• Jennifer Eadie, Alexander T van de Water, Chris Lonsdale, Mark A Tully, Willem van Mechelen, Colin A Boreham, Leslie Daly, Suzanne M McDonough, and Deirdre A Hurley.
• Institute for Sport and Health, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland; Physiotherapy Department, Beaumont Hospital, Dublin, Ireland.
• Arch Phys Med Rehabil. 2013 Nov 1;94(11):2083-92.

ObjectiveTo determine the feasibility of a randomized controlled trial investigating the effectiveness of physiotherapy for sleep disturbance in chronic low back pain (CLBP) (≥12wks).DesignRandomized controlled trial with evaluations at baseline, 3 months, and 6 months.SettingOutpatient physiotherapy department in an academic teaching hospital.ParticipantsParticipants with CLBP were randomly assigned to a walking program (n=20; mean age ± SD, 46.4±13.8y), supervised exercise class (n=20; mean age ± SD, 41.3±11.9y), or usual physiotherapy (n=20; mean age ± SD, 47.1±14.3y). The 3-month evaluation was completed by 44 participants (73%), and 42 (70%) participants completed the 6-month evaluation.InterventionsParticipants received a physiotherapy-delivered 8-week walking program, an 8-week group supervised exercise class (1 class/wk), or 1-to-1 usual physiotherapy (advice, manual therapy, and exercise).Main Outcome MeasuresSleep was assessed by the self-reported Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Pittsburgh Sleep Diary, and objective actigraphy.ResultsGroups were comparable at baseline. Most (95%, n=57) of the participants had sleep disturbance. The acceptability of actigraphy was excellent at baseline (58 of 60 participants), but dropped at 3 months (26 of 44 participants). There were improvements on the PSQI and ISI in all groups at 3 and 6 months, with predominantly medium effect sizes (Cohen d=0.2-0.5).ConclusionsThe high prevalence of sleep disturbance indicated the feasibility of good recruitment in future trials. The PSQI would be a suitable screening tool and outcome measure alongside an objective nonobtrusive sleep outcome measure. The effectiveness of physiotherapy for sleep disturbance in CLBP warrants investigation in a fully powered randomized controlled trial.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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