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Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

Publication ,  Journal Article
Archer, KR; Devin, CJ; Vanston, SW; Koyama, T; Phillips, SE; Mathis, SL; George, SZ; McGirt, MJ; Spengler, DM; Aaronson, OS; Cheng, JS; Wegener, ST
Published in: J Pain
January 2016

UNLABELLED: The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery. PERSPECTIVE: This study investigated a targeted cognitive-behavioral-based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes.

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Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

January 2016

Volume

17

Issue

1

Start / End Page

76 / 89

Location

United States

Related Subject Headings

  • Spinal Diseases
  • Physical Therapy Modalities
  • Pain, Postoperative
  • Middle Aged
  • Male
  • Lumbar Vertebrae
  • Humans
  • Health Education
  • Female
  • Cognitive Behavioral Therapy
 

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Archer, K. R., Devin, C. J., Vanston, S. W., Koyama, T., Phillips, S. E., Mathis, S. L., … Wegener, S. T. (2016). Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial. J Pain, 17(1), 76–89. https://doi.org/10.1016/j.jpain.2015.09.013
Archer, Kristin R., Clinton J. Devin, Susan W. Vanston, Tatsuki Koyama, Sharon E. Phillips, Shannon L. Mathis, Steven Z. George, et al. “Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.J Pain 17, no. 1 (January 2016): 76–89. https://doi.org/10.1016/j.jpain.2015.09.013.
Archer KR, Devin CJ, Vanston SW, Koyama T, Phillips SE, Mathis SL, et al. Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial. J Pain. 2016 Jan;17(1):76–89.
Archer, Kristin R., et al. “Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.J Pain, vol. 17, no. 1, Jan. 2016, pp. 76–89. Pubmed, doi:10.1016/j.jpain.2015.09.013.
Archer KR, Devin CJ, Vanston SW, Koyama T, Phillips SE, Mathis SL, George SZ, McGirt MJ, Spengler DM, Aaronson OS, Cheng JS, Wegener ST. Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial. J Pain. 2016 Jan;17(1):76–89.
Journal cover image

Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

January 2016

Volume

17

Issue

1

Start / End Page

76 / 89

Location

United States

Related Subject Headings

  • Spinal Diseases
  • Physical Therapy Modalities
  • Pain, Postoperative
  • Middle Aged
  • Male
  • Lumbar Vertebrae
  • Humans
  • Health Education
  • Female
  • Cognitive Behavioral Therapy