The Effect of a Fear-Avoidance–Based Physical Therapy Intervention for Patients With Acute Low Back Pain: Results of a Randomized Clinical Trial

Spine ◽  
2003 ◽  
Vol 28 (23) ◽  
pp. 2551-2560 ◽  
Author(s):  
Steven Z. George ◽  
Julie M. Fritz ◽  
Joel E. Bialosky ◽  
Douglas A. Donald
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Randomized Clinical Trial ◽  
Low Back ◽  
Fear Avoidance ◽  
Acute Low Back Pain ◽  
Therapy Intervention ◽  
Physical Therapy Intervention

Changes in Pain Catastrophizing and Fear-Avoidance Beliefs as Mediators of Early Physical Therapy on Disability and Pain in Acute Low-Back Pain: A Secondary Analysis of a Clinical Trial

Pain Medicine ◽  
2021 ◽  
Author(s):  
Brittany L Sisco-Taylor ◽  
John S Magel ◽  
Molly McFadden ◽  
Tom Greene ◽  
Jincheng Shen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Pain Catastrophizing ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Acute Low Back Pain ◽  
Early Physical Therapy

Abstract Objective The Fear-Avoidance Model of chronic pain (FAM) posits that pain catastrophizing and fear-avoidance beliefs are prognostic for disability and chronicity. In acute low-back pain, early physical therapy (PT) is effective in reducing disability in some patients. How early PT impacts short- and long-term changes in disability for patients with acute pain is unknown. Based on the FAM, we hypothesized that early reductions in pain catastrophizing and fear-avoidance beliefs would mediate early PT’s effect on changes in disability (primary outcome) and pain intensity (secondary outcome) over 3 months and 1 year. Subjects Participants were 204 patients with low-back pain of < 16 days duration, who enrolled in a clinical trial (NCT01726803) comparing early PT sessions or usual care provided over 4 weeks. Methods Patients completed the Pain Catastrophizing Scale (PCS), Fear-Avoidance Beliefs Questionnaire (FABQ work and physical activity scales) and outcomes (Oswestry Disability Index and Numeric Pain Rating Scale) at baseline, 4 weeks, 3 months, and 1 year. We applied longitudinal mediation analysis with single and multiple mediators. Results Early PT led to improvements in disability and pain over 3 months, but not 1 year. In the single mediator model, four-week reductions in pain catastrophizing mediated early PT’s effects on 3-month disability and pain intensity improvements, explaining 16% and 22% of the association, respectively, but the effects were small. Pain catastrophizing and fear-avoidance beliefs did not jointly mediate these associations. Conclusions In acute low-back pain, early PT may improve disability and pain outcomes at least partly through reducing patients’ catastrophizing.

Evaluating the Feasibility of an Emergency Department Physical Therapy Intervention for Acute Low Back Pain

2019 ◽  
Vol 11 (3) ◽  
pp. 113-119
Author(s):  
Howard S. Kim ◽  
Kyle J. Strickland ◽  
Daniel Pinto ◽  
Christina Arroyo ◽  
D. Mark Courtney ◽  
...  
Keyword(s):  
Emergency Department ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Therapy Intervention ◽  
Physical Therapy Intervention

Early Intervention Options for Acute Low Back Pain Patients: A Randomized Clinical Trial with One-Year Follow-Up Outcomes

2010 ◽  
Vol 20 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Travis Whitfill ◽  
Robbie Haggard ◽  
Samuel M. Bierner ◽  
Glenn Pransky ◽  
Robert G. Hassett ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Early Intervention ◽  
Randomized Clinical Trial ◽  
Low Back ◽  
Acute Low Back Pain ◽  
One Year ◽  
Pain Patients

scholarly journals Effect of muscle energy technique with and without strain–counterstrain technique in acute low back pain — A randomized clinical trial

2018 ◽  
Vol 38 (01) ◽  
pp. 41-51
Author(s):  
Vivek Dineshbhai Patel ◽  
Charu Eapen ◽  
Zulfeequer Ceepee ◽  
Ramachandra Kamath
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Randomized Clinical Trial ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Muscle Energy Technique ◽  
Difference Formula ◽  
Significant Difference ◽  
Muscle Energy

Background: Muscle energy technique (MET) and strain–counterstrain (SCS) technique are found to be effective as a sole treatment of acute low back pain (LBP), but the combined effect of these two techniques has not been evaluated. Objective: The purpose of this randomized clinical trial was to evaluate the added effect of SCS to MET in acute LBP patients. Methods: In this trial, 50 patients were randomly allocated to MET or MET-SCS group to receive the assigned two treatment sessions for two consecutive days. Oswestry disability index (ODI) and Roland Morris disability questionnaire (RMDQ), visual analogue scale (VAS), lumbar range of motion (ROM) were recorded at baseline, after first and second session. Results: All the outcome measures showed statistically significant ([Formula: see text]) improvement in both the groups after second session. Between the groups, analysis showed no statistically significant difference ([Formula: see text]) after the first or second session. Conclusions: The improvement after second treatment sessions was noted in pain, ROM, and disability in both the groups, but immediate effect was seen only on pain intensity after first treatment session. When compared between the groups, no added effect of SCS to MET was found in reducing pain and disability and increasing lumbar ROM in acute LBP patients.

scholarly journals Physical Therapist Management of a Patient With Acute Low Back Pain and Elevated Fear-Avoidance Beliefs

2004 ◽  
Vol 84 (6) ◽  
pp. 538-549 ◽  
Author(s):  
Steven Z George ◽  
Joel E Bialosky ◽  
Julie M Fritz
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Physical Therapist ◽  
Previous History ◽  
Sales Manager ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Acute Low Back Pain

Abstract Background and Purpose. Elevated fear-avoidance beliefs are believed to be a precursor of chronic disability, yet effective intervention options have not been described in the literature. The purpose of this case report is to describe physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs. Case Description. The patient was a 42-year-old sales manager with acute low back pain. The patient had no previous history of activity-limiting low back pain and initially had limitations in straight leg raising, limitations in lumbar movement, and elevated fear-avoidance beliefs. Intervention. Treatment-based classification and graded exercise were used. Outcome. Disability, fear-avoidance beliefs, and pain decreased 4 weeks after starting physical therapy. Six months later, disability and fear-avoidance beliefs had increased, but were still improved when compared with the initial measurements. Discussion. Disability and fear-avoidance beliefs improved following a fear-avoidance-based physical therapy intervention. Research is warranted to investigate the effectiveness of this approach.

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