PMID- 20506027
OWN - NLM
STAT- MEDLINE
DCOM- 20110104
LR  - 20220330
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Print)
IS  - 0940-6719 (Linking)
VI  - 19
IP  - 9
DP  - 2010 Sep
TI  - Daily functioning and self-management in patients with chronic low back pain 
      after an intensive cognitive behavioral programme for pain management.
PG  - 1517-26
LID - 10.1007/s00586-010-1435-5 [doi]
AB  - Chronic low back pain (CLBP) is associated with persistent or recurrent 
      disability which results in high costs for society. Cognitive behavioral 
      treatments produce clinically relevant benefits for patients with CLBP. 
      Nevertheless, no clear evidence for the most appropriate intervention is yet 
      available. The purpose of this study is to evaluate the mid-term effects of 
      treatment in a cohort of patients with CLBP participating in an intensive pain 
      management programme. The programme provided by RealHealth-Netherlands is based 
      on cognitive behavioral principles and executed in collaboration with orthopedic 
      surgeons. Main outcome parameters were daily functioning (Roland and Morris 
      Disability Questionnaire and Oswestry Disability Questionnaire), self-efficacy 
      (Pain Self-Efficacy Questionnaire) and quality of life (Short Form 36 Physical 
      Component Score). All parameters were measured at baseline, last day of 
      residential programme and at 1 and 12 months follow-up. Repeated measures 
      analysis was applied to examine changes over time. Clinical relevance was 
      examined using minimal clinical important differences (MCID) estimates for main 
      outcomes. To compare results with literature effect sizes (Cohen's d) and 
      Standardized Morbidity Ratios (SMR) were determined. 107 patients with CLBP 
      participated in this programme. Mean scores on outcome measures showed a similar 
      pattern: improvement after residential programme and maintenance of results over 
      time. Effect sizes were 0.9 for functioning, 0.8 for self-efficacy and 1.3 for 
      physical functioning related quality of life. Clinical relevancy: 79% reached 
      MCID on functioning, 53% on self-efficacy and 80% on quality of life. Study 
      results on functioning were found to be 36% better and 2% worse when related to 
      previous research on, respectively, rehabilitation programmes and spinal surgery 
      for similar conditions (SMR 136 and 98%, respectively). The participants of this 
      evidence-based programme learned to manage CLBP, improved in daily functioning 
      and quality of life. The study results are meaningful and comparable with results 
      of spinal surgery and even better than results from less intensive rehabilitation 
      programmes.
FAU - van Hooff, Miranda L
AU  - van Hooff ML
AD  - Department Research Development and Education, Sint Maartenskliniek, PO Box 9011, 
      6500 GM Nijmegen, The Netherlands. m.vanhooff@maartenskliniek.nl
FAU - van der Merwe, Johannes D
AU  - van der Merwe JD
FAU - O'Dowd, John
AU  - O'Dowd J
FAU - Pavlov, Paul W
AU  - Pavlov PW
FAU - Spruit, Maarten
AU  - Spruit M
FAU - de Kleuver, Marinus
AU  - de Kleuver M
FAU - van Limbeek, Jacques
AU  - van Limbeek J
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20100527
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Adult
MH  - Chronic Disease
MH  - Cognitive Behavioral Therapy/*methods
MH  - Cohort Studies
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Low Back Pain/*rehabilitation
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods
MH  - Quality of Life
MH  - *Recovery of Function
MH  - Self Care/*methods
MH  - Surveys and Questionnaires
MH  - Young Adult
PMC - PMC2989287
EDAT- 2010/05/28 06:00
MHDA- 2011/01/05 06:00
PMCR- 2010/05/27
CRDT- 2010/05/28 06:00
PHST- 2009/10/01 00:00 [received]
PHST- 2010/05/02 00:00 [accepted]
PHST- 2010/02/23 00:00 [revised]
PHST- 2010/05/28 06:00 [entrez]
PHST- 2010/05/28 06:00 [pubmed]
PHST- 2011/01/05 06:00 [medline]
PHST- 2010/05/27 00:00 [pmc-release]
AID - 1435 [pii]
AID - 10.1007/s00586-010-1435-5 [doi]
PST - ppublish
SO  - Eur Spine J. 2010 Sep;19(9):1517-26. doi: 10.1007/s00586-010-1435-5. Epub 2010 
      May 27.