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Spinal Stenosis LumbarNCT06935201

Evaluation of a Digital Person-Centered Rehabilitation Program Targeting Physical Activity in Spinal Stenosis Surgery (Get Back)

A study testing Get Back in people with Spinal Stenosis Lumbar, run by Sophiahemmet University at 4 sites in Sweden.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study aims to investigate whether Get Back is more effective than standard rehabilitation in increasing the number of steps per day, improving physical activity levels, and functional ability for patients undergoing surgery for lumbar spinal stenosis (LSS). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Spinal Stenosis Lumbar
What is being tested?
Get Back
Could I receive a placebo?
No, everyone receives an active treatment
How many people
252 participants
Where
4 sitesSweden
Study dates
12 May 2025to May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients planned for decompression surgery due to central lumbar spinal stenosis

Who cannot join

  • Patients with malignancy under treatment or with metastases;
  • History of neurological or other disorders resulting in severe movement dysfunction;
  • Untreated or instable heart conditions that prohibits physical tests;
  • Poor understanding of Swedish.

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Sweden4 sites, 4 recruiting
  • Ryggkirurgiskt centrum Stockholm

    Stockholm, 11433

    Recruiting
  • Södersjukhuset

    Stockholm, 11861

    Recruiting
  • Akademiska sjukhuset

    Uppsala, 75185

    Recruiting
  • Capio Spine Center Göteborg

    Västra Frölunda, 42130

    Recruiting

Other trials in Sweden

About this study

Official title: Get Back, A Digital Person-Centered Rehabilitation Program to Increase Physical Activity After Lumbar Spinal Stenosis Surgery - a Randomized Controlled Trial

This study aims to investigate whether Get Back is more effective than standard rehabilitation in increasing the number of steps per day, improving physical activity levels, and functional ability for patients undergoing surgery for lumbar spinal stenosis (LSS). LSS is common, especially among older adults, leading to increased health risks and reduced quality of life. Despite its prevalence (about 60% of all spinal surgeries in Sweden), many LSS patients remain physically inactive post-surgery, worsening their health. Rehabilitation remains a global challenge with unequal access, and many patients feel disengaged from the process. Get Back is a digital rehabilitation program including three components: gradually increasing physical activity, managing fear and avoidance behaviors, and using behavior change techniques. It has shown promising results in a pilot study, increasing daily steps. The program uses a person-centered approach tailored to personal needs. This multicenter randomized controlled trial will assess efficacy, process, and cost-effectiveness. It will also explore how preoperative values such as physical capacity and psychological factors predict changes in daily steps after surgery. Data will be collected via questionnaires, functional tests, and interviews, with the primary outcome being daily steps measured with motion sensors. The study will involve 252 patients from four spinal clinics. Get Back promotes increased physical activity and accessible rehabilitation, contributing to better health for LSS patients.

Read the detailed description

The Get Back rehabilitation program has been developed using the Medical Research Councils (MRC) framework. A feasibility study (NCT05806593) has been completed involving 29 patients (mean age 67) who underwent surgery for LSS. The Get Back intervention (completely digital i.e. assessments and rehabilitation) was shown to be feasible and resulted in clinically significant improvements in daily steps at 12 weeks' post-surgery.

To evaluate the effectiveness and process of Get Back a multicenter randomized controlled trial including three sub-studies will be conducted. The specific research questions we aim to investigate in this RCT are:

  1. if Get Back is more effective than standard rehabilitation in increasing daily steps (primary outcome) and physical activity behavior, disability, or pain-related factors (secondary outcomes) after surgery for LSS
  2. if Get Back is more cost effective than standard rehabilitation after surgery for LSS
  3. how baseline values (psychological factors, physical capacity and physical activity) predict changes in daily steps after surgery for LSS
  4. how participants' experiences contribute to an enhanced understanding of what impact the intervention content had on their physical activity behavior.

Patients will be recruited from four clinical study sites (two private spine clinics and two hospitals). All patients undergo a clinical examination by an orthopedic surgeon as part of standard preoperative care. If a surgical decision is made and the patient is placed on the waiting list, a local recruiter at each site will hand out written study information to the patients meeting inclusion criteria and ask if a physical therapist from the study can make contact to provide further information about the study and ask for participation. As the intervention is fully digital, the patient information in written will also be sent to the patient digitally.

At baseline (approx. 2 weeks pre-surgery), participants meet with an assessor (physical therapist) via a digital care platform for collection of demographic data, personal goals, and to conduct physical capacity tests. Questionnaires are sent out through a digital application and patients wear an accelerometer for 7 days sent out by mail. Outcome variables are described more in detail under the heading Outcome Measures in the trial registration. The follow-ups are scheduled at 6 weeks, 3 months, 6 months, and 1-year post-surgery. Accelerometry and questionnaires will be collected at each follow-up, whereas physical capacity tests will be conducted at 3 and 12 months post-surgery. Clinical data such as type of surgery, complications, discharge destination will be collected from the patients' medical records at 3 months post-surgery.

After baseline assessments, patients are randomly assigned (1:1) to either control or intervention group. The randomization will be based on a computerized random list converted to concealed envelopes. The assessor will be blinded to group allocation.

Participants in the intervention group (Get Back, n=126) will have one pre-surgery video session with a physical therapist, followed by up to five core video sessions and five booster telephone sessions over 13 weeks. Session frequency is decided collaboratively, based on person-centered care. The intervention includes three components: graded physical activity, addressing fear avoidance beliefs, and promoting behavior change. A person-centered health plan is created at the first session, based on the patient's story and baseline assessment. The plan includes personalized activity goals, monitored using a weekly physical activity diary to track steps, barriers, and progress. A sub-sample of the intervention group, approximately 15-20 participants, will be interviewed regarding their experiences of the intervention and intervention content at 3 months post-surgery using a semi-structured interview guide.

Participants in the control group (n=126) will follow standard rehabilitation (physical therapy as provided at each site). Data on the frequency and content of rehabilitating sessions during the study will be collected as a control variable at each follow-up assessment.

Being tested
Get Back
Keywords
Rehabilitation, Person-centred care, Physical activity, Steps per day, Behavioral medicine, Telerehabilitation, Telehealth
Medical subject headings
Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Get BackBehavioural

    A rehabilitation program, targeting physical activity behavior, with a person-centered approach led by a physical therapist during 12 weeks (1 week before surgery until 12 weeks after surgery) in a digital format.

Study groups in NCT06935201
Study groupRoleWhat they receive
Intervention (Get Back)ExperimentalThe intervention includes up to 5 core sessions (video call) and 5 booster sessions (telephone) over 13 weeks (approx. 1 week before until 12 weeks after surgery). All sessions will be led by a physical therapist. The focus of each core session (1-5) is as follows: 1. To establish the patient as an active, equal partner in the treatment and to formulate a shared health plan according to person-centered care. 2. To follow up with postoperative analysis and activity initiation. 3. To support graded physical activity by analysis, problem-solving, and behavioral strategies. 4. To support graded physical activity by analysis, problem-solving, and behavioral strategies. 5. To support the patient to independently continue with activity progress towards long term health and to formulate a maintenance plan.
Receives: Behavioral: Get Back
Control (standard physical therapy)No interventionThe control group will follow standard physical therapy, meaning physical therapy as it is provided at each recruiting site when undergoing surgery due to spinal stenosis. As this may differ substantially between clinical sites nationally, data on frequency of physical therapy and the content of the physical therapy sessions during the study period will be collected as a control variable from the control group.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Steps per day collected with a activity tracker/accelerometer (Actigraph GT3X+).

    Reported as number of steps per day. The primary endpoint is 3 months postoperatively.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up

Secondary outcomes (11)
  1. Physical activity level collected with a activity tracker/accelerometer (Actigraph GT3X+).

    Reported as time spent in light physical activity, moderate to vigorous physical activity (MVPA) and time spent sedentary.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up

  2. Physical function measured with the Timed-up-and-go test (TUG).

    The time it takes for a participant to rise from a chair, walk 3 meters, turn, walk back to the chair and sit down. Reported in seconds.

    Measured: At preoperative baseline, 3 and 12 months postoperative follow-up.

  3. Postural balance measured with the One Leg Stand test.

    The time a participant can stand on one leg, reported in seconds.

    Measured: At preoperative baseline, 3 and 12 months postoperative follow-up.

  4. Functional leg strength measured with the 30 seconds sit-to-stand test.

    Reported as the number of chair rises a participant can complete during 30 seconds.

    Measured: At preoperative baseline, 3 and 12 months postoperative follow-up.

  5. Pain intensity level in the leg and back reported with the Numeric Rating Scale (NRS).

    On a scale from 0 to 10, where a higher reported number means higher pain intensity.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up.

  6. Self-reported back-related disability collected with the Oswestry Disability Index (ODI).

    Score range from 0 to 50. Higher scores represent greater disability.

    Measured: At preoperative baseline, 3 and 12 months postoperative follow-up.

  7. The person's own goals regarding function collected with the Patient Specific Functional Scale (PSFS).

    The participant will choose three activities of individual importance and rate the ability to perform each activity on a scale from 0 (not able to perform the activity) to 10 (can perform the activity unhindered).

    Measured: At preoperative baseline, 3 and 12 months postoperative follow-up.

  8. Catastrophizing thoughts related to pain collected with the Pain Catastrophizing Scale (PCS).

    Score range from 0 to 52. Higher scores mean higher degree of catastrophizing thoughts related to pain.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up

  9. Patient-reported kinesiophobia collected with the Swedish version of the Tampa Scale of Kinesiophobia (TSK-SV).

    Score range from 17 to 68. Higher scores mean higher degree of fear of movement.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up.

  10. Depressed mood collected with the depression subscale of the Hospital Anxiety and Depression Scale.

    Score range from 0 to 21. A score of 8 or more indicates depression.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up.

  11. Pain self-efficacy collected with the 2-item Pain Self-Efficacy Questionnaire (PSEQ-2).

    The questions are rated on a scale from 0 (not at all confident) to 6 (completely confident). A score of 5 or less indicates that the person might be in need of help with their confidence in functioning in the presence of their pain. A score of 8 or higher reflects a desirable level of pain self-efficacy or confidence in functioning in the presence of pain.

    Measured: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Apr 2025
  2. Study start12 May 2025
  3. Primary completionAug 2027 (estimated)
  4. Study completionMay 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
252 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06935201
Sponsor's protocol ID
Get Back RCT
Status last verified
Apr 2026
First submitted
11 Apr 2025
Last updated
28 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The data in the study will be pseudonymized (coded) personal data, and Swedish legislation prohibits us from sharing this completely open. Some data is available upon request, which will be handled according to the relevant legislation.

Questions about this trial

What is this clinical trial studying?

A study testing Get Back in people with Spinal Stenosis Lumbar, run by Sophiahemmet University at 4 sites in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 28 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mari K Lundberg (+46 8-406 20 91, mari.lundberg@shh.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Steps per day collected with a activity tracker/accelerometer (Actigraph GT3X+). (time frame: At preoperative baseline, and at 6 weeks, 3 months, 6 months, 12 months postoperative follow-up). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Apr 2026.

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