“Myths and Facts” Education Is Comparable to “Facts Only” for Recall of Back Pain Information but May Improve Fear-Avoidance Beliefs: An Embedded Randomized Trial

• Published in: The journal of orthopaedic and sports physical therapy 2022-09, Vol.52 (9), p.586-594
• Main Authors: Viana da Silva, Priscilla, Kamper, Steven J., Robson, Emma, Davidson, Simon R. E., Gleadhill, Connor, Donald, Bruce, Yamato, Tiê Parma, Nolan, Erin, Lee, Hopin, Williams, Christopher
• Format: Article
• Language: English
• ISSN: 0190-6011; 1938-1344
• DOI: 10.2519/jospt.2022.10989

OBJECTIVETo assess the effectiveness of patient education with "myths and facts" versus "facts only" on recall of back pain information and fear-avoidance beliefs in patients with chronic low back pain (LBP). DESIGNRandomized Study Within A Trial. METHODSOne hundred fifty-two participants with chronic LBP were included. Participants allocated to the "facts only" group received an information sheet with 6 LBP facts, whereas those allocated to the "myths and facts" group received the same information sheet, with each myth refuted by its respective fact. The primary outcome was a correct recall of back pain facts, and the secondary outcome was the physical activity component of the Fear-Avoidance Beliefs Questionnaire (FABQ-PA), 2 weeks after the provision of the information sheet. RESULTSThere was no evidence of a difference in the proportion of participants with a correct recall between the "myths and facts" and "facts only" groups (odds ratio = 0.98; 95% confidence interval [CI]: 0.48, 1.99) and no significant difference in FABQ-PA mean scores between groups (-1.58; 95% CI: -3.77, 0.61). Sensitivity analyses adjusted for prognostic factors showed no difference in information recall but a larger difference in FABQ-PA scores (-2.3; 95% CI: -4.56, -0.04). CONCLUSIONWe found no overall difference in the recall of back pain information for patients provided with "myths and facts" compared with that for patients provided with "facts only" and a slight reduction in fear-avoidance beliefs for physical activity using "myths and facts" compared with that using "facts only," but the meaningfulness of this result is uncertain. J Orthop Sports Phys Ther 2022;52(9):586-594. Epub: 9 July 2022. doi:10.2519/jospt.2022.10989.