Evaluation of a 7-year return-to-work cognitive-behavioural based physiotherapy back rehabilitation programme
Hong Kong Physiotherapy Journal
and purpose: Studies found that psychological factors predicted extent of chronic disability and hinder the process of return to work. Thus, this study aimed to determine whether a programme of conventional therapy and education using cognitive behavioural therapy approach reduced pain, disability, fear-avoidance belief and also anxiety and depression among patients with low back pain. Methods: This was a pre-and post-test study. Patients who had injured their back at work of less than 8 weeks
... less than 8 weeks and high fear avoidance beliefs were recruited. Outcome measures were Numerical Global Rating of Change Scale, Numeric Pain Rating Scale (NPRS), Roland Morris Disability Questionnaire (RMDQ), Hospital Anxiety and Depression Scale (HADS-Anxiety and HADS-Depression) and Fear-Avoidance Beliefs Questionnaire (FABQ)-Physical activity and FABQ-Work. Results: From August 2007 to December 2014, a total of 712 patients were recruited. The mean value of NGRCS was 5.6AE2.2. The post-programme evaluation of NPRS (from mean value of 5.9AE2.4 to 4.8AE2.7 with p<0.001), RMDQ (from mean value of 16.2AE3.8 to 13.1AE 4.6 with p<0.001), HADS-Anxiety (from mean value of 12.1AE4.6 to 7.8AE4.7 with p<0.001), HADS-Depression (from mean value of 12.5AE4.6 to 9.4AE4.8 with p<0.001), FABQ-Physical activity (from mean value of 18.3AE3.4 to 16.6AE4.3 with p<0.001) and FABQ-Work (from mean value of 36.8AE4.1 to 30.6AE7.3 with p<0.001) were found to be significantly improved. Conclusion: Our study showed that cognitive behavioural-based physiotherapy programme was found to be effective in decreasing back pain, the fear-avoidance behaviours, the anxiety and depressive mood in patients with work-related back injury. However, randomized controlled trials are recommended to determine its effectiveness. http://dx.