Chung-Wei Christine Lin, Simon D. French, Jane Latimer, Dafna Merom, Anne Tiedemann, Christopher G. Maher, Johanna M. van Dongen, Ornella Clavisi, Mark J. Hancock
Format: Article
Language:English
Published: BMC 2023-03-01
Series:Trials
Subjects:
Online Access:https://doi.org/10.1186/s13063-023-07119-0
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author Natasha C. Pocovi
Petra L. Graham
Chung-Wei Christine Lin
Simon D. French
Jane Latimer
Dafna Merom
Anne Tiedemann
Christopher G. Maher
Johanna M. van Dongen
Ornella Clavisi
Mark J. Hancock
author_facet Natasha C. Pocovi
Petra L. Graham
Chung-Wei Christine Lin
Simon D. French
Jane Latimer
Dafna Merom
Anne Tiedemann
Christopher G. Maher
Johanna M. van Dongen
Ornella Clavisi
Mark J. Hancock
author_sort Natasha C. Pocovi
collection DOAJ
description Abstract Background Exercise for the prevention of low back pain recurrences is recommended, but under-researched. The effectiveness and cost-effectiveness of a walking program for preventing low back pain recurrence remains unknown. This a priori statistical analysis plan describes the methods of analysis for the WalkBack trial. Methods WalkBack is a prospectively registered, pragmatic, randomised controlled trial. The aim is to investigate the effectiveness and cost-effectiveness of a 6-month progressive and individualised walking and education program (intervention) for the prevention of low back pain recurrences, compared to a no-treatment control group. The primary outcome is days to the first recurrence of an episode of activity-limiting low back pain. Key secondary outcomes include days to any recurrence of low back pain, days to a care-seeking recurrence of low back pain, disability level, health-related quality of life, costs associated with low back pain and adverse events. All participants will be followed for a minimum of 12 months. Analysis will follow the intention-to-treat principle. Cox regression is planned to assess the effects for the outcomes of time to activity-limiting, minimal and care-seeking recurrence. Hazard ratios and median survival times with 95% confidence intervals will be calculated. The effect of the intervention on continuous outcomes will be estimated with repeated-measure linear mixed models. An economic evaluation will be performed from the societal perspective for recurrence prevented (yes/no) and quality-adjusted life years. The proportion of adverse events between groups will be compared using Fisher’s exact test. Discussion The WalkBack trial will provide evidence on the effectiveness and cost-effectiveness of a walking intervention to prevent low back pain recurrences. This statistical analysis plan provides transparency on the analysis of the trial. Trial registration WalkBack - Effectiveness and cost-effectiveness of a progressive individualised walking and education program for the prevention of a recurrence of low back pain. ACTRN12619001134112 . Date Registered: 14/08/2019.
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spelling doaj.art-a654315c93c440e6ac7c4ccb18dd44512023-03-22T12:17:23ZengBMCTrials1745-62152023-03-0124111110.1186/s13063-023-07119-0Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trialNatasha C. Pocovi0Petra L. Graham1Chung-Wei Christine Lin2Simon D. French3Jane Latimer4Dafna Merom5Anne Tiedemann6Christopher G. Maher7Johanna M. van Dongen8Ornella Clavisi9Mark J. Hancock10Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie UniversitySchool of Mathematical and Physical Sciences, Macquarie UniversityThe University of Sydney, Sydney Musculoskeletal Health, Gadigal CountryDepartment of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie UniversityThe University of Sydney, Sydney Musculoskeletal Health, Gadigal CountrySchool of Health Sciences, Western Sydney UniversityThe University of Sydney, Sydney Musculoskeletal Health, Gadigal CountryThe University of Sydney, Sydney Musculoskeletal Health, Gadigal CountryDepartment of Health Sciences, Vrije University of AmsterdamMusculoskeletal AustraliaDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie UniversityAbstract Background Exercise for the prevention of low back pain recurrences is recommended, but under-researched. The effectiveness and cost-effectiveness of a walking program for preventing low back pain recurrence remains unknown. This a priori statistical analysis plan describes the methods of analysis for the WalkBack trial. Methods WalkBack is a prospectively registered, pragmatic, randomised controlled trial. The aim is to investigate the effectiveness and cost-effectiveness of a 6-month progressive and individualised walking and education program (intervention) for the prevention of low back pain recurrences, compared to a no-treatment control group. The primary outcome is days to the first recurrence of an episode of activity-limiting low back pain. Key secondary outcomes include days to any recurrence of low back pain, days to a care-seeking recurrence of low back pain, disability level, health-related quality of life, costs associated with low back pain and adverse events. All participants will be followed for a minimum of 12 months. Analysis will follow the intention-to-treat principle. Cox regression is planned to assess the effects for the outcomes of time to activity-limiting, minimal and care-seeking recurrence. Hazard ratios and median survival times with 95% confidence intervals will be calculated. The effect of the intervention on continuous outcomes will be estimated with repeated-measure linear mixed models. An economic evaluation will be performed from the societal perspective for recurrence prevented (yes/no) and quality-adjusted life years. The proportion of adverse events between groups will be compared using Fisher’s exact test. Discussion The WalkBack trial will provide evidence on the effectiveness and cost-effectiveness of a walking intervention to prevent low back pain recurrences. This statistical analysis plan provides transparency on the analysis of the trial. Trial registration WalkBack - Effectiveness and cost-effectiveness of a progressive individualised walking and education program for the prevention of a recurrence of low back pain. ACTRN12619001134112 . Date Registered: 14/08/2019.https://doi.org/10.1186/s13063-023-07119-0Low back painPreventionWalkingRandomised-controlled trialStatistical analysis plan
spellingShingle Natasha C. Pocovi
Petra L. Graham
Chung-Wei Christine Lin
Simon D. French
Jane Latimer
Dafna Merom
Anne Tiedemann
Christopher G. Maher
Johanna M. van Dongen
Ornella Clavisi
Mark J. Hancock
Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial
Trials
Low back pain
Prevention
Walking
Randomised-controlled trial
Statistical analysis plan
title Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial
title_full Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial
title_fullStr Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial
title_full_unstemmed Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial
title_short Effectiveness and cost-effectiveness of a progressive, individualised walking and education program for prevention of low back pain recurrence in adults: statistical analysis plan for the WalkBack randomised controlled trial
title_sort effectiveness and cost effectiveness of a progressive individualised walking and education program for prevention of low back pain recurrence in adults statistical analysis plan for the walkback randomised controlled trial
topic Low back pain
Prevention
Walking
Randomised-controlled trial
Statistical analysis plan
url https://doi.org/10.1186/s13063-023-07119-0
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