Steve R. Woby, Neil K. Roach, Martin Urmston and Paul J. Watson
The objective of this study was to examine whether patients with chronic low back pain exhibit changes in cognitive factors following Interactive Behavioural Modification Therapy (IBMT), delivered by physiotherapists; and to examine the association between pre- to post-treatment changes in cognitive factors (cognitive processes) and pre- to post-treatment changes in pain, disability and depression. One hundred and thirty-seven patients with chronic low back pain underwent IBMT in a â€˜Work Back to Lifeâ€™ rehabilitation programme. Pre- to post-treatment changes in pain, disability and a range of cognitive factors. Patients demonstrated significant favourable changes for a range of cognitive factors. Furthermore, pre- to post-treatment changes in these cognitive factors explained an additional 22%, 17% and 15% of the variance in changes in pain, disability and depression, respectively, after controlling for other important factors.
Changes that emerge in cognitive factors are strongly related to treatment outcome within a physiotherapy treatment context. Specifically, reductions in fear of movement and catastrophising, and increases in functional self-efficacy appear to be particularly important. Modifying these cognitive factors should be seen as a priority when treating patients with chronic low back pain.
Physiotherapy, 2008, 94(2), 115-124