Motivational Support Program in Chronic Low Back Pain After Multidisciplinary Functional Rehabilitation

Multidisciplinary functional rehabilitation program (FRP) have shown their efficacy in disabilitie patient suffering from Chronic low back pain (CLBP). Unfortunately, at medium and long term two thirds of patients stop their physical activity due to lack of motivation. These patients then fall back into their painful vicious circle. Investigators hypothesis that motivational support program (MSP) based on an application, piloted by a care coordinator could increase the motivation to continue physical activity and thus limit the consequences of CLBP for the patient and society. The main objective is to evaluate the impact of a MSP (EMOTIV) on pain and functional abilities assessed according to the COMI scale (Core Outcome Measure Index), 12 months after a FRP in patients with LPBC. This program is compared to usual care as currently done. The secondary criteria concern: physical, neuropsychological and medico-economical criteria. This is a multicentre, cluster randomized trial. All adult patient suffering from low back pain, having finished a FRP and possessing a smartphone, will be included. Investigators plan to include 150 patients in 6 centres. The duration of the inclusion period is 12 months; The duration of participation of each subject is 24 months. Inclusion will be on the last day of the FRP program. The Follow-up in consultation is scheduled at 3, 12 and 24 months with evaluation of usual criteria (physical, self-questionnaires, and advice on the practice of physical activities depending on what is achieved). In Pitie salpetriere center only, patients will have in addition: lumbar MRI at 3 and 12 months; central pain awareness assessment. The activity of patients in the MSP group will be recorded continuously par EMOTIV App; pain, mental health and days off every week and self-questionnaires at 1, 2 and 6 months. The primary analysis of all endpoints will be performed in the intent-to-treat population, i.e. all patients randomized to the study. The COMI score will be compared between the 2 randomized groups by a linear mixed model.

• Evolution of pain [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of flexibility [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of muscular endurance [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of muscular endurance [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of disability and pain [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of endurance and sports performance (VO2 max) [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of the intensity of physical activity [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of muscular trophicity in the 2 groups [Срок оценки: At 3 months and 12 months]
• Evolution of the level of anxiety and depression [Срок оценки: At 3 months, 12 months and 24 months]
• Evolution of the level of central pain awareness [Срок оценки: At inclusion, 3 months, 12 months and 24 months]
• Medico-economic analysis [Срок оценки: At 3 months, 12 months and 24 months]
• Cost of care (i.e, health resource use and related costs or direct costs) [Срок оценки: At 3 months, 12 months and 24 months]