First trans-diagnostic experiences with novel micro-choice based group rehabilitation for low back pain, long COVID, type 2 DM, 2024, Kvale+

First trans-diagnostic experiences with a novel micro-choice based concentrated group rehabilitation for patients with low back pain, long COVID, and type 2 diabetes: a pilot study
Kvale, Gerd; Søfteland, Eirik; Jürgensen, Marte; Wilhelmsen-Langeland, Ane; Haugstvedt, Anne; Hystad, Sigurd William; Ødegaard-Olsen, Øystein Theodor; Aarli, Bernt Bøgvald; Rykken, Sidsel; Frisk, Bente

The health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses. Hence, novel high-capacity and cost-effective treatments with trans-diagnostic effects are warranted.

In accordance with the protocol paper, we aimed to examine the acceptability, satisfaction, and effectiveness of an interdisciplinary micro-choice based concentrated group rehabilitation for patients with chronic low back pain, long COVID, and type 2 diabetes. Patients with low back pain > 4 months sick-leave, long COVID, or type 2 diabetes were included in this clinical trial with pre-post design and 3-month follow-up.

The treatment consisted of three phases: (1) preparing for change, (2) the concentrated intervention for 3–4 days, and (3) integrating change into everyday life. Patients were taught and practiced how to monitor and target seemingly insignificant everyday micro-choices, in order to break the patterns where symptoms or habits contributed to decreased levels of functioning or increased health problems. The treatment was delivered to groups (max 10 people) with similar illnesses. Client Satisfaction Questionnaire (CSQ-8)) (1 week), Work and Social Adjustment Scale (WSAS), Brief Illness Perception Questionnaire (BIPQ), and self-rated health status (EQ-5D-5L) were registered at baseline and 3-month follow-up.

Of the 241 included participants (57% women, mean age 48 years, range 19–84), 99% completed the concentrated treatment. Treatment satisfaction was high with a 28.9 (3.2) mean CSQ-8-score. WSAS improved significantly from baseline to follow-up across diagnoses 20.59 (0.56) to 15.76 (0.56). BIPQ improved from: 22.30 (0.43) to 14.88 (0.47) and EQ-5D-5L: 0.715 (0.01) to 0.779 (0.01)), all P<0.001.

Across disorders, the novel approach was associated with high acceptability and clinically important improvements in functional levels, illness perception, and health status. As the concentrated micro-choice based treatment format might have the potential to change the way we deliver rehabilitation across diagnoses, we suggest to proceed with a controlled trial.

ClinicalTrials.gov NCT05234281

Link | PDF (BMC Medicine)

 

More unblinded, subjective outcome nonsense, and as usual the term "trans-diagnostic" indicates that findings are spurious.

Not a good start with the abstract: "The health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses."

Apparently all these complex and expensive chronic illnesses can be hand-waved away with group therapy: very cheap, very good.

A good example of how questionnaires will be filled in showing a positive change, because a professional spent time "helping" the patient.

(Is this the Lightning Process?)

All of which should tell you that you're not measuring what you think you're measuring.

I have no doubt that more studies will be forthcoming.

 

Apparently not, but very similar. See A safe and effective micro‑choice based rehabilitation for patients with long COVID: results from a quasi‑experimental study 2023, Frisk et al

 

oh dear. This approach has been discussed in several threads and is already on offer in Norway.

Here's a media article from 2023 about this "novel" approach. Towards the end of the article they mention a study that will be published soon and has followed up patients for a year, which I assume is the study to this thread.

Science Norway: Can Long Covid be treated in three days?

quote:

The researchers call them micro-choices. They are the small and seemingly insignificant choices we make in everyday life that often happen automatically, and that we make to regulate anxiety and discomfort. Kvale and her colleagues try to make patients aware of exactly when these moments happen and the choices they are making.

“For some people, this means focusing on the choices they make early in the day, which can contribute to them being tired,” says Kvale.

Others might find it more relevant to look directly at the choices they make regarding rest.

“There are lots of ways to rest. Just doing something else – like increasing one’s activity level – can be a good rest for some people,” she says.

 

Good grief I hope an LLM wrote this title because it's just chock-full of meaningless buzzwords and it would be less embarrassing.

I'm just baffled by the two first paragraphs, which have nothing to do with one another, in fact pretty much contradict each other. Again it sounds like an LLM wrote this, and frankly probably did. It's true that effective treatments are needed, but they are not trying to do that, instead they're just doing the same old failed nonsense. Also, spoiler: health care is already broken. In part because of pseudoscience like this.

Also how can something be both novel and evidence-based? This ideology is seriously just straight up offensive on philosophical grounds alone, it doesn't just make no pretense to make sense, it challenges common sense and reason in ways that should make people angry.

This nonsense seems to be called "The Bergen 4-day treatment", and appears to be their creation, and the reference for ME/CFS is this paper: A 4-Day Mindfulness-Based Cognitive Behavioral Intervention Program for CFS/ME. An Open Study, With 1-Year Follow-Up, so really just the same old repackaged CBT stuff, as is tradition.

 

And just continues the old scam model of "does random variation of CBT" "improve X/Y/Z" in "group A/B/C/.../Z" using "useless rating questionnaire". It's a combinational scam, there are just endless permutations that they can go through. In fact this same group is doing exactly this. All of which add up to exactly as much difference, or even distinction, as wearing different hats while doing the same thing.

This is seriously the biggest scam in the history of medicine. It makes Theranos look downright honest and good-natured.