Multidisciplinary bio-psycho-social rehabilitation for chronic low-back pain

Guzman, Jaime; Esmail, Rosmin; Karjalainen, Kaija; Malmivaara, Antti; Irvin, Emma; Bombardier, Claire

doi:10.1002/14651858.cd000963.pub2

Cited by 80 publications

(81 citation statements)

References 57 publications

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“…Exercises are a central component in almost all multidisciplinary treatment programs for CBP patients [11,30]. In recent reviews on exercise therapy the specific value of aerobic exercises could not be evaluated since only a minority of the studies had specifically used aerobic exercises [1,14].…”

Section: Discussionmentioning

confidence: 99%

The impact of aerobic fitness on functioning in chronic back pain

Wormgoor¹,

Indahl²,

Tulder

et al. 2007

Eur Spine J

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Despite lack of convincing evidence that reduced aerobic fitness is associated with chronic back pain (CBP), exercise programs are regarded as being effective for persons with non-specific CBP. It is unsure whether gain in aerobic fitness following intervention is associated with functioning improvement in persons with CBP. The objective of this prospective cohort study was to study the impact of aerobic fitness on functioning in persons with CBP, at baseline and following 3-week intensive interdisciplinary intervention. This study included persons who had passed 8 weeks of sick-listing because of back pain (n = 94) and were referred to a 3-week intensive biopsychosocial rehabilitation program. Aerobic fitness was assessed with a sub-maximal bicycle test at baseline, at admission to and discharge from the rehabilitation program, and at 6 months follow-up. Contextual factors, body function, activity and participation were evaluated before and after intervention. In addition, working ability was recorded at 3-years followup. At baseline aerobic fitness was reduced in most subjects, but improved significantly following intervention. Baseline measurements and intervention effects did not differ among the diagnostic sub-groups. Neither contextual factors nor functioning at baseline were associated with aerobic fitness. Increase in aerobic fitness was not associated with improvements in functioning and contextual factors and work-return following intervention either. From this study we conclude that improvement of aerobic fitness seems of limited value as goal of treatment outcome for patients with CBP.

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Section: Discussionmentioning

confidence: 99%

The impact of aerobic fitness on functioning in chronic back pain

Wormgoor¹,

Indahl²,

Tulder

et al. 2007

Eur Spine J

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show abstract

“…Current biopsychosocial interventions designed to target psychosocial barriers to occupational re-integration are typically offered in the context of services available through multidisciplinary pain rehabilitation centers. Intervention disciplines involved in multidisciplinary pain rehabilitation might include medicine, physical therapy, occupational therapy, and psychology [9,13].…”

Section: Introductionmentioning

confidence: 99%

A telephonic intervention for promoting occupational re-integration in work-disabled individuals with musculoskeletal pain

Sullivan

Simon

2012

Behav. Med. Pract. Policy Res.

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The purpose of the present research was to examine the feasibility of a telephonic occupational rehabilitation program. A sample of 23 individuals with chronic musculoskeletal pain was enrolled in the telephonic version of the Progressive Goal Attainment Program (PGAP-Tel). The PGAP-Tel is a risk-targeted intervention designed to reduce pain-related disability consequent to musculoskeletal injury. Treatment outcomes of PGAP-Tel were compared to a group of individuals with chronic musculoskeletal pain, who participated in the face-to-face format of the PGAP. Results showed that PGAP-Tel was acceptable to the majority of participants (76%) to whom it was offered. There were indications that engagement and adherence issues were more problematic in PGAP-Tel than in the face-to-face intervention. Both groups showed comparable reductions in pain, depression, fear of symptom exacerbation, and self-reported disability. Participants in the face-to-face intervention showed greater reduction in catastrophic thinking than participants in PGAP-Tel. Finally, 26% of participants in PGAP-Tel had resumed some form of employment at treatment termination compared to 56% of the participants in the face-to-face intervention. Given the low cost of the PGAP-Tel intervention and the accessibility advantages of a telephonic delivery, this type of intervention might be an important resource for targeting occupational disability in rural or remote communities when face-to-face services are not available.

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“…The data are clear that for the most disabled and distressed chronic pain patients, only intensive, multidisciplinary intervention is sufficient to produce clinically meaningful improvements [29,30]. However, a 100-h, multidisciplinary pain management program is an expensive treatment as a lump sum, and funding for such programs would be beyond the scope of many injured workers who were faced with paying themselves.…”

Section: Case Studymentioning

confidence: 99%

Pain management in the context of workers compensation: a case study

Newton‐John¹,

McDonald²

2012

Behav. Med. Pract. Policy Res.

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The clinical management of chronic pain is a biopsychosocial challenge in itself; however, when the pain occurs in the context of workers compensation, there is even greater clinical complexity. A review of the literature shows that patients being treated for chronic pain under workers compensation are generally more distressed and have poorer outcomes both clinically and vocationally than non-compensated patients. A range of factors is identified to explain these differences, including operation of the system itself. However, a case study is presented involving a 49-yearold woman with chronic neck pain, whose clinical history illustrates how workers compensation can negatively influence outcomes, but where successful rehabilitation is also possible.

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Multidisciplinary bio-psycho-social rehabilitation for chronic low-back pain

Cited by 80 publications

References 57 publications

The impact of aerobic fitness on functioning in chronic back pain

The impact of aerobic fitness on functioning in chronic back pain

A telephonic intervention for promoting occupational re-integration in work-disabled individuals with musculoskeletal pain

Pain management in the context of workers compensation: a case study

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