Pain Education With Therapeutic Exercise in Chronic Nonspecific Low Back Pain Rehabilitation: A Critically Appraised Topic

Jones, Kaitlyn; Tocco, Evelyn C; Marshall, Ashley N.; McLeod, Tamara C. Valovich; Bacon, Cailee E. Welch

doi:10.1123/jsr.2019-0345

Cited by 7 publications

(7 citation statements)

References 17 publications

(26 reference statements)

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“…16 The purpose of a biopsychosocial evaluation is to gain a holistic view of the patient's presentation, identify any impairments across health dimensions, and guide a holistic treatment plan, which can help the clinician promote pain neuroscience education. 16,17 Educating the patient on their pain could be an effective treatment strategy. Jones et al 17 found that patients who had pain education in addition to therapeutic exercise showed the greatest improvements in self-reported pain.…”

Section: Main Findingsmentioning

confidence: 99%

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The Influence of Kinesiophobia on Perceived Disability in Patients With an Upper-Extremity Injury: A Critically Appraised Topic

Bartlett¹,

Farnsworth²

2021

Journal of Sport Rehabilitation

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Clinical Scenario: Kinesiophobia is a common psychological phenomenon that occurs following injury involving fear of movement. These psychological factors contribute to the variability among patients’ perceived disability scores following injury. In addition, the psychophysiological, behavioral, and cognitive factors of kinesiophobia have been shown to be predictive of a patient’s self-reported disability and pain. Previous kinesiophobia research has mostly focused on lower-extremity injuries. There are fewer studies that investigate upper-extremity injuries despite the influence that upper-extremity injuries can have on an individual’s activities of daily living and, therefore, disability scores. The lack of research calls for a critical evaluation and appraisal of available evidence regarding kinesiophobia and its contribution to perceived disability for the upper-extremity. Focused Clinical Question: How does kinesiophobia in patients with upper-extremity injuries influence perceptions of disability and quality of life measurements? Summary of Key Findings: Two cross-sectional studies and one cohort study were included. The first study found a positive relationship between kinesiophobia and a high degree of perceived disability. Another study found that kinesiophobia and catastrophic thinking scores were the most important predictors of perceived upper-extremity disability. The third study found that kinesiophobia contributes to self-reported disability in the shoulder. Clinical Bottom Line: There is moderate evidence that supports the relationship between kinesiophobia and perceived disability, and the relationship between elevated perceptions of disability and increased kinesiophobia scores in patients with an upper-extremity injury. Clinicians should evaluate and monitor kinesiophobia in patients following injury, a condition that can enhance perceptions of disability. An elevated perception of disability can create a cycle of fear that leads to hypervigilance and fear-avoidance behavior. Strength of Recommendation: Consistent findings from reviewed studies suggest there is grade B evidence to support that kinesiophobia is related to an increased perceived disability following upper-extremity injuries.

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Section: Main Findingsmentioning

confidence: 99%

“…16,17 Educating the patient on their pain could be an effective treatment strategy. Jones et al 17 found that patients who had pain education in addition to therapeutic exercise showed the greatest improvements in self-reported pain.…”

Section: Main Findingsmentioning

confidence: 99%

The Influence of Kinesiophobia on Perceived Disability in Patients With an Upper-Extremity Injury: A Critically Appraised Topic

Bartlett¹,

Farnsworth²

2021

Journal of Sport Rehabilitation

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“…Medical treatments and physiotherapy are recommended to treat and resolve issues associated with cNLBP [ 3 ]. Therapeutic exercise and manual therapy have a lower risk of increasing future back injuries or work absence and are more effective treatment options for chronic pain than medication or surgery, and they can be performed at rehabilitation clinics [ 4 – 6 ]. Exercise therapy is a widely used strategy to cope with low back pain that includes a heterogeneous group of interventions ranging from aerobic exercise or general physical fitness to muscle strengthening and various types of flexibility and stretching exercises [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Lipid and metabolic alteration involvement in physiotherapy for chronic nonspecific low back pain

Zhang

et al. 2022

Lipids Health Dis

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Background Chronic nonspecific low back pain (cNLBP) is a common health problem worldwide, affecting 65–80% of the population and greatly affecting people’s quality of life and productivity. It also causes huge economic losses. Manual therapy (MT) and therapeutic exercise (TE) are effective treatment options for cNLBP physiotherapy-based treatment. However, the underlying mechanisms that promote cNLBP amelioration by MT or TE are incompletely understood. Methods Seventeen recruited subjects were randomly divided into an MT group and a TE group. Subjects in the MT group performed muscular relaxation, myofascial release, and mobilization for 20 min during each treatment session. The treatment lasted for a total of six sessions, once every two days. Subjects in the TE group completed motor control and core stability exercises for 30 min during each treatment session. The motor control exercise included stretching of the trunk and extremity muscles through trunk and hip rotation and flexion training. Stabilization exercises consisted of the (1) bridge exercise, (2) single-leg-lift bridge exercise, (3) side bridge exercise, (4) two-point bird-dog position with an elevated contralateral leg and arm, (5) bear crawl exercise, and (6) dead bug exercise. The treatment lasted for a total of six sessions, with one session every two days. Serum samples were collected from subjects before and after physiotherapy-based treatment for lipidomic and metabolomic measurements. Results Through lipidomic analysis, we found that the phosphatidylcholine/phosphatidylethanolamine (PC/PE) ratio decreased and the sphingomyelin/ceramide (SM/Cer) ratio increased in cNLBP patients after MT or TE treatment. In addition, eight metabolites enriched in pyrimidine and purine differed significantly in cNLBP patients who received MT treatment. A total of nine metabolites enriched in pyrimidine, tyrosine, and galactose pathways differed significantly in cNLBP patients after TE treatment during metabolomics analysis. Conclusion Our study was the first to elucidate the alterations in the lipidomics and metabolomics of cNLBP physiotherapy-based treatment and can expand our knowledge of cNLBP physiotherapy-based treatment.

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“…In fact, in a study on knowledge about the triggers of cLBP, only 3% of the professionals involved in the therapeutic approach to pain point to psychological factors as the main determinant [3]. Therefore, we thought that the identification of psychological reactions in the process of physiotherapy care for patients with chronic cLBP is necessary to identify and differentiate the different clinical profiles that serve as a basis for maximizing treatment results [11][12][13]. The purpose of our study was to describe and quantify the linear association between pain intensity and different psychological variables in patients suffering from cLBP.…”

Section: Introductionmentioning

confidence: 99%

Association of pain intensity and psychological factors among patients with chronic low back pain (LBP). A correlational cross-sectional study

Pérez¹,

Lupgens²,

Pagés³

et al. 2022

Iberoam J Med

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Introduction: Chronic low back pain (cLBP) is associated with a dynamic interaction of multiple psychological factors that act as predictors of recovery time. Our goal was to quantify the association between pain intensity and psychological variables. Material and methods: A cross-sectional study using convenience sampling was conducted at Universidad Europea de Canarias (Spain) between January 24, 2022 and June 10, 2022. In addition, adults and children with cLBP older than 13 years with cLBP for at least 12 weeks of symptoms were included. Finally, the descriptive analysis and the calculation of the correlation coefficients of the data was carried out with SPSS v.28.0. Results: We recruited 146 subjects (n=85 women, 58.3%; n=61 men,41.7%) aged 50.4 ± 12.21 years suffering from cLBP with a moderate pain intensity (7.02±0.188), kinesiophobia (22.79 ± 0.559), catastrophism (13.42 ± 0.897), anxiety (24.47±0.560) and the quality of life SF36-PF (65.65±2.291), SF36-PR (48.03±2.727), SF36-BP (33.14±1.566), SF36-GH (43.98±1.873), SF36-V (48.56±1.812), SF36-SF (61.39±2.353), SF36-ER (76.29±2.043) and SF36-MH (49.76±1.666). Pain intensity in cLBP patients was negatively and moderately correlated with SF36-BP score (Pearson's r = -0.561, p < 0.001). In addition, the main variable was negatively and weakly correlated with SF36-PF (Pearson's r= -0.395, p<.001), SF36-PR (Pearson's r=-0.433, p<.001), SF36-V (Pearson's r = -0.260, p = 0.006), SF36-GH (Pearson's r = -0.203, p=0.032), SF36-SF (Pearson's r=-0.215, p=0.024). and SF36-MH (Pearson's r= -0.203, p = 0.032). Furthermore, pain intensity showed positive and weak with kinesiophobia score (Pearson’s r=0.310, p<.001) and positive and very weak with catastrophism (Pearson’s r=0.136, p<.001). In contrast, there was not correlation between pain intensity and anxiety in cLBP subjects (Pearson’s r=0.025, p=0.794). Conclusions: Psychological variables were not associated with pain intensity in patients with cLBP. However, physical perception of pain was the only variable that remained moderately linearly associated with pain intensity.

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Pain Education With Therapeutic Exercise in Chronic Nonspecific Low Back Pain Rehabilitation: A Critically Appraised Topic

Cited by 7 publications

References 17 publications

The Influence of Kinesiophobia on Perceived Disability in Patients With an Upper-Extremity Injury: A Critically Appraised Topic

The Influence of Kinesiophobia on Perceived Disability in Patients With an Upper-Extremity Injury: A Critically Appraised Topic

Lipid and metabolic alteration involvement in physiotherapy for chronic nonspecific low back pain

Association of pain intensity and psychological factors among patients with chronic low back pain (LBP). A correlational cross-sectional study

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