Multidisciplinary biopsychosocial rehabilitation for chronic low back pain

Kamper, Steven J.; Apeldoorn, Adri T.; Chiarotto, Alessandro; Smeets, Rob; Ostelo, Raymond; Guzman, Jaime; Tulder, Maurits W. van

doi:10.1002/14651858.cd000963.pub3

Cited by 458 publications

(509 citation statements)

References 193 publications

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“…With small to medium sized effects, many patients will not benefit as intended [28]. The current state of evidence, provides little support as to identify those circumstances in which patients with CP or FSS will likely have the best experiences and outcomes from which (computer-based) bio-psychosocial or alternative treatments, and why [16,18,66,67]. In this regard, present findings point towards potential positive effects when (mindfulness-based) serious gaming is presented later on in a rehabilitation process to patients with chronic back pain and comorbid psychosocial problems.…”

Section: Suggestions For Research and Practicementioning

confidence: 99%

“…Intensive multidisciplinary rehabilitation programs are indicated if locally accessible and (unimodal) conservative medication, minimal self-guided intervention, physical and/or psychological therapy do not suffice [10,18,19]. Ideally, treatment plans are tailored to (unique) individual symptom patterns through interdisciplinary procedures [10].…”

Section: Existing Treatment Gapsmentioning

confidence: 99%

“…Behavioral interventions, typically cognitive behavioral therapy, have approximately equivalent effects when delivered via computer systems, but adherence can be disappointing [22]. Improvement is sought to the modest additional effects of multi-or interdisciplinary rehabilitation over other kinds of 'unimodal' treatments [10,18,23]. Moreover, evidence has grown for the efficacy of acceptance and mindfulness interventions, which became a common component of multi-or interdisciplinary rehabilitation [20].…”

Section: Existing Treatment Gapsmentioning

confidence: 99%

“…Change techniques integrated in the game play of LAKA (e.g. prompting practice, problem solving, and reducing negative emotions) may be commonly included in regular rehabilitation protocols [10,18]. However, LAKA may add covert learning as a distinctive technique, experiential qualities, and independence of delivery by means of a serious game.…”

Section: The Serious Game Lakamentioning

confidence: 99%

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Effectiveness of Serious Gaming During Multidisciplinary Rehabilitation for Patients with Complex Chronic Pain or Fatigue: A Natural Quasi-experiment (Preprint)

Vugts¹,

Joosen²,

Mert³

et al. 2017

Preprint

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Background: Current evidence for the effectiveness of specialist multidisciplinary programs for burdensome chronic pain and functional somatic syndromes drive effort to improve approaches, strategies, and delivery modes. It is unknown to what extent and in what respect serious gaming during regular outpatient rehabilitation can contribute to health outcomes. Objective: Study objectives are: to determine the effect of additional serious gaming on 1) physical and/or emotional functioning in general, 2) particular outcome domains, and 3) patient global impressions of change, general health, and functioning; and to determine 4) dependency of serious gaming effects on adherence. Methods: A naturalistic quasi-experiment with embedded qualitative methods was conducted. Intervention group patients received an additional guided (mindfulness based) serious gaming intervention ('LAKA') during week 9-12 of a 16-week rehabilitation program at 2 sites of a Dutch rehabilitation clinic. Simultaneously, 119 control group patients followed the same program without serious gaming at 2 similar sites of the same clinic. Data consisted of 10 semi-structured patient interviews and routinely collected patient self-reported outcomes. First, multivariate

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Section: Suggestions For Research and Practicementioning

confidence: 99%

Section: Existing Treatment Gapsmentioning

confidence: 99%

Section: Existing Treatment Gapsmentioning

confidence: 99%

Section: The Serious Game Lakamentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of Serious Gaming During Multidisciplinary Rehabilitation for Patients with Complex Chronic Pain or Fatigue: A Natural Quasi-experiment (Preprint)

Vugts¹,

Joosen²,

Mert³

et al. 2017

Preprint

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“…[5]. Dass interdisziplinäre Verfahren im Schmerzmanagement kos teneffektiv sind, belegen Studien im nationalen und internatio nalen Kontext [6][7][8][9] • ▶ Tab. 3 charakterisiert die PS gematchten Studienpopulationen je Schmerztyp auf Basis ausgewählter Matching-Parameter.…”

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Welche Rückenschmerzpatienten profitieren von einer multimodalen Schmerztherapie? Eine komparative Kostenanalyse auf Basis von GKV-Routinedaten

et al. 2016

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Aim: Multidisciplinary pain therapy (MPT) is considered as best practice for treating patients with chronical back pain. Several studies showed the cost effectiveness of interdisciplinary treat ment. The aim of the present study is to identify patient characteristics that, under condition of MMT, can be associated with favourable cost tra jectories after intervention. We assume that an improved health status leads to less health care utilisation. Furthermore, we aim at identifying those patients with back pain without MPT for whom we can expect favourable cost trajecto ries. Methods: On the basis of pseudonymised claims data of a nationwide health insurance, we identi fied MMT back pain patients as well as a control group of back pain patients without MMT. Using comparative cost analysis (costs insensitive to indication), we determined those MMT patients for whom the cumulated total costs per patient for the two postinterventional years were lo wer than the mean cumulated total costs of the control group. By means of a CART analysis, we identified statistically significant characteristics (profiles) associated with these favourable cost trajectories. Additionally, we quantified control group patients with the same profiles. Results: The study population comprised 1 252 patients with specific back pain and 767 pa tients with pain due to spinal disc conditions who received MPT. Compared to the control group, to tal post-therapy costs (insensitive to indication) of MPT patients were higher. For roughly half of MPT patients per pain type, we could identify fa vourable cost trajectories as per definition. These patients mainly displayed lower levels of pain intensity, no pain-related hospitalisation, and less (mental) co-morbidity in the year preceding the intervention. These profiles concerned to 58-65 % of back pain patients without MPT. License terms THIEME Originalarbeit e121Behrendt S et al. Welche Rückenschmerzpatienten profitieren von … Gesundheitswesen 2016; 78 (Suppl. 1): e120-e127

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Multidisciplinary biopsychosocial rehabilitation for subacute low back pain

Marin

Eerd

Irvin

et al. 2017

Cochrane Database of Systematic Reviews

134

110

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Background Low back pain (LBP) is associated with enormous personal and societal burdens, especially when it reaches the chronic stage of the disorder (pain for a duration of more than three months). Indeed, individuals who reach the chronic stage tend to show a more persistent course, and they account for the majority of social and economic costs. As a result, there is increasing emphasis on the importance of intervening at the early stages of LBP. According to the biopsychosocial model, LBP is a condition best understood with reference to an interaction of physical, psychological, and social influences. This has led to the development of multidisciplinary biopsychosocial rehabilitation (MBR) programs that target factors from the different domains, administered by healthcare professionals from different backgrounds. This review is an update of a Cochrane Review on MBR for subacute LBP, which was published in 2003. It is part of a series of reviews on MBR for musculoskeletal pain published by the Cochrane Back and Neck Group and the Cochrane Musculoskeletal Group. Objectives To examine the effectiveness of MBR for subacute LBP (pain for a duration of six to 12 weeks) among adults, with a focus on pain, back-specific disability, and work status.

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Multidisciplinary biopsychosocial rehabilitation for chronic low back pain

Cited by 458 publications

References 193 publications

Effectiveness of Serious Gaming During Multidisciplinary Rehabilitation for Patients with Complex Chronic Pain or Fatigue: A Natural Quasi-experiment (Preprint)

Effectiveness of Serious Gaming During Multidisciplinary Rehabilitation for Patients with Complex Chronic Pain or Fatigue: A Natural Quasi-experiment (Preprint)

Welche Rückenschmerzpatienten profitieren von einer multimodalen Schmerztherapie? Eine komparative Kostenanalyse auf Basis von GKV-Routinedaten

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain

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