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Title: BACKonLINE : development of an online self-assessment and self-management tool for patients with chronic low back pain
Author: Alothman, Dalal
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2019
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Chronic low back pain (CLBP) is a cause of disability globally. CLBP can lead to psychological, cognitive, behavioural responses and associated amplification in pain processing in the central nervous system (central sensitisation). Centrally sensitised pain is associated with poorer outcomes that require longer management. Timely assessment and appropriate management are therefore paramount. In the National Health Service physiotherapy services, low back pain patients wait in intermediate care for 14-24 weeks for treatment. This window period can be better used to identify those at risk of centrally sensitised pain and deliver tailored biopsychosocial oriented self-management techniques. An online self-assessment and self-management tool (BACKonLINE™), for discerning between characteristics of predominantly centrally or peripherally sensitised CLBP, was developed in this study in 3 phases. Phase 1: A 2 Round E-Delphi study, with an international, physiotherapy expert panel, to develop BACKonLINE™ was conducted. From this, 39 self-assessment items were identified, and pain education and exercise were identified as main themes for self-management. Phase 2: Readability of BACKonLINE™ was assessed in 3 stages and items were amended accordingly. Phase 3: Test retest reliability and construct validity were assessed and the preliminary cut-off scores of BACKonLINE™ for people with CLBP were determined. Additionally, the patients’ experience of using BACKonLINE™ was explored. The findings showed good test retest reliability, good construct validity, and promising potential of BACKonLINE™ in discerning between people with characteristics of predominantly centrally or peripherally sensitised CLBP. Preliminary results show that scores ≥ 42 in BACKonLINE™ indicate centrally sensitised CLBP while scores < 42 indicate peripherally sensitised CLBP. Additionally, participants expected pain education and exercise as self-management and preferred BACKonLINE™ to be delivered online or as a phone app. BACKonLINE™ was conceptualised, within the biopsychosocial framework, to be an autonomous, cost effective, and practical tool to help patients with CLBP in intermediate care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available