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Table 2 Components of each treatment protocol used in the trial

From: Specific treatment of problems of the spine (STOPS): design of a randomised controlled trial comparing specific physiotherapy versus advice for people with subacute low back disorders

Treatment component DHR NRDP RDP ZJD MFP Advice
Patho-anatomical/physiological explanation including generally favourable prognosis X
Advice in accordance with Indahl et al. [35] X X X X X
Explanation of pain physiology and central sensitisation for ongoing pain with multiple biopsychosocial contributing factors O O O O X
Discussion of treatment options available X
Discussion of timeframes and expectations X
Posture education including lifting technique O X X
Teaching pacing and graded exposure strategies O X
Goal setting (establishment and regular reviews) X
Specific motor control training (transversus abdominis, lumbar multifidus and pelvic floor) O X
Teaching and supervision of functional restoration exercises in the clinic with additional sessions at home X X X
Demonstration of functional restoration exercises for implementation at home X X X X
Education regarding pain management strategies (pharmacological) O O O O O X
Education regarding pain management strategies (non-pharmacological) O O O O O X
Strategies to control inflammation O O O O O X
Application of strapping tape to lumbar spine O X X
Discussion of strategies to manage work issues O O O O O X
Directional preference management (McKenzie program)...includes mechanical loading strategies, repeated movements, walking program, taping, and postural advice O O X X X
Manual therapy X X X X X
Relaxation strategies O O O O O X
Sleep strategies O O O O O X
Management of increases in pain O O O O X X
Explanation of improvement in function V's improvement in pain O O O O X X
Cognitive restructuring of counterproductive beliefs (via use of information sheets relating to the above treatment components) X
Behavioural strategies to support and reinforce the education and information provided and to modify unproductive behaviours X
Transfer to MFP protocol if inadequate progress with pathoanatomical approach after five sessions O O O O X X
Targeted cognitive restructuring and behavioural modification based on review of the Orebro Musculoskeletal Pain Questionnaire subscales X X X X X
Specific discussion of psychosocial barriers as an explanation for failure to recover O O O O X
Discharge planning for long-term management X
  1. ✔ = component mandatory, O = component optional/if required, X = component not allowed, DHR = disc herniation with associated radiculopathy, NRDP = non-reducible discogenic pain, RDP = reducible discogenic pain, ZJD = zygapophyseal joint dysfunction, MFP = multi-factorial persistent pain