Are changes in fear‐avoidance beliefs, catastrophizing, and appraisals of control, predictive of changes in chronic low back pain and disability?

European Journal of Pain - Tập 8 Số 3 - Trang 201-210 - 2004
Steve Woby1,2, P. J. Watson3, Neil K. Roach4, Martin Urmston2
1Centre for Biophysical and Clinical Research into Human Movement, Department of Exercise and Sport Science, Manchester Metropolitan University, Alsager Campus, Hassall Road, Alsager, Stoke‐on‐Trent ST7 2HL, UK
2Department of Physiotherapy, North Manchester General Hospital, Manchester M8 5RB, UK
3University Department of Anaesthesia, Critical Care and Pain Management, Leicester General Hospital, Leicester LE5 4PW, UK
4Department of Exercise and Sport Science, Manchester Metropolitan University, ST7 2HL, UK

Tóm tắt

Abstract

Interventions for chronic low back pain (CLBP) often attempt to modify patients' levels of catastrophizing, their fear‐avoidance beliefs, and their appraisals of control. Presumably, these interventions are based on the notion that changes in these cognitive factors are related to changes in measures of adjustment. The aim of the present study was to explore whether changes on these cognitive factors were related to changes in CLBP and disability. Fifty‐four CLBP patients completed a series of self‐report measures prior to beginning a cognitive‐behavioral based intervention and again upon discharge. Change scores (post‐treatment scoreminuspre‐treatment score) were calculated for each of the self‐report measures. The study found that changes in the cognitive factors were not significantly associated with changes in pain intensity. In contrast, reductions in fear‐avoidance beliefs about work and physical activity, as well as increased perceptions of control over pain were uniquely related to reductions in disability, even after controlling for reductions in pain intensity, age and sex. The final model explained 71% of the variance in reductions in disability.

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WobySR WatsonPJ RoachNK UrmstonM.Adjustment to chronic low back pain—the relative influence of fear‐avoidance beliefs catastrophizing and appraisals of control.Behav Res Ther2003{in press}.

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Thông tin xuất bản

European Journal of Pain

Tập 8 Số 3

201-210

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