Article

Chronic low back pain (CLBP) remains prevalent in society, and conservative
treatment strategies appear to have little effect. It is proposed that patients
with CLBP may have altered cognition and increased fear, which impacts their
ability to move, perform exercise, and partake in activities of daily living.
Neuroscience education (NE) aims to change a patient's cognition regarding their
pain state, which may result in decreased fear, ultimately resulting in
confrontation of pain barriers and a resumption of normal activities. A
64-year-old female with history of CLBP was the patient for this case report. A
physical examination, the Numeric Pain Rating Scale (NPRS), Oswestry Disability
Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Zung Depression
Scale were assessed during her initial physical therapy visit, immediately after
her first physical therapy session, and at 7-month follow-up. Treatment consisted
of an abbreviated NE approach, exercises (range of motion, stretches, and
cardiovascular), and aquatic therapy. She attended twice a week for 4 weeks, or 8
visits total. Pre-NE, the patient reported NPRS = 9/10; ODI = 54%; FABQ-W =
25/42,; FABQ-PA = 20/24, and Zung = 58. Immediately following the 75-minute
evaluation and NE session, the patient reported improvement in all four outcome
measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to
1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE
aimed at decreasing fear associated with movement may be a valuable adjunct to
movement-based therapy, such as exercise, for patients with CLBP.

Langue : ANGLAIS