Cognitive behavioural therapy and core stabilization exercise on pain-related disability and psychological status in patients with non-specific chronic low back pain
DOI:
https://doi.org/10.15584/ejcem.2020.3.6Keywords:
chronic low back pain, cognitive behavioural therapy, disability, exercises, patientAbstract
Introduction. Exercises have been shown to relieve symptoms in non-specific chronic low back pain (NSCLBP) patients.
Aim. This study compared the effects of cognitive behavioural therapy (CBT) and core stabilization exercises (CSE) on pain-related disability, psychological status and sleep disturbance in patients with NSCLBP.
Material and methods. This randomized controlled trial involved a total of thirty-seven (37) participants. They were randomly allotted into three groups [CBT (11), CSE (14) and control (12)]. The intervention was done once per week for duration of 60 minutes for the CBT group, 30 minutes for CSE group and 10 minutes for the control group twice per week for 8 consecutive weeks. Assessment of outcome was done at baseline, 4 weeks and 8 weeks. Data were analyzed using statistical package for social science version 25 at alpha level of less than 0.05.
Results. The results of this study showed that there was significant improvement in the level of pain-related disability (p= 0.001), level of anxiety (p =0.001), depression (p = 0.01, p = 0.001, p =0.001) and sleep disturbance (p = 0.001) in all the groups (CBT, CSE, control) post treatment.
Conclusion. CBT and CSE are both effective in the treatment of pain-related disability, sleep disturbance, and psychological status of NSCLBP patients.
Downloads
References
Penstri P, Janwantanakul P. Effectiveness of brief education combined with home-based exercise programme on pain and disability of office workers with chronic low back pain: A pilot study. JPTS. 2012;24:217–222.
Bello AI, Quartey J, Lartey M. Efficacy of Behavioural Graded Activity compared with Conventional Exercise Therapy in Chronic Non-Specific Low Back Pain: Implication for Direct Health Care Cost. Ghana Med J. 2015;49(3):173–180.
Huijnen IP, Verbunt JA, Peters ML. Differences in activity-related behaviour among patients with chronic low back pain. Eur J Pain. 2011;15:748–755.
Yamamoto M, Sasaki N, Somemura H, Nakamura S, KaneitaY, Uchiyama M. Efficacy of sleep education program based on principles of cognitive behavioral therapy to alleviate workers’ distress. Sleep and Biological Rhythms. 2015;14(10):1007.
Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist. 2014;69(2):153–166.
Bhadauria EA, Gurudut P. Comparative effectiveness of lumbar stabilization, dynamic strengthening, and Pilates on chronic low back pain: randomized clinical trial. J Exerc Rehabil. 2017;13(4):477-485.
Odebiyi DO, Akinpelu OA, Alonge TO, and Adegoke BOA. Back School: The Development of a Nigerian Urban Model. Nig Qt J Hosp Med. 2009;19:3.
Ayanniyi O, Ige OG. Back care education on peasant farmers suffering from chronic mechanical low back pain. J Exp and Integr Med. 2015;5(4):215-221.
Akodu AK, Akindutire OM. The effect of stabilization exercise on pain-related disability, sleep disturbance and psychological status of patients with non-specific chronic low back pain. Korean J Pain. 2018;31(3):199-205.
Cherkin D, Sherman K, Balderson B, Cook A, Anderson M, Hawkes R. Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioural Therapy or Usual Care on Back Pain and Functional Limitations in Adults with Chronic Low Back Pain. JAMA. 2016;315(12):1240.
Magalhães MO, Comachio J, Ferreira PH, Pappas E, Marques AP. Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial. BJPT. 2018;22(1):82–91.
Wang H. and Chow SC. Sample Size Calculation for Comparing Proportions 2007. Wiley Encyclopedia of Clinical Trials.
Balague F, Mannion AF, Pellise F. Non-specific Low Back Pain. Lancet. 2012; 379:482-491.
Crum RM, Anthony JC, Bassett SS, Folstein MF. Population-based norms for the mini- mental state examination by age and educational level. JAMA. 1993;269(18):2386-2391.
Reddy RS, Alahmari KA. Effect of Lower Extremity Stretching Exercises on Balance in Geriatric Population. Int J Health. 2016;10(3):389-395.
Suh JH, Kim H, Jung GP, Ko JY, Ryu JS. The effect of lumbar stabilization and walking exercises on chronic low back pain. Med. 2019;98(26):16173.
Bagheri R, Parhampour B, Pourahmadi MR, Fazeli SH, Takamjani IE, Akbari M. The Effect of Core Stabilization Exercises on Trunk-Pelvis Three-Dimensional Kinematics during Gait in Non-Specific Chronic Low Back Pain. Spine. 2019;44(13):927-936.
Sumaila FG and Sokunbi GO. Effect of core stability and treadmill walk exercises on the functional status of postlumbar - Surgical patients with low back pain: A pilot study. NJECB. 2019;7(1):23-29.
Jalali ZM, Farghadani A, Ejlali-Vardoogh M. Effect of Cognitive-Behavioral Training on Pain Self-Efficacy, Self-Discovery, and Perception in Patients with Chronic Low-Back Pain: A Quasi-Experimental Study. Anesth Pain Med. 2019;9(2):78905.
Kim EH, Crouch TB, Olatunji BO. Adaptation of behavioral activation in the treatment of chronic pain. Psychother. 2017;54:237-244.
Hajihasani A, Rouhani M, Salavati M, Hedayati R, Kahlaee AH. The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review. PMR. 2019;11(2):167-176.
O'Keeffe M, O'Sullivan P, Purtill H, Bargary N, O'Sullivan K. Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT). Br J Sports Med. 2019;10:1136.
Van Ryckeghem DM, De Houwer J, Van Bockstaele B, et al. Implicit associations between pain and self-schema in patients with chronic pain. Pain. 2013;154(12):2700-2706.
Devan H, Hale L, Hempel D, Saipe B, Perry MA. What Works and Does Not Work in a Self-Management Intervention for People with Chronic Pain? Qualitative Systematic Review and Meta-Synthesis. Phys Ther. 2018;98(5):381-397.
Paolucci T, Attanasi C, CecchiniW, MarazziA, Capobianco SV, Santilli V. Chronic lowback pain and postural rehabilitation exercise: a literature review. J Pain Res. 2018;12:95–107.
Garcia AN, Costa L, da Silva TM, Gondo FL, Cyrillo FN, Costa RA. Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Phys Ther. 2013;93(6):729-747.
Járomi M, KuklaA, Szilágyi B, Simon-UgronÁ, Bobály VK, Makai A. Back School programme for nurseshas reduced lowback pain levels: a randomized controlled trial. J Clin Nurs. 2018;27:895-902.
Balasubramaniam A, Bharathi M. Effect of motor control exercises on psychological variables in chronic low back pain in computer professionals. IJPBS. 2016;7:490-494.
Santoft F, Axelsson E, Öst LG, Hedman-Lagerlöf M, Fust J, Hedman-Lagerlöf E. Cognitive behaviour therapy for depression in primary care: systematic review and meta- analysis. Psychol Med. 2019;49(8):1266-1274.
Wenzel A, Brown GK, Karlin BE. Cognitive Behavioral Therapy for Depression in Veterans and Military Service members: Therapist Manual. Washington, 2011, DC: U.S. Department of Veterans Affairs.
Schuh-Hofer S, Wodarski R, Pfau DB, Caspani O, Mager lW, Kennedy JD. One night of total sleep deprivation promotes a state of generalized hyperalgesia: a surrogate pain model to study the relationship of insomnia and pain. Pain. 2013;154:1613-1621.
Batterham PJ, Glozier N, Christensen H, Aust NZ. Sleep disturbance, personality and the onset of depression and anxiety: prospective cohort study. Psychiatry. 2012;46(11):1089-1098.
Lee HJ, Choi EJ, Nahm FS, Yoon IY, Lee PB. Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases. Korean J Pain. 2018;31(2):116-124.
Finan PH, Buenaver LF, Coryell VT, Smith MT. Cognitive-Behavioral Therapy for Comorbid Insomnia and Chronic Pain. Sleep Med Clinics. 2014;9(2):261-274.
Murphy J, McKellar J, Raffa S, Clark M, Kerns R and Karlin B. Cognitive Behavioural Therapy for Chronic Pain among veterans: Therapist Manual. Washington, 2016, DC: U.S. Department of Veterans Affairs.
Kumar S, Beaton K, Hughes T. The effectiveness of massage therapy for the treatment of nonspecific low back pain. A systematic review of systematic review. Int J Gen Med. 2013;6:733-741.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 European Journal of Clinical and Experimental Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
