Chaory K, Rannou F, Fermanian J, Genty M, Rosenberg S, Billabert C, Kemoun G, Richard I, Thevenon A, Coudeyre L, Sender J, Revel M, Poiraudeau S
Département de médecine physique et rééducation, hôpital Cochin, AP-HP, université René-Descartes, 27, rue du Faubourg-Saint-Jacques, 75014 Paris cedex 14, France.
Ann Readapt Med Phys. 2004 Apr;47(3):93-7. doi: 10.1016/j.annrmp.2003.10.007.
To assess the impact of functional restoration programs on fears, avoidance and beliefs in chronic low back pain.
Open prospective study in eight spine centers. Seventy patients enrolled in several restoration programs were evaluated before and at the end of the program. Variables recorded were pain (VAS), disability (Quebec back pain disability scale), handicap (VAS), anxiety and depression (HAD scale), and fears, avoidance and beliefs (FABQ).
All variables recorded significantly improved at the end of the programs except for fears about professional activities (FABQ1) and lumbar mobility. Fears about physical activities (FABQ2) significantly decreased after these programs. Variations in FABQ1 and FABQ2 scores were not correlated with variations in scores of outcome measures assessing impairment, disability, and handicap.
Functional restoration programs in their current form in France do not decrease fears and beliefs about professional activities in chronic low back pain patients. Adding psychosocial intervention at the work place to the functional restoration programs may lead to a better impact on fears about work thus reducing work loss.
评估功能恢复计划对慢性下腰痛患者恐惧、回避及信念的影响。
在八个脊柱中心开展开放性前瞻性研究。对参加多个恢复计划的70名患者在计划开始前及结束时进行评估。记录的变量包括疼痛（视觉模拟评分法）、残疾（魁北克腰痛残疾量表）、功能障碍（视觉模拟评分法）、焦虑和抑郁（医院焦虑抑郁量表），以及恐惧、回避和信念（FABQ问卷）。
除了对职业活动的恐惧（FABQ1）和腰椎活动度外，计划结束时记录的所有变量均有显著改善。这些计划实施后，对体育活动的恐惧（FABQ2）显著降低。FABQ1和FABQ2评分的变化与评估损伤、残疾和功能障碍的结局指标评分变化无关。
法国目前形式的功能恢复计划并不能减少慢性下腰痛患者对职业活动的恐惧和信念。在功能恢复计划中增加工作场所的社会心理干预可能会对工作恐惧产生更好的影响，从而减少工作损失。
