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Cognitive treatment of illness perceptions in patients with chronic low back pain

Illness perceptions have been shown to predict patient activities.
Therefore, studies of the effectiveness of a targeted illness-perception
intervention on chronic nonspecific low back pain (CLBP) are needed.
The purpose of this study was to compare the effectiveness of treatment of
illness perceptions against a waiting list for patients with CLBP. DESIGN: This
was a prospectively registered randomized controlled trial with an assessor
blinded for group allocation. SETTING: The study was conducted in an outpatient
rehabilitation clinic. PARTICIPANTS: The participants were 156 patients (18-70
years of age) with CLBP (>3 months). INTERVENTION: Patients were randomly
assigned to either a treatment group or to a waiting list (control) group.
Trained physical therapists and occupational therapists delivered 10 to 14
one-hour treatment sessions according to the treatment protocol. MEASUREMENTS:
The primary outcome measure was change in patient-relevant physical activities
(patient-specific complaints questionnaire). The secondary outcome measures were
changes in illness perceptions (illness perceptions questionnaire) and generic
physical activity level (quebec back pain disability scale). Measurements were
taken at baseline (0 weeks) and after treatment (18 weeks). RESULTS: A
baseline-adjusted analysis of covariance showed that there were statistically
significant differences between intervention and control groups at 18 weeks for
the change in patient-relevant physical activities.
This was a clinically
relevant change (19.1 mm) for the intervention group. Statistically significant
differences were found for the majority of illness perception scales. There were
no significant differences in generic physical activity levels. LIMITATIONS:
Longer-term effectiveness was not studied.
CONCLUSIONS: This first trial
evaluating cognitive treatment of illness perceptions concerning CLBP showed
statistically significant and clinically relevant improvements in
patient-relevant physical activities at 18 weeks.

Langue : ANGLAIS

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