Implementation of the Specific Treatment Of Problems of the Spine (STOPS) approach in Nigeria for persistent low back pain: A prospective sequential comparison - Trial PACTR202305707317550

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Summary

The prevalence of low back pain (LBP) in Africa is high and Nigeria has been reported as having the highest prevalence rate. Despite advances in the physiotherapy management of LBP worldwide, previous studies showed that there is a large variation in the quality of physiotherapy management of LBP in Nigeria, which increases disability and reinforces the disparity in LBP care between Nigeria and developed nations. These findings indicate that the quality of physiotherapy care for LBP in Nigeria needs to be optimized. Aims and objectivesThe study aims to evaluate the implementation of the STOPS treatment approach for managing persistent low back pain in a hospital setting in Nigeria. The specific objectives of the study are:1. To improve physiotherapists’ knowledge and skills in providing evidence-based treatment of persistent LBP in Nigeria. 2. To improve outcomes for patients with persistent LBP treated by physiotherapists in Nigeria. 3. To determine the cost-effectiveness of the STOPS treatment approach relative to usual care for managing persistent LBP in Nigeria.4. To evaluate the effectiveness of the STOPS treatment approach in a different country to where it was developed. This will be a prospective, sequential comparison design, comprising three phases:1. Phase 1: Evaluation of usual physiotherapy care in Nigeria. Physiotherapists’ evaluation (self-confidence, implementation behaviour and treatment methods employed), observation of usual clinical practice and clinical outcomes of participants recruited prospectively over a 6-month baseline period.2. Phase 2: A quality improvement program comprising a STOPS training program led by the developers.3. Phase 3: Evaluation of STOPS physiotherapy care in Nigeria post-implementation. Physiotherapists’ evaluation, observation of clinical practice and clinical outcomes of a new cohort of participants recruited over 6 months following therapist training and implementation of the STOPS treatment protocols

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