Chronic low-back pain: What does cognitive coping skills training add to operant behavioral treatment? Results of a randomized clinical trial.

Abstract

This study examined the supplemental value of a cognitive coping skills training when added to an operant-behavioral treatment for chronic low-back pain patients. The complete treatment package (OPCO) was compared with an operant program + group discussion (OPDI) and a waiting-list control (WLC). After the WL period, the WLC patients received a less protocolized operant program usually provided in Dutch rehabilitation centers (OPUS). Regression analyses showed that, compared with WLC, both OPCO and OPDI led to less negative affect, higher activity tolerance, less pain behavior, and higher pain coping and pain control. At posttreatment, OPCO led to better pain coping and pain control than OPDI. Calculation of improvement rates revealed that OPCO and OPDI had significantly more improved patients than OPUS on all the dependent variables. The discussion includes findings regarding treatment credibility, compliance, and contamination bias.

Lumbar spinal fusion patients’ demands to the primary health sector: evaluation of three rehabilitation protocols. A prospective randomized study

“…Hence, our findings suggest a significant effect from the incorporation of even a limited behavioral element. This comply with findings in chronic LBP patients treated conservatively [6,10,23,24]. On the other hand, a recent review of 12 RCTs by Guzman et al [8] concluded the existence of evidence for an intensive multidisciplinary rehabilitation but did not find evidence for a light multidisciplinary approach.…”

De angst voor bewegen: geleidelijke exposure in vivo bij chronische lagerugpijn

“…Uit onderzoek van Kole-Snijders et al (1999) blijkt dat de reguliere revalidatie, waarin principes uit de operante behandeling (Fordyce, 1976 ;Roberts, 1986) bij individuele chronische lagerugpijn-patie¨nten worden toegepast, niet leidt tot een afname van de variabelen angst, catastroferen en depressie. Na afloop van de reguliere revalidatie neemt de angst zelfs toe tot gemiddeld ver boven de klinische cut-off score.…”

“…Het revalidatieprogramma werd aangeboden op basis van de principes van operante behandeling. Dit bestond uit een geleidelijk activiteitenprogramma, relaxatie en groepseducatie over ergonomie (Fordyce, 1976, Kole-Snijders et al, 1999. De geleidelijke exposure en de het geleidelijk activiteitenprogramma werden gegeven door een fysiotherapeut en een gezondheidswetenschapper.…”

Development of Multi-Family Group and Mindfulness Treatment for Chronic Pain: Preliminary Outcomes

“…Behavioral and family education and support can reduce pain intensity, psychological distress, and utilization of health resources, as well as improve physical activity tolerance, marital satisfaction and pain behavior, coping and control [11][12][13]. Additionally, family-focused interventions providing education, practical skills, guidance and supportive resources have been shown to improve the outcomes for both patients and family members with psychiatric and related chronic conditions [14,15].…”

“…The provision of behavioral interventions coupled with family education and support [13] and coping skills [12] have been shown to improve outcomes such as negative effect, activity tolerance, pain behavior, pain coping and pain control. Preliminary evidence indicates that cognitive behavioral interventions for spouses of CP sufferers are effective in reducing pain intensity [17], psychological distress [12,17], utilization of health resources [18] and improved marital satisfaction [17]. Despite these promising findings, families have not been systematically engaged in the management of CP, especially in cases of chronic opioid therapy.…”