Table 2.
Session | Self-management behaviours targeted within the session | Intervention content and participant materials | Behaviour change techniques embedded within sessions (as per Michie et al)53 |
---|---|---|---|
1 | i. Physical activity iia. Specific exercise for pain condition |
Education: aims of programme, back pain and OA causes, cycle of change, exercise recommendations, physical activity levels in Ireland, benefits of exercise/physical activity, review of SOLAS exercise programme, physical activity diary and goal setting Exercise: explanation and demonstration of all exercise stations, practice of sample of exercises Materials: participant programme handbook |
1.1 Goal-setting [behaviour] 1.2 Problem –solving 1.3 Goal-setting (outcome) 1.4 Action planning 1.5 Review behaviour goal 1.6 Discrepancy between current behaviour and goal 1.7 Review outcome goal 1.8 Behavioural contract 2.2 Feedback on behaviour |
2 | i. Physical activity iia. Specific exercise for pain condition |
Education: activity rest cycle and pacing activities, use of pedometer, walking technique, understanding pain, physical activity diary, goal setting and action plan Exercise: supervised group exercise class Materials: Yamax SW-200 Pedometer |
2.3 Self-monitoring of behaviour 2.7 Feedback on outcome of behaviour 3.1 Social support [unspecified] 3.2 Social support [practical] 3.3 Social support [emotional] |
3 | i. Physical activity iia. Specific exercise for pain condition iib. Healthy eating for lifestyle and balanced weight |
Education: balanced weight, obesity levels in Ireland, healthy eating, measuring waist circumference, physical activity diary, goal setting and action plan, food and drink diary Exercise: supervised group exercise class Materials: tape measure, Your Guide to Healthy Eating using the Food Pyramid, 101+Square Meals cookbook |
4.1 Instruction on how to perform the behaviour 4.2 Information about antecedents of the behaviour 5.1 Information about health consequences of the behaviour 5.6 Information about emotional consequences of the behaviour 6.1 Demonstration of the behaviour |
4 | i. Physical activity iia. Specific exercise for pain condition iic. Use evidence-based pain management approaches to self-manage pain condition |
Education: mid-way review, evidence-based pain management with ice/heat, medication, TENS, acupuncture, physical activity diary, goal setting and action plan Exercise: supervised group exercise class |
6.2 Social comparison 8.1 Behavioural practice/rehearsal 8.6 Generalisation of target behaviour 8.7 Graded tasks 9.1 Credible source 10.4 Social reward 11.1 Pharmacological support |
5 | i. Physical activity iia. Specific exercise for pain condition iid. Use of pain coping strategies |
Education: anxiety, mood and pain, managing flare-ups, pain coping strategies, relaxation techniques and practice, physical activity diary, goal setting and action plan Exercise: supervised group exercise class Relaxation skills: practical group session of contract-relax relaxation technique led by PT Materials: relaxation CD |
11.2 Reduce negative emotions 12.5 Adding objects to the environment 12.6 Body changes 13.2 Framing/Reframing 15.1 Verbal persuasion about capability |
6 | i. Physical activity iia. Specific exercise for pain condition |
Education: discharge planning, maintaining a good exercise routine in the long term, local resources and activity information, long-term physical activity diary, goal setting and action plan, programme feedback Exercise: supervised group exercise class Materials: local resources to support physical activity leaflet, graduation certificate |
Structure: once weekly, 90 min group class involving 45 min education/group discussion in an informal lecture format using PowerPoint and 45 min of supervised exercise in a gym setting. Exercise: range of general aerobic (n=8: step ups, stationary cycling) and joint specific mobility and strengthening exercises for the lumbar spine (n=4), hip (n=6) and knee (n=4) designed to increase participants’ participation in exercise and physical activity. The frequency and number of exercise stations completed is determined by each participant with support from the PT if needed.
OA, osteoarthritis; PT, physiotherapy; SOLAS, Self-management of Osteoarthritis and Low back pain through Activity and Skills.