| Autor: |
Archer, Kristin R., Motzny, Nicole, Abraham, Christine M., Yaffe, Donna, Seebach, Caryn L., Devin, Clinton J., Spengler, Dan M., McGirt, Matthew J., Aaronson, Oran S., Cheng, Joseph S., Wegener, Stephen T. |
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| Zdroj: |
Physical Therapy; Aug2013, Vol. 93 Issue 8, p1130-1139, 10p, 3 Charts, 3 Graphs |
| Abstrakt: |
Background and Purpose. Fear of movement is a risk factor for poor post-operative outcomes in patients following spine surgery. The purposes of this case series were: (1) to describe the effects of a cognitive-behavioral–based physical therapy (CBPT) intervention in patients with high fear of movement following lumbar spine surgery and (2) to assess the feasibility of physical therapists delivering cognitive-behavioral techniques over the telephone. Case Description. Eight patients who underwent surgery for a lumbar degenerative condition completed the 6-session CBPT intervention. The intervention included empirically supported behavioral self-management, problem solving, and cognitive restructuring and relaxation strategies and was conducted in person and then weekly over the phone. Patient-reported outcomes of pain and disability were assessed at baseline (6 weeks after surgery), post-intervention (3 months after surgery), and at follow-up (6 months after surgery). Performance-based outcomes were tested at baseline and post-intervention. The outcome measures were the Brief Pain Inventory, Oswestry Disability Index, 5-Chair Stand Test, and 10-Meter Walk Test. Outcomes. Seven of the patients demonstrated a clinically significant reduction in pain, and all 8 of the patients had a clinically significant reduction in disability at 6-month follow-up. Improvement on the performance-based tests also was noted post-intervention, with 5 patients demonstrating clinically meaningful change on the 10-Meter Walk Test. Discussion. The findings suggest that physical therapists can feasibly implement cognitive-behavioral skills over the telephone and may positively affect outcomes after spine surgery. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the CBPT intervention. Clinical implications include broadening the availability of well-accepted cognitive-behavioral strategies by expanding implementation to physical therapists and through a telephone delivery model. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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