Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: Results of a Randomized Controlled Trial
OBJECTIVE:To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain. METHODS:Study designparallel-group, rando...
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| Veröffentlicht in: | The Clinical journal of pain 2013-11, Vol.29 (11), p.929-938 |
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| container_title | The Clinical journal of pain |
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| creator | Monticone, Marco Ferrante, Simona Rocca, Barbara Baiardi, Paola Farra, Fulvio Dal Foti, Calogero |
| description | OBJECTIVE:To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain.
METHODS:Study designparallel-group, randomized, superiority controlled study. Ninety patients were randomly assigned to a multidisciplinary program consisting of cognitive-behavior therapy and exercise training (experimental group, 45 patients) or exercise training alone (control group, 45 patients). Before treatment (T1), 5 weeks later (instructive phase, T2), and 12 (posttreatment analysis, T3) and 24 months after the end of the instructive phase (1-year follow-up, T4), all of the patients completed a booklet containing the Roland-Morris Disability Questionnaire Scale (primary outcome), the Tampa Scale for Kinesiophobia, a pain numerical rating scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used to analyze each outcome measure, and the reliable change index/clinically significant change method was used to assess the clinical significance of the changes.
RESULTS:The linear mixed model analysis showed a remarkable group, time, and interaction effect for group * time in all of the primary and secondary outcomes (P always |
| doi_str_mv | 10.1097/AJP.0b013e31827fef7e |
| format | Article |
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METHODS:Study designparallel-group, randomized, superiority controlled study. Ninety patients were randomly assigned to a multidisciplinary program consisting of cognitive-behavior therapy and exercise training (experimental group, 45 patients) or exercise training alone (control group, 45 patients). Before treatment (T1), 5 weeks later (instructive phase, T2), and 12 (posttreatment analysis, T3) and 24 months after the end of the instructive phase (1-year follow-up, T4), all of the patients completed a booklet containing the Roland-Morris Disability Questionnaire Scale (primary outcome), the Tampa Scale for Kinesiophobia, a pain numerical rating scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used to analyze each outcome measure, and the reliable change index/clinically significant change method was used to assess the clinical significance of the changes.
RESULTS:The linear mixed model analysis showed a remarkable group, time, and interaction effect for group * time in all of the primary and secondary outcomes (P always <0.001). The majority of the patients in the experimental group achieved a reliable and clinically significant improvement, whereas the majority of those in the control group experienced no change.
CONCLUSIONS:The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear-avoidance beliefs and pain, and enhancing the quality of life of patients with chronic low back pain. The effects were clinically tangible and lasted for at least 1 year after the intervention ended.</description><identifier>ISSN: 0749-8047</identifier><identifier>EISSN: 1536-5409</identifier><identifier>DOI: 10.1097/AJP.0b013e31827fef7e</identifier><identifier>PMID: 23328343</identifier><language>eng</language><publisher>United States: by Lippincott Williams & Wilkins</publisher><subject>Adult ; Cognitive Behavioral Therapy - methods ; Disability Evaluation ; Disabled Persons - psychology ; Double-Blind Method ; Exercise Therapy - methods ; Fear ; Female ; Humans ; Longitudinal Studies ; Low Back Pain - psychology ; Low Back Pain - rehabilitation ; Male ; Middle Aged ; Pain Measurement ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; Treatment Outcome</subject><ispartof>The Clinical journal of pain, 2013-11, Vol.29 (11), p.929-938</ispartof><rights>2013 by Lippincott Williams & Wilkins</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c305e-e2b03709000bbbc0d7e94a84b8a85ce6573591a30ac4734a40974ccc436b8413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23328343$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Monticone, Marco</creatorcontrib><creatorcontrib>Ferrante, Simona</creatorcontrib><creatorcontrib>Rocca, Barbara</creatorcontrib><creatorcontrib>Baiardi, Paola</creatorcontrib><creatorcontrib>Farra, Fulvio Dal</creatorcontrib><creatorcontrib>Foti, Calogero</creatorcontrib><title>Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: Results of a Randomized Controlled Trial</title><title>The Clinical journal of pain</title><addtitle>Clin J Pain</addtitle><description>OBJECTIVE:To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain.
METHODS:Study designparallel-group, randomized, superiority controlled study. Ninety patients were randomly assigned to a multidisciplinary program consisting of cognitive-behavior therapy and exercise training (experimental group, 45 patients) or exercise training alone (control group, 45 patients). Before treatment (T1), 5 weeks later (instructive phase, T2), and 12 (posttreatment analysis, T3) and 24 months after the end of the instructive phase (1-year follow-up, T4), all of the patients completed a booklet containing the Roland-Morris Disability Questionnaire Scale (primary outcome), the Tampa Scale for Kinesiophobia, a pain numerical rating scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used to analyze each outcome measure, and the reliable change index/clinically significant change method was used to assess the clinical significance of the changes.
RESULTS:The linear mixed model analysis showed a remarkable group, time, and interaction effect for group * time in all of the primary and secondary outcomes (P always <0.001). The majority of the patients in the experimental group achieved a reliable and clinically significant improvement, whereas the majority of those in the control group experienced no change.
CONCLUSIONS:The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear-avoidance beliefs and pain, and enhancing the quality of life of patients with chronic low back pain. The effects were clinically tangible and lasted for at least 1 year after the intervention ended.</description><subject>Adult</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Disability Evaluation</subject><subject>Disabled Persons - psychology</subject><subject>Double-Blind Method</subject><subject>Exercise Therapy - methods</subject><subject>Fear</subject><subject>Female</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Low Back Pain - psychology</subject><subject>Low Back Pain - rehabilitation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain Measurement</subject><subject>Quality of Life</subject><subject>Retrospective Studies</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><issn>0749-8047</issn><issn>1536-5409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EokPhDRDykk2KEztjh910aPnRIEbVSCyjG-dmYurYg-10VB6KZ8RoCgsWrK6le-451vkIeVmyi5I18s3q0_aCdazkyEtVyQEHiY_Ioqz5sqgFax6TBZOiKRQT8ow8i_EbY2VdKfaUnFWcV4oLviA_r4YBdaJ-oEA33u0LCzEZt6efZ5tMb6I2B2schHu6DX4fYKLe0XcmQmesSfcUXE-vEUKxuvOmB6eRXuIId8aHSI2jW0gGXYr0q0kjXY_BO6Nz1JFegr7Na-Pe0huMOS6evnGTLf1kfmBP196l4K3Nz10wYJ-TJwPYiC8e5jnZXV_t1h-KzZf3H9erTaE5q7HAqmNcsoYx1nWdZr3ERoASnQJVa1zWktdNCZyBFpILyHVJobUWfNkpUfJz8vpkewj--4wxtVMuAq0Fh36ObSkEF5mCarJUnKQ6-BgDDu0hmCnX1Zas_Q2qzaDaf0Hls1cPCXM3Yf_36A-ZLFAnwdHbhCHe2vmIoR0RbBr_7_0L8rukiw</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Monticone, Marco</creator><creator>Ferrante, Simona</creator><creator>Rocca, Barbara</creator><creator>Baiardi, Paola</creator><creator>Farra, Fulvio Dal</creator><creator>Foti, Calogero</creator><general>by Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: Results of a Randomized Controlled Trial</title><author>Monticone, Marco ; Ferrante, Simona ; Rocca, Barbara ; Baiardi, Paola ; Farra, Fulvio Dal ; Foti, Calogero</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305e-e2b03709000bbbc0d7e94a84b8a85ce6573591a30ac4734a40974ccc436b8413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>Disability Evaluation</topic><topic>Disabled Persons - psychology</topic><topic>Double-Blind Method</topic><topic>Exercise Therapy - methods</topic><topic>Fear</topic><topic>Female</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Low Back Pain - psychology</topic><topic>Low Back Pain - rehabilitation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain Measurement</topic><topic>Quality of Life</topic><topic>Retrospective Studies</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Monticone, Marco</creatorcontrib><creatorcontrib>Ferrante, Simona</creatorcontrib><creatorcontrib>Rocca, Barbara</creatorcontrib><creatorcontrib>Baiardi, Paola</creatorcontrib><creatorcontrib>Farra, Fulvio Dal</creatorcontrib><creatorcontrib>Foti, Calogero</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Clinical journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Monticone, Marco</au><au>Ferrante, Simona</au><au>Rocca, Barbara</au><au>Baiardi, Paola</au><au>Farra, Fulvio Dal</au><au>Foti, Calogero</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: Results of a Randomized Controlled Trial</atitle><jtitle>The Clinical journal of pain</jtitle><addtitle>Clin J Pain</addtitle><date>2013-11</date><risdate>2013</risdate><volume>29</volume><issue>11</issue><spage>929</spage><epage>938</epage><pages>929-938</pages><issn>0749-8047</issn><eissn>1536-5409</eissn><abstract>OBJECTIVE:To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain.
METHODS:Study designparallel-group, randomized, superiority controlled study. Ninety patients were randomly assigned to a multidisciplinary program consisting of cognitive-behavior therapy and exercise training (experimental group, 45 patients) or exercise training alone (control group, 45 patients). Before treatment (T1), 5 weeks later (instructive phase, T2), and 12 (posttreatment analysis, T3) and 24 months after the end of the instructive phase (1-year follow-up, T4), all of the patients completed a booklet containing the Roland-Morris Disability Questionnaire Scale (primary outcome), the Tampa Scale for Kinesiophobia, a pain numerical rating scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used to analyze each outcome measure, and the reliable change index/clinically significant change method was used to assess the clinical significance of the changes.
RESULTS:The linear mixed model analysis showed a remarkable group, time, and interaction effect for group * time in all of the primary and secondary outcomes (P always <0.001). The majority of the patients in the experimental group achieved a reliable and clinically significant improvement, whereas the majority of those in the control group experienced no change.
CONCLUSIONS:The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear-avoidance beliefs and pain, and enhancing the quality of life of patients with chronic low back pain. The effects were clinically tangible and lasted for at least 1 year after the intervention ended.</abstract><cop>United States</cop><pub>by Lippincott Williams & Wilkins</pub><pmid>23328343</pmid><doi>10.1097/AJP.0b013e31827fef7e</doi><tpages>10</tpages></addata></record> |
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| ispartof | The Clinical journal of pain, 2013-11, Vol.29 (11), p.929-938 |
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| subjects | Adult Cognitive Behavioral Therapy - methods Disability Evaluation Disabled Persons - psychology Double-Blind Method Exercise Therapy - methods Fear Female Humans Longitudinal Studies Low Back Pain - psychology Low Back Pain - rehabilitation Male Middle Aged Pain Measurement Quality of Life Retrospective Studies Surveys and Questionnaires Treatment Outcome |
| title | Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: Results of a Randomized Controlled Trial |
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