A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work‐related activities

Linton, Steven J.; Boersma, Katja; Jansson, Markus; Overmeer, Thomas; Lindblom, Karin; Vlaeyen, Johan W.S.

doi:10.1016/j.ejpain.2007.11.001

Cited by 135 publications

(91 citation statements)

References 31 publications

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“…Further, it is acknowledged that NSCLBP is a multifactorial biopsychosocial disorder, where numerous factors other than posture and movement patterns must be considered (McCarthy et al 2004, Linton et al 2007). …”

Section: Limitationsmentioning

confidence: 99%

“…Low back pain (LBP) is a very common and costly disorder that should be considered within a biopsychosocial framework (Maniadakis and Gray 2000, O'Sullivan 2005, Hansson et al 2006, Linton et al 2007. Most LBP lacks a specific radiological diagnosis and has been termed non-specific chronic low back pain (NSCLBP) (Borkan et al 2002, Dankaerts et al 2006a.…”

Section: Introductionmentioning

confidence: 99%

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The between-day and inter-rater reliability of a novel wireless system to analyse lumbar spine posture

et al. 2010

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Peter(2011) 'The between-day and inter-rater reliability of a novel wireless system to analyse lumbar spine posture ', Ergonomics, 54: 1,[82][83][84][85][86][87][88][89][90] To link to this Article: DOI: 10.1080/00140139.2010.535020 URL: http://dx.doi.org/10.1080/00140139.2010.535020Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.The between-day and inter-rater reliability of a novel wireless system to analyse lumbar spine posture Lumbar posture is commonly assessed in non-specific chronic low back pain (NSCLBP), although quantitative measures have mostly been limited to laboratory environments. The BodyGuard TM is a spinal position monitoring device that can monitor posture in real time, both inside and outside the laboratory. The reliability of this wireless device was examined in 18 healthy participants during usual sitting and forward bending, two tasks that are commonly provocative in NSCLBP. Reliability was determined using intraclass correlation coefficients (ICC), the standard error of measurement (SEM), the mean difference and the minimal detectable change (MDC90). Betweenday ICC values ranged from 0.84 to 0.87, with small SEM (5%), mean difference (59%) and MDC90 (514%) values. Inter-rater ICC values ranged from 0.91 to 0.94, with small SEM (4%), mean difference (6%) and MDC90 (9%) values. Between-day and inter-rater reliability are essential requirements for clinical utility and were excellent in this study. Further studies into the validity of this device and its application in clinical trials in occupational settings are required. Statement of Relevance:A novel device that can analyse spinal posture exposure in occupational settings in a minimally invasive manner has been developed. This study established that the device has excellent between-day and inter-rater reliability in healthy pain-free subjects. Further studies in people with low back pain are planned.

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Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The between-day and inter-rater reliability of a novel wireless system to analyse lumbar spine posture

et al. 2010

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“…2,12,14,44,46,52 Furthermore, effective FAM treatment strategies have been reported, including patient education, 3,5 graded exercise, 13,36 and graded exposure. 6,20,21,37,58,59 While portions of the FAM are well supported in the literature, there are unresolved questions and issues affecting its application in clinical settings. …”

mentioning

confidence: 99%

“…6,20,21,37,58,59 While portions of the FAM are well supported in the literature, there are unresolved questions and issues affecting its application in clinical settings. 33 One unresolved issue is related to measurement of FAM constructs in outpatient physical therapy settings, which is the focus of this particular study.…”

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confidence: 99%

A Psychometric Investigation of Fear-Avoidance Model Measures in Patients With Chronic Low Back Pain

George¹,

Valencia²,

Beneciuk³

2010

Journal of Orthopaedic & Sports Physical Therapy

157

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t he fear-avoidance model of musculoskeletal pain (FAM) has been highlighted as a psychological model of potential importance for rehabilitation. 33 The FAM proposes that during a musculoskeletal pain episode, anxiety, pain-related fear, and pain catastrophizing interact to determine whether an individual will resume normal activities (low psychological distress) or will avoid normal activities due to anticipation of increased pain and/or reinjury (high psychological distress). 33,35,60 The FAM suggests that high psychological distress will be associated with poor clinical outcomes, potentially resulting in depressive symptoms, elevated pain intensity, greater physical impairments, and continued disability. 33,35,60 Evidence supporting validity of the FAM can be found in the clinical studies of low back pain (LBP). Longitudinal studies have indicated that elevated FAM measures were predictive of poor outcomes for individuals with LBP. 2,12,14,44,46,52 Furthermore, effective FAM treatment strategies have been reported, including patient education, 3,5 graded exercise, 13,36 and graded exposure. 6,20,21,37,58,59 While portions of the FAM are well supported in the literature, there are unresolved questions and issues affecting its application in clinical settings. 33One unresolved issue is related to measurement of FAM constructs in outpatient physical therapy settings, which is the focus of this particular study. The FAM is associated with multiple psychological constructs, and there are several available measurement tools. Examples include the Fear-Avoidance Beliefs Questionnaire (FABQ), 61 Fear of Pain Questionnaire (FPQ), 40 Tampa �ca-Tampa �ca-le for Kinesiophobia (T�K), 64 and Pain Catastrophizing �cale (PC�). 49 Typically, psychometric studies incorporate 1 or 2 t sTuDY DesiGn: Validity and test-retest reliability of questionnaires related to the fear-avoidance model (FAM).t oBJeCTiVe: To investigate test-retest reliability, construct redundancy, and criterion validity for 4 commonly used FAM measures.t BaCkGrounD: Few studies have reported psychometric properties for more than 2 FAM measures within the same cohort, making it difficult to determine which specific measures should be implemented in outpatient physical therapy settings.t MeTHoDs: Fifty-three consecutive patients (mean age, 44.3  18.5 years) with chronic low back pain participated in this study. Data were collected with validated measures for FAM constructs, including the Fear-Avoidance Beliefs Questionnaire (FABQ), Fear of Pain Questionnaire (FPQ), Tampa Scale for Kinesiophobia, and Pain Catastrophizing Scale. Validated measures were used to investigate criterion validity of the FAM measures, including the Patient Health Questionnaire for depression, the numerical rating scale for pain intensity, the Physical Impairment Scale for physical impairment, and the Oswestry Disability Questionnaire for self-report of disability. Test-retest reliability of the FAM measures was determined with intraclass correlation coefficients (ICC 2,1 ) for total ...

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“…Graded exposure in vivo is a new, specific, cognitive-behavioural treatment that is especially tailored to patients with high levels of pain-related fear. Overall exposure has moderate effects on function, fear and pain intensity and should go in parallel with physical therapy (Linton, 2008). On this basis we exploited the exposure and included work situations with specific movements.…”

Section: Discussionmentioning

confidence: 99%

Return to Work and Painkiller Medication after Rehabilitation for Subacute Back Conditions—A 2-Year Follow-Up

Gison¹,

Bruti²,

Dall’Armi³

et al. 2013

AASoci

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The study was aimed at evaluating the outcome after 2 years in a population of outpatients suffering from Low Back Pain (LBP) who were treated with a multi-disciplinary approach. The end-points were: 1) the rate of return to work (RTW); 2) the frequency of painkiller medication; 3) the frequency of unavoidable surgical operation; 4) the rate of relapses. Eighty consecutive subjects (75% women) were enrolled. They were referred by general physicians and completed the rehabilitation program at our centre. We followed an open, prospective design. The main results were: RTW: 92.5% positive cases; 7.5% failure. Job cohort settlement: 93.1% the same; 6.9% change. Time interval between discharge and RTW: 76.8% few days after discharge. Painkillers: At follow-up 46 participants (57.5%) could stop the medication. Surgical operations: At admission 39 participants presented with lumbar root involvement (48.7%). Only 4 of them had a surgical intervention (10.2%). In a third of cases of the all sample relapses did not occur. In conclusion, a multi-disciplinary model of intervention led to a high rate of RTW, a reduction of painkiller medication, a low rate of surgical interventions and of relapses as well. Further controlled studies are warranted for assessing the cost/benefit ratio. The clear prevalence of LBP in women recommends measures of preventing Medicine.

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A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work‐related activities

Cited by 135 publications

References 31 publications

The between-day and inter-rater reliability of a novel wireless system to analyse lumbar spine posture

The between-day and inter-rater reliability of a novel wireless system to analyse lumbar spine posture

A Psychometric Investigation of Fear-Avoidance Model Measures in Patients With Chronic Low Back Pain

Return to Work and Painkiller Medication after Rehabilitation for Subacute Back Conditions—A 2-Year Follow-Up

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