A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study

Eur Spine J. 2014 Oct;23(10):2105-13. doi: 10.1007/s00586-014-3478-5. Epub 2014 Jul 27.

Abstract

Purpose: To evaluate the effect of a multidisciplinary rehabilitation programme on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic low back pain (CLBP).

Methods: This was a parallel-group, randomised, superiority-controlled pilot study in which 20 patients were randomly assigned to a programme consisting of motor training (spinal stabilising exercises plus usual-care) and cognitive-behavioural therapy (experimental group, 10 subjects) or usual-care alone (control group, 10 subjects). Before treatment, 8 weeks later (post-treatment), and 3 months after the end of treatment, the Oswestry Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale, and the Short-Form Health Survey were assessed. Spatio-temporal gait parameters were also measured by means of an electronic walking mat. A linear mixed model for repeated measures was used for each outcome measure.

Results: The programme had significant group (p = 0.027), time (p < 0.001), and time-by-group interaction (p < 0.001) effects on disability, with the experimental group showing an improvement after training of about 61 % (25 % in the control group). The analyses of kinesiophobia, catastrophizing, and the quality of life also revealed significant time, group, and time-by-group interaction effects in favour of the experimental group, and there was a significant effect of time on pain. Both groups showed a general improvement in gait parameters, with the experimental group increasing cadence significantly more.

Conclusion: The multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to the exercise programme in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life and gait cadence of patients with CLBP.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Catastrophization* / psychology
  • Catastrophization* / rehabilitation
  • Catastrophization* / therapy
  • Chronic Pain / psychology
  • Chronic Pain / rehabilitation
  • Chronic Pain / therapy
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Behavioral Therapy / organization & administration
  • Disability Evaluation*
  • Disabled Persons / psychology
  • Disabled Persons / rehabilitation
  • Exercise Therapy / methods*
  • Exercise Therapy / organization & administration
  • Female
  • Humans
  • Low Back Pain* / psychology
  • Low Back Pain* / rehabilitation
  • Low Back Pain* / therapy
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Care Team
  • Pilot Projects
  • Program Evaluation
  • Quality of Life*
  • Treatment Outcome
  • Walking