Biopsychosocial primary care versus physiotherapy as usual in chronic low back pain: results of a pilot-randomised controlled trial

Erp, R.M.A. van; Huijnen, Ivan P.J.; Ambergen, A.W.; Verbunt, Jeanine; Smeets, Rob

doi:10.1080/21679169.2019.1630855

Cited by 8 publications

(27 citation statements)

References 32 publications

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“…Based on the results from the PEDro scale data, almost all studies were judged to be at low risk of bias for most of the items. Two studies were considered at high evidence level (level I) [ 21 , 23 ], nine studies at evidence level II [ 11 , 12 , 13 , 15 , 16 , 17 , 19 , 20 , 22 ] and two (one of which has a quasi-experimental design) with a low level of evidence [ 14 , 15 ].…”

Section: Resultsmentioning

confidence: 99%

Pain Education in the Management of Patients with Chronic Low Back Pain: A Systematic Review

Ferlito

Blatti

Lucenti

et al. 2022

JFMK

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New prospective of chronic low back pain (CLBP) management based on the biopsychosocial model suggests the use of pain education, or neurophysiological pain education, to modify erroneous conceptions of disease and pain, often influenced by fear, anxiety and negative attitudes. The aim of the study is to highlight the evidence on the outcomes of a pain education-oriented approach for the management of CLBP. The search was conducted on the Pubmed, Scopus, Pedro and Cochrane Library databases, leading to 2673 results until September 2021. In total, 13 articles published in the last 10 years were selected as eligible. A total of 6 out of 13 studies support a significant reduction in symptoms in the medium term. Disability is investigated in only 11 of the selected studies, but 7 studies support a clear reduction in the medium-term disability index. It is difficult to assess the effectiveness of the treatments of pain education in patients affected by CLBP, due to the multimodality and heterogeneity of the treatments administered to the experimental group. In general, methods based on pain education or on cognitive-behavioral approaches, in association with physical therapy, appear to be superior to physiotherapeutic interventions alone in the medium term.

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Section: Resultsmentioning

confidence: 99%

Pain Education in the Management of Patients with Chronic Low Back Pain: A Systematic Review

Ferlito

Blatti

Lucenti

et al. 2022

JFMK

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“…Four trials compared cognitive-behavioral-based physical therapy to standardized exercise, 10 , 40 , 76 , 77 whereas 5 trials compared to a multimodal (eg, manual therapy and exercise) or pragmatic rehabilitation program. 44 , 61 , 72 , 81 , 82 …”

Section: Resultsmentioning

confidence: 99%

“…Five trials reported no difference between the cognitive-behavioral-based physical therapy group compared to control. 40 , 44 , 61 , 72 , 81 Of these 5 trials, 4 trials included a control group of multimodal or pragmatic rehabilitation, 44 , 61 , 72 , 81 whereas the remaining trial was a small pilot study. 40 In the small pilot study of 20 patients, Hunt et al 40 established the feasibility of a pain-coping skills training program that was later tested in a larger randomized trial.…”

Section: Resultsmentioning

confidence: 99%

Psychologically informed physical therapy for musculoskeletal pain: current approaches, implications, and future directions from recent randomized trials

Coronado

Brintz

McKernan

et al. 2020

PR9

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Supplemental Digital Content is Available in the Text. Randomized trials have examined the efficacy of psychologically informed physical therapy methods including graded activity or graded exposure, cognitive-behavioral-based physical therapy, acceptance and commitment-based physical therapy, and internet-based psychological programs compared to traditional physical therapy approaches for musculoskeletal pain. Summary findings suggest that psychologically informed physical therapy is a promising care model; however, more convincing evidence is needed to support widespread adoption, especially in light of clinician training demands.

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“…Eventually, 18 RCTs (21 articles) met eligibility criteria and were included in the systematic review. [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]…”

Section: Study Inclusionmentioning

confidence: 99%

The effectiveness of low‐dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: A systematic review with meta‐analysis

Hochheim

Ramm²,

Amelung

2023

Pain Practice

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To evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus active physical interventions on pain intensity and disability in adults with nonspecific chronic low back pain. Introduction: Research has shown that primary care biopsychosocial interventions (PCBI) can reduce pain intensity and disability. While scattered studies support low-dosed (≤ 15 treatment hours) PCBI, no systematic review exists comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP).Inclusion Criteria: Randomized controlled trials that evaluate low-dosed PCBI compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older), who suffer from CLBP were included. Not recommended interventions that feature only passive therapies, spinal surgery or pharmacological treatment, and studies with inpatient multidisciplinary-based rehabilitation (MBR) were excluded. Methods: Databases were searched from inception to December 31, 2021. Language was restricted to English or German. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" were used. Sources were CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science. Search was finished on March 08, 2022. Data appraisal, extraction and synthesis followed JBI guidance for systematic reviews of effectiveness. Risk of Bias was assessed using JBI 13-item checklist for randomized controlled trials. The GRADE approach for grading the certainty of evidence was followed. Systematic Review Registration Number: PROSPERO 2022 CRD42022302771. Results: Eighteen RCTs were found eligible and 15 trials comprising a total of 1531 participants suffering from CLBP were entered in the meta-analyses. Risk of Bias was low. Overall evidence was moderate. Significant effects in favor of PCBI were found for pain intensity post-treatment (standardized mean difference (SMD) = −1.09, 95% confidence interval (CI) = −1.84 to −0.34, I 2 = 97%, p = 0.004) as well as at short-term (SMD = −0.23, 95% CI = −0.39 to −0.08, I 2 = 0%, p = 0.004), long term (SMD = −0.79, 95% CI = −1.42 to −0.17, I 2 = 96%, p = 0.01) and very long-term (SMD = −1.13, 95% CI = −1.93 to −0.33, I 2 = 94%, p = 0.005) follow-up. Significant effects in favor of PCBI for physical function were found post-treatment (SMD = −1.33, 95% CI = −2.17 to −0.49, I 2 = 97%, p = 0.002) atThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Biopsychosocial primary care versus physiotherapy as usual in chronic low back pain: results of a pilot-randomised controlled trial

Abstract: Biopsychosocial primary care versus physiotherapy as usual in chronic low back pain: results of a pilot-randomised controlled trial, European Journal of Physiotherapy,

Cited by 8 publications

References 32 publications

Pain Education in the Management of Patients with Chronic Low Back Pain: A Systematic Review

Pain Education in the Management of Patients with Chronic Low Back Pain: A Systematic Review

Psychologically informed physical therapy for musculoskeletal pain: current approaches, implications, and future directions from recent randomized trials

The effectiveness of low‐dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: A systematic review with meta‐analysis

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