Comparing cost-effective care models for musculoskeletal disorders

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study aims to evaluate the effectiveness of a Stepped Care Model for treating musculoskeletal disorders (MSKDs) compared to Usual Medical Care and Usual Rehabilitation Care. The Stepped Care Model prioritizes patient education before determining the need for further medical intervention, potentially leading to reduced healthcare costs. The trial will involve 369 adults suffering from conditions such as low back pain, neck pain, anterior knee pain, and rotator cuff-related shoulder pain. By assessing functional limitations and associated costs, the study seeks to optimize healthcare resource utilization for MSKDs.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* present with one of the four targeted MSKDs (low back pain, neck pain, anterior knee pain, rotator cuff-related shoulder pain).
* have had pain for at least 6 weeks.
* For low back pain (LBP): 1) non-specific LBP with or without radiation to the lower limbs, 2) minimal score of 15 on the ODI.
* For neck pain : 1) non-specific neck pain with or without radiation to the upper limbs, 2) minimal score of 21 on the NDI.
* For anterior knee pain : 1) anterior knee pain during walking, running or going up or down stairs, or during at least two activities among: kneeling, squatting, and resisted knee extension, 2) maximum score of 79 on the KOS-ADL.
* For rotator cuff-related shoulder pain : 1) minimal score of 15 on the QuickDASH, and 2) shoulder pain attributed to a rotator cuff-related shoulder pain using diagnostic guidelines of the British Elbow and Shoulder Society.

Exclusion Criteria:

* Unavailable to participate during the 24 weeks of the study.
* Do not understand French or English.
* Diagnosis of rheumatoid, inflammatory or neurodegenerative diseases.
* Received a corticosteroid injection in the previous 3 months.
* Cognitive problems interfering (Mini-Mental State Examination ≥ 24).
* Received a corticosteroid injection in the previous 3 months.
* Less than 6 weeks since an intervention for their condition (including performing prescribed condition-specific exercises or taking prescribed medication).
* For low back pain (LBP): 1) LBP related to specific conditions (e.g., vertebral fracture, infections, neuropathic pain \[\>4 at the DN4 questionnaire\]), 2) history of spine surgery or signs of upper motor neuron lesions (bilateral paresthesia, hyperreflexia or spasticity)..
* For neck pain : 1) neck pain related to specific conditions (e.g.; vertebral fracture, infections, neuropathic pain \[\>4 at the DN4 questionnaire\]), 2) history of spine surgery or signs of upper motor neuron lesions.
* For anterior knee pain : 1) history of knee surgery or patellar dislocation, 2) pain believed to originate either from meniscus or from any knee ligament.
* For rotator cuff-related shoulder pain : 1) history of shoulder surgery, dislocations, fractures or capsulitis, 2) full thickness rotator cuff tear identified by imagery or clinical tests (lag signs and gross weakness).

Where it's running

• Centre for interdisciplinary research in rehabilitation and social integration (Cirris)
  Québec, Quebec, Canada Recruiting

Study contacts

• Principal investigator: Jean-Sebastien Roy, PT, PhD — Laval University
• Study coordinator: Jean Tittley, PT, MSc
• Email: jean.tittley@cirris.ulaval.ca
• Phone: 1-418-529-9141

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.