What does GLA:D Back consist of?
GLA:D Back consists of:
EDUCATION of clinicians in running GLA:D Back courses for patients.
TREATMENT PROGRAM consisting of a 9-week education and exercise program for patients.
REGISTRATION of clinician and patient data in the GLA:D Back registry.
The purpose of GLA:D Back is to help patients manage their back pain better themselves through a well-described and structured course of treatment. In Canada, the clinician training program is available to physiotherapists, chiropractors and kinesiologists to offer patient education and exercise based on high quality evidence. Data from the program is entered in a secure clinical registry so that together, we create new knowledge about back pain and GLA:D Back can be continuously improved.
Patient education and supervised exercise for patients with persistent and/or recurrent back pain are recommended as first-line interventions in several international guidelines based on expert reviews of hundreds of randomized controlled trials. Patient education and exercise have positive effects on back problems and little risk of harms. At the same time, education and exercise have been shown to prevent new episodes of back pain. Evidence and theories behind GLA:D Back have been published in several academic journals.
The program is designed for patients with persistent and/or recurrent back pain that negatively affects their everyday life and function. The patient and the therapist jointly decide whether GLA:D Back is relevant. As with any other treatment, the decision about patient participation in a GLA:D Back course is based on a clinical assessment and patient preference.
Frequently Asked Questions
Is GLA:D Back better than other treatment options?
There are many good treatment options for patients with back pain. However, no other programs are as well-described as GLA:D Back, and no other program provides systematic registration of outcomes in a clinical registry.
Has GLA:D Back been tested?
Yes, the results of the pilot study that took place in 2017 are published in the Journal BioMed Central (BMC) Pilot & Feasibility Studies. The ongoing results are documented and made publicly available in newsletters, annual reports and scientific articles.
Who can offer GLA:D Back to patients?
GLA:D® is a registered trademark of SDU. The use of the GLA:D® Back or GLA:D® Hip and Knee trademark requires that the therapist:
Has completed the course from approved trainers
Provides the GLA:D intervention as described
Records data in the clinical registry. Over time, we expect that therapists will be required to be periodically be re-certified in order to continue offering GLA:D Back
Should accredited GLA:D Hip and Knee clinicians complete the whole GLA:D Back training course?
Yes, they should. GLA:D® Back and GLA:D® Hip and Knee may have the same overall structure, but the content is different.
Is research underway about GLA:D Back?
Yes, a comprehensive research program is linked to GLA:D Back. The program is described and published in BMC Musculoskeletal Disorders and other scientific jour. There is also an overview of the information and efficacy goals recorded in the clinical register.
Scientific publications can be found at gladryg.sdu.dk
Which patients can participate in GLA:D Back?
At present, a stratification tool is not used in selecting the target group, as it is still unclear how treatment choices are best guided in the patient group seeking care from a physiotherapist / chiropractor. GLA:D Back has a dedicated clinical registry, which will be used to explore how to better help particular patient groups. The registry includes, among other things, the ‘START Back Tool’, which is designed to assess whether a patient needs minimal or more comprehensive treatment. Currently, it is up to the individual clinician whether tools such as this should be included as part of their assessment of whether GLA:D Back is relevant.
Is GLA:D only for patients with arthritis?
GLA:D® stands for “Good Life with osteoArthritis in Denmark”. This is because it was originally a program for patients with osteoarthritis of the knees and hips. GLA:D® includes: 1) patient education and training, 2) courses for licensed clinicians to provide this, and 3) a clinical registry that monitors how participants are progressing. It is these elements, which are also basic elements of GLA:D Back, that define the GLA:D® concept, which are not only aimed at osteoarthritis and may be beneficial for a range of patients.
Is it 'one size fits all'?
No, definitely not. Patients with long-term and recurrent back pain are a diverse group with different conditions and different needs. GLA:D Back can and must therefore be adapted to the individual patient’s capacity and needs.
Do GLA:D Back researchers have a conflict of interest when they develop the program, offer courses and test GLA:D Back?
It is quite natural and common for researchers to develop interventions and to be involved in subsequent research of these. Therefore, GLA:D Backhas established an affiliation with an independent ‘Data Safety Monitoring Board’, which is constantly kept informed and has access to data on patient inclusion and drop-out, patient benefit measured by satisfaction, pain and function, and any unintended events that have occurred in connection with GLA:D Back. In addition, there are also researchers who have not been involved in developing the program who conduct research into GLA:D Back. None of the researchers involved have personal financial interests in GLA:D Back. All potential conflicts of interest are detailed in the protocol article for GLA:D Back in the journal BMC Pilot & Feasibility Studies.
The GLA:D Back Canada Team
Our team is currently comprised of Physical Therapists and Chiropractors working out of the University of Alberta in Edmonton, Alberta and led by principal investigator Dr. Greg Kawchuk. We coordinate with various GLA:D Back teams around the world, including the founding group in at the University of Southern Denmark in Odense, Denmark.
Greg Kawchuk, DC, PhD
James Lemieux, DC, MSc *
Brandyn Powelske, PT, PhD Candidate
Sylvia Cao, PT
Jen Glumpak, PT
Sarah Harding, PT *
* currently running GLA:D Back classes - click here for contact information