Pain Management Research Institute, University of Sydney, St Leonards, New South Wales 2065, Australia.
Phys Ther. 2011 May;91(5):765-76. doi: 10.2522/ptj.20100278. Epub 2011 Mar 30.
A central theme of current evidence-based guidelines for managing low back pain is endorsement of the resumption of activities despite the presence of pain. This task can be challenging for both therapists and patients, and there are many essentially psychological obstacles to implementing the guidelines. These obstacles can be overcome by knowing how to recognize potential psychological obstacles and understanding the options for managing psychological obstacles in combination with activity-based interventions. This article is intended to address these tasks by explaining and describing the application of empirically based psychological principles and strategic clinical reasoning. Importantly, the roles of skills in assessment, treatment planning, and communication with patients are identified as essential but feasible skills for physical therapists to acquire with appropriate training.
当前针对管理下背痛的循证指南的一个核心主题是，尽管存在疼痛，但仍支持恢复活动。对于治疗师和患者来说，这项任务都极具挑战性，并且在实施这些指南时存在许多本质上的心理障碍。通过了解如何识别潜在的心理障碍以及了解如何将心理障碍管理与基于活动的干预相结合，可以克服这些障碍。本文旨在通过解释和描述基于经验的心理原则和策略性临床推理的应用来解决这些问题。重要的是，评估、治疗计划和与患者沟通方面的技能被确定为物理治疗师通过适当的培训可以获得的重要但可行的技能。
