Does group-based cognitive therapy improve functional ability, pain, catastrophic thoughts and quality of life in patients with persistent low back pain and psychological risk factors? A randomised controlled trial in a secondary care setting

2021 ◽  
pp. 026921552110562
Author(s):  
Nanna Rolving ◽  
Karina Agerbo ◽  
Stine Aalkjær Clausen ◽  
Kate Ane Rauff Denby ◽  
Anna Puk Jacobsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Care Group ◽  
Low Back ◽  
Psychological Risk Factors ◽  
Psychological Risk

Objective To investigate the effects of a group-based cognitive behavioural intervention for patients with persistent low back pain (LBP) and psychological risk factors referred to secondary care. Design A randomised controlled trial. Setting Silkeborg Regional Hospital, Denmark. Subjects A total of 136 participants with chronic LBP and psychological risk factors. Interventions Participants were randomised to the standard care group, including examination by a rheumatologist and/or a physiotherapist, or the intervention group, including standard care plus a multidisciplinary group-based pain management programme. Main measures Patient-reported outcomes were collected at baseline and after 6 and 12 months. The primary outcome was disability (Roland Morris Disability Questionnaire). Secondary outcomes included low back pain intensity, pain catastrophising, health-related quality of life, and sick leave. Results Among 136 participants, 68 (mean age: 41.7 years (SD 11.8)) were randomised to standard care and 68 (mean age: 46.0 years (SD 10.8)) were randomised to the intervention group. Except for age, baseline characteristics were comparable between groups. 12-month follow-up was completed by 92.6% in the intervention group and 80.9% in the standard care group. Both groups achieved significant improvements on disability, with a reduction of −4.8 points (SD 6.1) in the intervention group compared to −3.7 points (SD 5.2), resulting in an insignificant difference between groups. No significant differences were found in the secondary outcomes. Conclusion A group-based pain management programme was no more effective than standard care for patients with persistent LBP and psychological risk factors.

Chronic low back pain and the transdiagnostic process: How do cognitive and emotional dysregulations contribute to the intensity of risk factors and pain?

2017 ◽  
Vol 17 (1) ◽  
pp. 309-315 ◽  
Author(s):  
Margaux Le Borgne ◽  
Abdel Halim Boudoukha ◽  
Audrey Petit ◽  
Yves Roquelaure
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Multiple Regression ◽  
Chronic Low Back Pain ◽  
Emotional Regulation ◽  
Low Back ◽  
Psychological Risk Factors ◽  
Somatosensory Amplification ◽  
Psychological Risk

AbstractBackground and aimsBased on a transdiagnostic approach, this study assesses the impact of cognitive and emotional processes (difficulties in emotional regulation, impulsiveness, rumination and somatosensory amplification) on the psychological risk factors of chronic low-back pain.MethodsThe study was carried out with 256 patients with chronic low-back pain. All the variables were assessed through a booklet of 10 validated questionnaires. Multiple regression analysis and moderation analysis were performed.ResultsPredictors included in multiple regression models explain 3%-42% (adjusted R2) of the variance in psychological risk factors. Moreover, analyses reveal a significant moderator effect of somatosensory amplification on the link between fear-avoidance beliefs linked to work and pain intensity (F(3;250) = 12.33; p = .00), of somatosensory amplification and brooding on the link between depression and functional repercussions (FR) on everyday life (F(3;252) = 13.36; p = .000; F(1;252) = 12.42; p = .00), of the reflection dimension of rumination on the link between the helplessness dimension of catastrophizing and FRs on sociability (F(3;252) = 37.02; p = .00). There is also a moderation analysis with a significant trend concerning the lack of emotional awareness and the difficulties in controlling impulsive behaviours.ConclusionsOur results indicate an important role of some dimensions of difficulties in emotional regulation, somatosensory amplification and rumination in the increase in negative affects and dysfunctional beliefs, and in the links between those psychological risk factors and pain/disability.ImplicationsThis study identifies some cognitive and emotional dysregulations substantially involved in work-related chronic pain. This contribute to put in place psychotherapeutic protocols to tackle these deficits and dysregulations in a relevant way.

Low-back-pain related disability: An integration of psychological risk factors into the stress process model

Pain ◽  
2008 ◽  
Vol 137 (3) ◽  
pp. 564-573 ◽  
Author(s):  
Manon Truchon ◽  
Denis Côté ◽  
Lise Fillion ◽  
Bertrand Arsenault ◽  
Clermont Dionne
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Process Model ◽  
Stress Process ◽  
Low Back ◽  
Stress Process Model ◽  
Psychological Risk Factors ◽  
Psychological Risk

scholarly journals Cost-effectiveness of acupuncture versus standard care for pelvic and low back pain in pregnancy: A randomized controlled trial

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0214195 ◽  
Author(s):  
Stephanie Nicolian ◽  
Thibault Butel ◽  
Laetitia Gambotti ◽  
Manon Durand ◽  
Antoine Filipovic-Pierucci ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Standard Care ◽  
Controlled Trial ◽  
Low Back ◽  
Randomized Controlled ◽  
In Pregnancy

The effectiveness of 12 weeks of Pilates intervention on disability, pain and kinesiophobia in patients with chronic low back pain: a randomized controlled trial

2018 ◽  
Vol 32 (9) ◽  
pp. 1249-1257 ◽  
Author(s):  
David Cruz-Díaz ◽  
Marta Romeu ◽  
Carmen Velasco-González ◽  
Antonio Martínez-Amat ◽  
Fidel Hita-Contreras
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Low Back ◽  
Randomized Controlled ◽  
Disability Questionnaire

Objective: To assess the effectiveness of 12 weeks of Pilates practice on disability, pain and kinesiophobia in patients with chronic non-specific low back pain. Design: This is a randomized controlled trial. Setting: This study was conducted in the university laboratory. Subjects: A total of 64 participants with chronic non-specific low back pain were included. Interventions: Participants were randomly allocated to intervention group consisted in Pilates intervention during 12 weeks ( n = 32) or control group who received no treatment ( n = 32). Main measures: Disability, pain and kinesiophobia were assessed by Roland Morris Disability Questionnaire, visual analogue scale and Tampa Scale of Kinesiophobia, respectively. Measurements were performed at baseline, at 6 and 12 weeks after study completion. Results: There were significant differences between groups with observed improvement in Pilates intervention group in all variables after treatment ( P < 0.001). Major changes on disability and kinesiophobia were observed at six weeks of intervention with no significant difference after 12 weeks ( P < 0.001). Mean changes of the intervention group compared with the control group were 4.00 (0.45) on the Roland Morris Disability Questionnaire and 5.50 (0.67) in the Tampa Scale of Kinesiophobia. Pain showed better results at six weeks with a slightly but statistically significant improvement at 12 weeks with Visual Analogue Scale scores of 2.40 (0.26) ( P < 0.001). Conclusion: Pilates intervention in patients with chronic non-specific low back pain is effective in the management of disability, pain and kinesiophobia.

scholarly journals Effects of seated lumbar rotation manipulation in treating degenerative lumbar instability: a protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui Xie ◽  
Long Liang ◽  
Kaiming Li ◽  
Jie Yu ◽  
Minshan Feng ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Low Back ◽  
Lumbar Instability ◽  
Randomized Controlled ◽  
Lumbar Traction

Abstract Background Degenerative lumbar instability (DLI) is a common disease that causes low back pain (LBP) in clinic. It is difficult to completely recover from DLI, and it occurs repeatedly, which seriously affects the quality of life of patients. The epidemiological survey showed that 20–30% of low back pain was related to lumbar instability. Increasing evidence shows that seated lumbar rotation manipulation can effectively improve the clinical symptoms of patients with low back pain. The primary aim of this clinical trial is to observe the intervention effect of seated lumbar rotation manipulation on DLI patients. Method/design A total of 60 participants with DLI will be recruited and randomly allocated into the seated lumbar rotation manipulation group (the intervention group) or lumbar traction in supine position group (the control group) in this prospective, outcome assessor-blind, two-arm randomized controlled clinical trial. The treatment of the two groups lasted for 3 weeks, and the manipulation of the intervention group would be carried out once every other day, three times a week, a total of 9 times; the control group would be given lumbar traction once a day, five times a week, a total of 15 times. JOA (Japanese Orthopaedic Association) and VAS (Visual Analogue Scales) scores will be recorded as the primary outcomes before the treatment and at the 1st, 3rd, 5th, 8th, 10th, 12th, 15th, 17th, and 19th days after treatment and follow-up visit at the first, third, and sixth months. JOA efficacy evaluation standard will be used to evaluate the overall efficacy as the secondary outcomes. Discussion The results of this prospective, randomized controlled trial will provide a clinical evidence for the treatment of DLI with seated lumbar rotation manipulation. Trial registration Chinese Clinical Trial Registry ChiCTR2000032017. Registered on 18 April 2020, Prospective registration.

Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients (DRAFT)

2018 ◽  
Author(s):  
Peter Lawlor
Keyword(s):  
Risk Factors ◽  
Comparative Effectiveness ◽  
Older Patients ◽  
Standard Care ◽  
Medical Service ◽  
Controlled Trial ◽  
Intervention Group ◽  
Baseline Risk ◽  
Care Group ◽  
Multicomponent Intervention

This chapter, reports on a prospectively matched controlled trial in which Inouye et al. examined the comparative effectiveness of a targeted multicomponent strategy for reducing the risk of delirium with that of usual standard care. The six targeted baseline risk factors in delirium-free patients admitted to a medical service in a teaching hospital were cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration. Using standardized interventions for each of these when present, 42/426 (9.9%) of those in the intervention group had a first-incident episode of delirium compared to 64/426 (15%) in the usual care group, representing a statistically significant reduction of approximately 33% in first-incident episodes of delirium. The number of patient-days with delirium (105 vs. 161) and delirium episodes (62 vs. 90) were significantly lower in the intervention group. Primary prevention of delirium was effective.

A randomised controlled trial of spinal manipulative therapy in acute low back pain

2008 ◽  
Vol 68 (9) ◽  
pp. 1420-1427 ◽  
Author(s):  
P Jüni ◽  
M Battaglia ◽  
E Nüesch ◽  
G Hämmerle ◽  
P Eser ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Standard Care ◽  
Controlled Trial ◽  
Spinal Manipulative Therapy ◽  
Low Back ◽  
Specific Patient ◽  
Manipulative Therapy ◽  
Acute Low Back Pain

Objective:To determine whether treatment with spinal manipulative therapy (SMT) administered in addition to standard care is associated with clinically relevant early reductions in pain and analgesic consumption.Methods:104 patients with acute low back pain were randomly assigned to SMT in addition to standard care (n  =  52) or standard care alone (n  =  52). Standard care consisted of general advice and paracetamol, diclofenac or dihydrocodeine as required. Other analgesic drugs or non-pharmacological treatments were not allowed. Primary outcomes were pain intensity assessed on the 11-point box scale (BS-11) and analgesic use based on diclofenac equivalence doses during days 1–14. An extended follow-up was performed at 6 months.Results:Pain reductions were similar in experimental and control groups, with the lower limit of the 95% CI excluding a relevant benefit of SMT (difference 0.5 on the BS-11, 95% CI −0.2 to 1.2, p = 0.13). Analgesic consumptions were also similar (difference −18 mg diclofenac equivalents, 95% CI −43 mg to 7 mg, p = 0.17), with small initial differences diminishing over time. There were no differences between groups in any of the secondary outcomes and stratified analyses provided no evidence for potential benefits of SMT in specific patient groups. The extended follow-up showed similar patterns.Conclusions:SMT is unlikely to result in relevant early pain reduction in patients with acute low back pain.

scholarly journals Daily Exercises and Education for Preventing Low Back Pain in Children: Cluster Randomized Controlled Trial

2015 ◽  
Vol 95 (4) ◽  
pp. 507-516 ◽  
Author(s):  
Julia J. Hill ◽  
Jennifer L. Keating
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Primary Schools ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cluster Randomized Controlled Trial ◽  
Low Back ◽  
Randomized Controlled ◽  
Cluster Randomized

Background Children report low back pain (LBP) as young as 8 years. Preventing LBP in children may prevent or delay adult incidence. Objectives The purpose of this study was to determine whether education and daily exercise affect LBP episodes in children compared with education alone. Design This was a prospective, multicenter cluster randomized controlled trial. Setting The study was conducted at 7 New Zealand primary schools. Participants Children (n=708), aged 8 to 11 years, from 7 schools stratified by sample size (36, 114, 151, 168, 113, 45, 83) were randomized and allocated to 2 masked groups: intervention (4 schools, n=469) or control (3 schools, n=239). Interventions Participants in the intervention group were taught 4 spinal movements for daily practice. Both groups participated in education that emphasized “back awareness.” Measurements Low back pain history at baseline was assessed. Children reported episodes of LBP during the previous week on trial days 7, 21, 49, 105, 161, and 270. Analysis was at the individual participant level, with adjustment for school clusters. Results There were no significant differences between groups in the odds of reporting no LBP in the previous week during the study period (odds ratio [OR]=0.72; 95% confidence interval [95% CI]=0.46, 1.14; P=.16). The intervention group reported significantly fewer episodes of LBP (OR=0.54; 95% CI=0.39, 0.74; P&lt;.001) and significantly fewer lifetime first episodes of LBP (n=86 [34%]) compared with the control group (n=58 [47%]) (OR=0.60; 95% CI=0.39, 0.91; P=.02). The odds of an episode of LBP were greater in participants with a history of LBP (OR=4.21; 95% CI=3.07, 5.78; P&lt;.001). Low back pain episodes decreased across the trial period for both groups (OR=0.89; 95% CI=0.84, 0.95; P&lt;.001). Adherence to exercise was poor. Limitations Replication in other settings is needed. Conclusions Regular exercise and education appear to reduce LBP episodes in children aged 8 to 11 years compared with education alone.

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