INTRODUCTION: Cognitive behavioural and exercises approaches that have shown their efficacy in chronic Low Back Pain (cLBP) are usually performed in high costs settings, such as long periods outpatient or inpatient treatments.
AIM: Verify the efficacy of an high efficiency cognitive behavioural exercise treatment for cLBP and the influence of starting disability on the final results.
METHODS: In a retrospective controlled study with 5 years follow up 76 (34 females) consecutive cLBP patients were included. The patients met an expert and trained physiotherapist 6 times once every 15‐30 days: during the 90 minutes sessions the cognitive behavioural treatment was administrated and patients learned specific exercises to be practiced every day at home for 20‐30 minutes. The exercises were modified at every session by the therapist according to results obtained. Outcome measures: Roalnd Morris (RM), VAS, Fear avoidance believe questionnaire. We considered patients changed for more than 3 (RM) or 2 (VAS) points. The patients were called telephonically after 5 years to verify the maintenance of results. According to the Italian guidelines, cLBP patients were divided in “High Disablity” (HD) for score of RM ≥14, and “Low Disability” (LD) if <14. Statistical analysis: Mann Whitney, chi‐square.
RESULTS: 16 patients were HD, 60 LD. The whole population had a median improvement of 3 for RM. For high disability patients the median improvement was 6 vs 2 for Low. Considering the number of changed patients we had 75% improved and 25% stable for HD vs 38.3% and 58.3% (3% worsened) for LD. Also the VAS improved in both populations with better results for HD.
DISCUSSION: It is possible to obtain good results in cLBP patients (mainly HD) with a cognitive‐behavioural exercises approach, offered by well trained physiotherapis, in only 6 sessions covering 4 to 6 months of treatment.