Cognitive functional approach to manage low back pain in male adolescent rowers: a randomised controlled trial

Abstract

Australian and New Zealand Clinical Trial Registry Number 12609000565246.

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

“…39 These brief intervention studies demonstrated re ductions in pain and disability, as well as improvements in back and lowerlimb endurance, while maintaining the ado lescents in their sport. 38,52 There was also evidence in 1 study of improvements in mental health, as measured by the Child Behaviour Checklist. 52 While we ac knowledge that these studies represent a narrow population, they provide a model for management that can be adapted to other atrisk groups.…”

“…This approach differs from more traditional physical therapy approaches 62 in that it explicitly explores and addresses multidimensional factors, such as painrelated beliefs, avoidance behaviors, and psychological distress, known to be important in disabling LBP presentations. 63 We have conducted 3 controlled clini cal trials 38,52,64 (2 were schoolbased in tervention studies) targeting adolescent rowers with LBP, broadly following the cognitive functional approach outlined below and based on successful manage ment of adults with LBP. 65 This group was chosen because it is known to be at risk for developing LBP.…”

“…This examination specifically focuses on painful, feared, and avoided activities. 38,44,65 Based on findings of the interview and examination, modifiable factors are identified and targeted under 3 broad areas. 38,44,65 Education Education via explanation and reflective questioning, as well as experiential learning to reinforce posi tive back pain beliefs, is central to the management of adolescent LBP.…”

“…38,44,65 Based on findings of the interview and examination, modifiable factors are identified and targeted under 3 broad areas. 38,44,65 Education Education via explanation and reflective questioning, as well as experiential learning to reinforce posi tive back pain beliefs, is central to the management of adolescent LBP. 44 This includes informing the patient that LBP doesn't mean the spine is damaged but, rather, reflects sensitization of spinal structures relating to various biopsycho social factors relevant to the individual, as identified in the interview and ex amination.…”

The Long-Term Effect of an Outpatient Intervention Program with a Behavioral Therapy Approach in Patients with Chronic Back or Neck Pain with a Focus on Psychosocial Aspects

“…Such programs appear to be helpful in the short or mid-term [4,5], but the results are usually not retained in the long term-i.e., over a period of 6 to 12 months [6,7]. As regards sustained effects, short-term programs with a behavioral therapy approach are not markedly superior to those without behavioral therapy approach even in patients with neck pain [8].…”