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Cognitive behavioural therapy low back pain

Ian Cowell, Peter O'Sullivan, Kieran O'Sullivan, Ross Poyton, Alison McGregor, Ged Murtagh
BACKGROUND: It has long been acknowledged that nonspecific chronic low back pain (NSCLBP) is associated with a complex combination of biopsychosocial (BPS) factors, and recent guidelines advocate that the management of back pain should reflect this multidimensional complexity. Cognitive functional therapy (CFT) is a behaviourally oriented intervention that targets patients' individual BPS profiles. Although the efficacy of CFT has been demonstrated in primary care, little evidence exists about the training requirements of this approach...
November 23, 2018: Musculoskeletal Care
Abdolhamid Hajihasani, Mitra Rouhani, Mahyar Salavati, Rosita Hedayati, Amir Hossein Kahlaee
OBJECTIVE: The purpose of this systematic review was to investigate the effect of adding the cognitive behavioral treatment (CBT) component to routine physical therapy (PT) on pain and depression reduction, improvement in quality of life, and enhanced function in patients with chronic low back pain (CLBP). TYPE: Systematic review LITERATURE SURVEY: Google Scholar, PubMed, Ovid, ScienceDirect, ProQuest, Scopus, Cochrane Library and Embase electronic databases were explored for the key terms of "behavioral (or behavioural) treatment" OR "behavior (behaviour) treatment" OR "behavior (behaviour) therapy" OR "cognitive behavior (or behaviour) treatment" OR "cognitive treatment" OR "cognitive therapy" OR "operant behavior (or behaviour) treatment" OR "respondent behavior (or behaviour) treatment" AND "Physical Therapy" OR "Physiotherapy" OR "exercise therapy" OR "electrotherapy" OR "electrical therapy" OR "manual therapy" OR "myofascial therapy" OR "rehabilitation" AND "Low Back Pain" OR "Lower Back Pain" OR "back pain" OR "chronic back pain" OR "chronic lower back pain", with no limitation on language, through January 2018...
September 25, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Fabiana Terra Cunha Belache, Cíntia Pereira de Souza, Jessica Fernandez, Julia Castro, Paula Dos Santos Ferreira, Elizana Rodrigues de Sousa Rosa, Nathalia Cristina Gimenez de Araújo, Felipe José Jandre Reis, Renato Santos de Almeida, Leandro Alberto Calazans Nogueira, Luís Cláudio Lemos Correia, Ney Meziat-Filho
INTRODUCTION: Chronic low back pain is a public health problem, and there is strong evidence that it is associated with a complex interaction of biopsychosocial factors. Cognitive functional therapy is an intervention that deals with potentially modifiable multidimensional aspects of pain (eg, provocative cognitive, movement and lifestyle behaviours). There is evidence (from a single randomised, controlled trial) that cognitive functional therapy is better than combined manual therapy and motor control exercise...
July 2018: Journal of Physiotherapy
Matheus Almeida, Bruno Saragiotto, Bethan Richards, Chris G Maher
Research in the past decade supports some major changes to the primary care management of non-specific low back pain (LBP). The present article summarises recommendations from recently published United Kingdom, Danish, Belgian and United States guidelines to alert readers to the important changes in recommendations for management, and the recommendations from previous guidelines that remain unchanged. Main recommendations: Use a clinical assessment to triage patients with LBP. Further diagnostic workup is only required for the small number of patients with suspected serious pathology...
April 2, 2018: Medical Journal of Australia
Bethany Barone Gibbs, Andrea L Hergenroeder, Sophy J Perdomo, Robert J Kowalsky, Anthony Delitto, John M Jakicic
OBJECTIVE: The Stand Back study evaluated the feasibility and effects of a multicomponent intervention targeting reduced prolonged sitting and pain self-management in desk workers with chronic low back pain (LBP). METHODS: This randomised controlled trial recruited 27 individuals with chronic LBP, Oswestry Disability Index (ODI) >10% and desk jobs (sitting ≥20 hours/week). Participants were randomised within strata of ODI (>10%-<20%, ≥20%) to receive bimonthly behavioural counselling (in-person and telephone), a sit-stand desk attachment, a wrist-worn activity-prompting device and cognitive behavioural therapy for LBP self-management or control...
May 2018: Occupational and Environmental Medicine
O Chehadi, A C Rusu, K Konietzny, E Schulz, O Köster, T Schmidt-Wilcke, M I Hasenbring
BACKGROUND: Recent evidence has shown that chronic back pain (CBP) can lead to functional alterations in the circuitry underlying the cognitive control of pain. Thought suppression (TS) is a common type of cognitive control of pain. Previous research has shown that TS has paradoxical effects that may increase the awareness of pain. Pain-related TS may also increase individuals' attention to pain, which may also increase pain sensation, but thus far, the relationship between pain-related TS and structural brain alterations is unknown...
April 2018: European Journal of Pain: EJP
Marcus Schiltenwolf, Michael Akbar, Eva Neubauer, Simone Gantz, Herta Flor, Andreas Hug, Haili Wang
OBJECTIVES: Little is known about the affected cognitive problems in chronic low back pain patients. For this patient cohort research mostly focused on memory of pain, rather than cognitive difficulties related to pain. Chronic pain may be associated with specific (yet undefined) cognitive deficits that affect everyday behaviour. We set out to compare the cognitive function of patients with chronic low back pain (cLBP) in the course of multidisciplinary pain treatments before and after therapy...
October 6, 2017: Scandinavian Journal of Pain
A Harris, T F Moe, H R Eriksen, T Tangen, S A Lie, T H Tveito, S E Reme
BACKGROUND AND OBJECTIVE: Cognitive-behavioural treatments (CBT) and physical group exercise (PE) have both shown promising effects in reducing disability and increasing work participation among chronic low back pain (CLBP) patients. A brief cognitive intervention (BI) has previously been demonstrated to reduce work disability in CLBP. The aim of this study was to test if the effect of BI could be further increased by adding either group CBT or group PE. METHODS: A total of 214 patients, all sick listed 2-10 months due to CLBP, were randomized to BI (n = 99), BI + group CBT (n = 55) or BI + group PE (n = 60)...
September 2017: European Journal of Pain: EJP
Silvano Ferrari, Carla Vanti, Francesco Costa, Maurizio Fornari
PURPOSE: Pain-related self-efficacy is defined as "the beliefs held by people with chronic pain that were able to carry out certain activities, even when experiencing pain", and it is considered a relevant mediator in the relationship between pain and disability in chronic low back pain. This case series describes a treatment aiming to improve pain self-efficacy in patients with symptomatic lumbar spondylolisthesis. METHOD: Ten consecutive outpatients with lumbar spondylolisthesis and chronic LBP referred to a rehabilitative clinic participated in this study...
July 2016: Journal of Bodywork and Movement Therapies
Kathleen Arden, Francis Fatoye, Gillian Yeowell
AIM: The Back Rehabilitation Programme (BRP) is a group exercise programme for patients with non-specific low back pain (NSLBP) that combines cognitive behavioural therapy principles and therapeutic exercise to empower patients to self-manage their condition. Poor attendance and high attrition rates resulted in changes to the format of the programme from a standard sequential approach to a continual rolling approach. The aim of this study was to evaluate the effectiveness of this new approach on patient outcomes and its impact on attendance rates...
April 2017: Journal of Evaluation in Clinical Practice
M John Petrozzi, Andrew Leaver, Mairwen K Jones, Paulo H Ferreira, Sidney M Rubinstein, Martin G Mackey
BACKGROUND: Various interventions are available for the treatment of chronic low back pain (LBP), including Manual Therapy and Cognitive Behavioural Therapy (CBT). The purpose of this study is to evaluate whether the addition of an internet-based CBT program leads to better outcomes in patients who are treated with multimodal manual therapy for chronic LBP. METHODS/DESIGN: A randomized controlled trial comparing a combined intervention, consisting of internet-based CBT utilising MoodGYM plus multimodal manual therapy, to multimodal manual therapy alone for patients with chronic LBP...
2015: Chiropractic & Manual Therapies
Jason Holden, Megan Davidson, Paul O'Halloran
Timely resumption of usual activities is integral to successful functional outcomes in individuals with low back pain (LBP). Little is known about how physiotherapists motivate their patients achieve this. This study examined physiotherapists' knowledge, reported usage and training in a set of 12 motivational strategies. The results of an online cross sectional survey of 170 Australian physiotherapists were compared descriptively, and potential associations between therapist training and strategy use, confidence and perceived effectiveness analysed...
December 2015: Manual Therapy
Helen Richmond, Amanda M Hall, Bethan Copsey, Zara Hansen, Esther Williamson, Nicolette Hoxey-Thomas, Zafra Cooper, Sarah E Lamb
OBJECTIVES: To assess whether cognitive behavioural (CB) approaches improve disability, pain, quality of life and/or work disability for patients with low back pain (LBP) of any duration and of any age. METHODS: Nine databases were searched for randomised controlled trials (RCTs) from inception to November 2014. Two independent reviewers rated trial quality and extracted trial data. Standardised mean differences (SMD) and 95% confidence intervals were calculated for individual trials...
2015: PloS One
M Monticone, E Ambrosini, B Rocca, D Cazzaniga, V Liquori, C Foti
BACKGROUND: There are still doubts concerning the clinical impact of multidisciplinary cognitive behavioural rehabilitation programmes conducted in group-based settings and about their long-term effects on subjects with chronic low back pain (CLBP). This randomized, parallel-group superiority-controlled trial aimed at evaluating the effect of such a programme on disability, kinesiophobia, catastrophizing, pain and quality of life in CLBP. METHODS: One hundred and fifty patients were randomly assigned to a 5-week group-based multidisciplinary programme of task-oriented exercises integrated with cognitive behavioural therapy mainly aimed at managing kinesiophobia (experimental group, 75 subjects) or group-based traditional exercises (control group, 75 subjects)...
April 2016: European Journal of Pain: EJP
Tamar Pincus, Shamaila Anwar, Lance M McCracken, Alison McGregor, Liz Graham, Michelle Collinson, John McBeth, Paul Watson, Stephen Morley, Juliet Henderson, Amanda J Farrin
BACKGROUND: Low Back Pain (LBP) remains a common and costly problem. Psychological obstacles to recovery have been identified, but psychological and behavioural interventions have produced only moderate improvements. Reviews of trials have suggested that the interventions lack clear theoretical basis, are often compromised by low dose, lack of fidelity, and delivery by non-experts. In addition, interventions do not directly target known risk mechanisms. We identified a theory driven intervention (Contexual Cognitive Behavioural Therapy, CCBT) that directly targets an evidence-based risk mechanism (avoidance and ensured dose and delivery were optimised...
2015: BMC Musculoskeletal Disorders
Mary O'Keeffe, Helen Purtill, Norelee Kennedy, Peter O'Sullivan, Wim Dankaerts, Aidan Tighe, Lars Allworthy, Louise Dolan, Norma Bargary, Kieran O'Sullivan
INTRODUCTION: Non-specific chronic low back pain (NSCLBP) is a very common and costly musculoskeletal disorder associated with a complex interplay of biopsychosocial factors. Cognitive functional therapy (CFT) represents a novel, patient-centred intervention which directly challenges pain-related behaviours in a cognitively integrated, functionally specific and graduated manner. CFT aims to target all biopsychosocial factors that are deemed to be barriers to recovery for an individual patient with NSCLBP...
June 1, 2015: BMJ Open
Charlotte Diana Nørregaard Rasmussen, Andreas Holtermann, Hans Bay, Karen Søgaard, Marie Birk Jørgensen
This study established the effectiveness of a workplace multifaceted intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) for low back pain (LBP). Between November 2012 and May 2014, we conducted a pragmatic stepped wedge cluster randomised controlled trial with 594 workers from eldercare workplaces (nursing homes and home care) randomised to 4 successive time periods, 3 months apart. The intervention lasted 12 weeks and consisted of 19 sessions in total (physical training [12 sessions], CBT [2 sessions], and participatory ergonomics [5 sessions])...
September 2015: Pain
Kerstin Luedtke, Alison Rushton, Christine Wright, Tim Jürgens, Astrid Polzer, Gerd Mueller, Arne May
OBJECTIVE: To evaluate the effectiveness of transcranial direct current stimulation alone and in combination with cognitive behavioural management in patients with non-specific chronic low back pain. DESIGN: Double blind parallel group randomised controlled trial with six months' follow-up conducted May 2011-March 2013. Participants, physiotherapists, assessors, and analyses were blinded to group allocation. SETTING: Interdisciplinary chronic pain centre...
2015: BMJ: British Medical Journal
J Brömme, M Mohokum, A C Disch, U Marnitz
BACKGROUND: Chronic low back pain (CLBP) is a major health problem in industrialized nations and is associated with very high total costs. These costs are split between direct costs brought about by the utilization of health care services and indirect costs due to back pain-related loss of productivity. Despite the existence of some evidence about the effectiveness of a multidisciplinary outpatient care programmes in Germany, the economic benefit of these programmes has not yet been studied in detail...
April 2015: Der Schmerz
Katherine Harman, Marsha MacRae, Michael Vallis
PURPOSE: There are reports of increased use of a variety of behaviour change techniques (BCT) by physiotherapists and findings of beneficial effects of use. However, there is a lack of physiotherapy-specific definitions of these techniques, as well as a sense of how physiotherapists use them in practice. Through this study, the authors created and field tested a preliminary nomenclature and description for BCT in patients with chronic non-specific low back pain (CNSLBP). METHODS: Items for the Physiotherapy Behaviour Change Technique (PT-BCT) checklist were derived from a nomenclature created for use in psychology and also from publications of studies using cognitive behaviour therapy-based approaches in physiotherapy...
2014: Physiotherapy Canada. Physiothérapie Canada
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