Disclosures: Heidi Prather, DO: No financial relationships or conflicts of interest
Objective: This study assesses improvements in general and behavioral health, function and pain in patients who completed an intensive lifestyle medicine pilot program aimed to optimize patients seeking joint replacement or improved management of low back pain (LBP).
Design: Baseline and end of program general and behavioral health, pain and function measures were compared and assessed for change and minimal clinically important difference (MCID). Setting : Tertiary university Participants : Patients participated in the program in order to undergo joint replacement surgery or improve management of LBP. Patients seeking surgery were unable to proceed because of risks associated with their obesity and/or elevated HgA1c.
Interventions: Patient care pathways were developed by the patient and physiatrist based on intake measures and previous history. Service options included: behavioral health and nutritional counseling, physical therapy, acupuncture, medical massage, aerobic exercise education, and smoking cessation.
Main Outcome Measures: Outcome measures included: completion of the program, goal achievement, patient reported outcomes management information system (PROMIS) domains (anxiety, depression, pain interference and function), blood pressure (BP), body mass index (BMI), C – reactive protein (CRP), hemoglobin A1C (HgA1c), and vitamin D level.
Results: Thirteen patients (9 females) mean age 60.7 years (33-78 years) completed the program with 7/13 (53.8%) meeting their goal. On average, patients participated in 8.7 total visits averaging 3.1-3.9 visits per service utilized. Average improvements included: -0.9 BMI, -0.2 CRP, -0.4 HgA1c, and +4.7 vitamin D. The average BP remained stable and one patient weaned off his BP medications. MCIDs were found in PROMIS domains: anxiety -4.0, depression, -2.7, + 1.9 physical function. PROMIS domain pain interference improved (-1.4) but did not meet MCID. Conclusions: An intensive lifestyle medicine program for patients seeking joint replacement or improved health and management of LBP successfully improves medical and behavioral health measures and function.
Level of Evidence: Level III
To cite this abstract in AMA style:
Prather H, Hunt D, Cheng AL. Outcomes of an Intensive Lifestyle Medicine Pilot Program for Patients Seeking Joint Replacement or Improvement in Overall Health and Management of Low Back Pain [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/outcomes-of-an-intensive-lifestyle-medicine-pilot-program-for-patients-seeking-joint-replacement-or-improvement-in-overall-health-and-management-of-low-back-pain/. Accessed May 9, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/outcomes-of-an-intensive-lifestyle-medicine-pilot-program-for-patients-seeking-joint-replacement-or-improvement-in-overall-health-and-management-of-low-back-pain/