Abstract
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.