Background
Methods
TARGET trial overview
PIPT training program
Training background
Content development
Stakeholder engagement
Beta testing
Modification of training
Final course objectives
1. | Summarize relationships between pain neuroscience, pain models, and the development and maintenance of chronic low back pain. |
2. | Identify patients at high risk for transitioning from acute to chronic low back pain. |
3. | Apply targeted treatment for patients at high risk for transitioning from acute to chronic low back pain. |
4. | Understand primary assumptions of CBT and specific skills associated with CBT based interventions. |
5. | Recognize effective communication skills and be able to implement as a key component to PIPT. |
6. | Differentiate key principles and application between graded activity and graded exposure. |
7. | Review the Low Back Pain Clinical Practice Guidelines from the Orthopaedic Section of the American Physical Therapy Association to become familiar with: 1) ICF-based classifications; 2) symptoms; 3) impairments; and 4) suggested intervention strategies. |
8. | Be able to implement PIPT practice principles for patients with low back pain. |
Final course content
Approximate time allotment dedicated during live workshop | Methods of delivery | |||
---|---|---|---|---|
PowerPoint presentations and instructor-led group discussion | Video-based mock case scenarios | Case-based role playing (breakout sessions) | ||
Overview | ||||
Pain science update | 30 min | X | ||
PIPT overview | 30 min | X | ||
Risk stratification | X | |||
Targeted treatment | X | |||
Cognitive behavioral therapy | 30 min | X | ||
Self-reflection | 45 min | X | X | X |
PIPT management | ||||
Patient-centered communication | 1 h, 45 min | |||
Active listening | X | X | ||
Motivational interviewing | X | X | X | |
Goal-setting | X | X | ||
Pain coping skills | 1 h, 15 min | |||
Physiologic relaxation | X | X | ||
Imagery | X | X | ||
Replacing cognitive distortions | X | X | X | |
Patient education | 15 min | X | ||
Activity-based | 60 min | |||
Graded exercise | X | X | X | |
Graded exposure | X | X | X | |
Impairment-based | 30 min | |||
Clinical practice guidelines | X | |||
Treatment monitoring | 30 min | X | ||
Challenges and opportunities | 30 min | X | X |
Methods of delivery
PIPT website
Live workshop
PIPT course materials
Quality improvement strategies to enhance and assess quality and impact of provider training
Strategies to enhance treatment quality
Measures to assess training impact
Quality improvement evaluation of PIPT training program
Total sample (n = 471) | Pittsburgh, PA (n = 77) | Boston, MA (n = 61) | Salt Lake City, UT (n = 80) | Baltimore, MD (n = 111) | Charleston, SC (n = 142) | P Value* | |
---|---|---|---|---|---|---|---|
Age (years) | 38.1 (11.0) | 40.3 (11.2) | 32.4 (8.1) | 39.3 (10.3) | 36.9 (11.2) | 39.5 (11.4) | < 0.001 |
Years in practice | 11.4 (10.6) | 14.6 (11.5) | 6.1 (7.0) | 11.0 (10.4) | 10.9 (11.4) | 12.6 (10.2) | < 0.001 |
PABS-PT biomedical (pre-training) | 31.0 (6.8) | 30.3 (6.5) | 30.4 (7.6) | 28.2 (6.8) | 31.0 (6.8) | 33.2 (6.0) | < 0.001 |
PABS-PT biomedical (post-training) | 25.2 (7.2) | 26.0 (7.0) | 24.3 (7.6) | 23.1 (6.8) | 25.2 (7.1) | 26.2 (7.4) | 0.032 |
PABS-PT behavioral (pre-training) | 36.9 (3.7) | 36.6 (3.2) | 36.9 (4.2) | 38.3 (3.8) | 37.1 (3.3) | 36.1 (3.7) | 0.001 |
PABS-PT behavioral (post-training) | 41.3 (4.2) | 40.1 (3.8) | 41.7 (5.2) | 41.7 (4.3) | 41.7 (4.4) | 41.2 (3.5) | 0.067 |
Confidence (pre-training) | 4.8 (2.2) | 4.8 (2.1) | 4.6 (2.3) | 4.9 (2.2) | 5.1 (2.3) | 4.5 (2.2) | 0.292 |
Confidence (post-training) | 7.3 (1.9) | 7.0 (1.7) | 5.6 (3.1) | 7.4 (1.8) | 7.8 (1.2) | 7.7 (1.4) | < 0.001 |