Cognitive-behavioral based physical therapy for patients with chronic pain undergoing lumbar spine surgery: a randomized controlled trial
Autor: | Kristin R, Archer, Clinton J, Devin, Susan W, Vanston, Tatsuki, Koyama, Sharon E, Phillips, Shannon L, Mathis, Steven Z, George, Matthew J, McGirt, Dan M, Spengler, Oran S, Aaronson, Joseph S, Cheng, Stephen T, Wegener |
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Jazyk: | angličtina |
Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Arthrodesis Article law.invention 03 medical and health sciences 0302 clinical medicine Lumbar Physical medicine and rehabilitation Randomized controlled trial law Activities of Daily Living medicine Humans 030212 general & internal medicine Brief Pain Inventory Health Education Physical Therapy Modalities Aged Pain Postoperative Lumbar Vertebrae Cognitive Behavioral Therapy business.industry Chronic pain Middle Aged medicine.disease Oswestry Disability Index Cognitive behavioral therapy Anesthesiology and Pain Medicine Neurology Physical therapy Female Spinal Diseases Neurology (clinical) Chronic Pain business Psychosocial 030217 neurology & neurosurgery |
Popis: | The purpose of this study was to determine the efficacy of a cognitive-behavioral–based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery. Perspective This study investigated a targeted cognitive-behavioral–based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes. |
Databáze: | OpenAIRE |
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