Long-term effects of rehabilitation and prevention of further chronification of pain among patients with non-specific low back pain

Abstract

BACKGROUND: Psychological factors influence the development and persistence of chronic low back pain (CLBP) and may impair the psychosocial rehabilitation success. OBJECTIVE: To examine the effects of a combined pain competence and depression prevention training compared to the pain competence training alone and as well as the patients’ stages of pain on the long-term psychosocial rehabilitation success. METHODS: In this controlled multicentre study with cluster-block randomization, patients with CLBP in different stages of pain (I–III) received either pain competence training (control group, CG; n= 255) or combined pain competence and depression prevention training (intervention group, IG; n= 271; per protocol). Depressive symptoms (primary outcome), anxiety, somatization, health status, and average pain intensity (secondary outcomes) were assessed up to 12 months of follow-up. Standardised questionnaires were used to record the outcomes, which were filled out by the patients themselves. Analyses after multiple imputation (N= 1225) were conducted to validate multi- and univariate analyses of variance. RESULTS: Patients in stage of pain I and II showed significant improvements in depressive symptoms, anxiety, mental health, and average pain intensity at the 12-month follow-up, irrespective from treatment condition. CONCLUSIONS: Multidisciplinary rehabilitation seems to be appropriate for patients with CLBP in stage of pain I and II. However, patients in stage of pain III need more psychological treatments to manage their mental comorbidities.

Approaching digital interventions for musculoskeletal rehabilitation

“…Aiming at enhancing musculoskeletal rehabilitation for patients with back and musculoskeletal pain complaints, the current issue of the Journal of Back and Musculoskeletal Rehabilitation (JBMR) combines articles that a) enhance the knowledge on the assessment and management of specific problems [1][2][3], b) evaluate treatment effects [4][5][6], and c) add new information evaluating the benefits of novel applications of biomedical technologies in therapeutic treatment [7][8][9]. In particular, the paper by Lee et al shows great potential and has thus been selected as the Editor's Choice for this issue and has been made freely available.…”

Total ergonomics approach to analyze work system and propose improvements for increasing worker productivity

“…Workers also complain about their muscle pain, because workers have to bend when placing and picking up paving pallets with a load of 45 kg to 108 kg for 8 hours of work. If the complaint is not handled properly, it can trigger musculoskeletal disorders in the long term [12]- [14]. Based on the problems that have been described, this research aims to carry out a work system assessment analysis using a total ergonomics approach and propose recommendations for doing improvements.…”