Article

Current approaches to the management of chronic nonspecific low back
pain (CNSLBP) have shown limited effectiveness. It appears that disruption of
cortical structure and function is a feature of CNSLBP and that these changes may
contribute to current treatment failures. Sensorimotor retraining approaches have
been shown to be effective in the management of other long-standing pain problems
that are characterized by cortical dysfunction. Similar treatments may be an
option for people with CNSLBP. The objectives of this study were to
describe the effects of participation in a graded sensorimotor retraining program
on pain intensity, interference of pain with daily life (pain interference), and
self-reported disability and to evaluate the safety of the program. DESIGN: A
multiple-baseline, replicated, single-case design was used for this study.
METHODS: Three people with disabling CNSLBP were assessed weekly during a
no-treatment baseline period. Each person then participated in a graded
sensorimotor retraining program for a minimum of 10 weeks, during which clinical
status was assessed weekly. Data collection continued weekly for 1 month after
the end of formal treatment. RESULTS: Pain intensity, pain interference, and
disability all were reduced, and the improvements were maintained throughout the
follow-up period. No adverse reactions to treatment were reported. LIMITATIONS:
The findings are preliminary and were based on a single-case design. The observed
improvements in clinical status may have been attributable to the effects of
factors other than treatment, such as the effect of time and other, nonspecific
effects. CONCLUSIONS: Positive outcomes were reported for 3 participants with
CNSLBP after the completion of a graded sensorimotor retraining program. However,
the findings are only preliminary and require replication with more-robust study designs.

Langue : ANGLAIS