Department of Physical Medicine and Rehabiltation, Policlinico Umberto I, Sapienza University, Rome, Italy.
Eur J Phys Rehabil Med. 2012 Jun;48(2):245-53. Epub 2011 Nov 18.
Low back pain is a worldwide health problem, affecting up to 80% of adult population. Psychological factors are involved in its development and maintenance. Many clinical trials have evaluated the efficacy of different interventions for chronic non-specific low back pain. In this field, Back School program has been demonstrated effective for people with chronic non-specific low back.
To evaluate the relationship between the effects of the Back School treatment and psychological features measured by MMPI-II of patients with chronic non-specific low back pain.
A randomised controlled trial with three and six-month follow-up.
Ambulatory rehabilitative university centre.
Fifty patients with chronic non-specific low back pain out of 77 screened patients.
Patients were randomly placed in a 3:2 form and were allocated into two groups (Treatment versus Control). The Treatment Group participated to an intensive multidisciplinary Back School program (BSG, N.=29), while the Control Group received medical assistance (CG, N.=21). Medication was the same in both groups. Then, patients were subgrouped in those with at least an elevation in one scale of MMPI-II, and those without it. The Short Form 36 Health Status Survey for the assessment of quality of life (primary outcome measure), pain Visual Analogue Scale, Waddel Index and Oswestry Disability Index were collected at baseline, at the end of treatment, and at the three and six-month follow-up.
Only the two treated subgroups showed a significant improvements in terms of quality of life, disability and pain. Among treated subjects, only those with at least one scale elevation in MMPI-II showed also a significant improvement in terms of Short Form 36 mental composite score and relevant subscores.
These results suggest that Back School program has positive effects, even in terms of mental components of quality of life in patients with scale elevations of MMPI-II. Probably these findings are due to its educational and cognitive-behavioural characteristics.
Because of its educational purposes, the Back School treatment can have positive effects also on the mental status of patients with low back pain when it affects their psychological features.
腰痛是一个全球性的健康问题，影响到高达 80%的成年人口。心理因素参与了其发展和维持。许多临床试验已经评估了不同干预措施对慢性非特异性腰痛的疗效。在这一领域，腰背学校计划已被证明对慢性非特异性腰痛患者有效。
评估腰背学校治疗的效果与慢性非特异性腰痛患者 MMPI-II 测量的心理特征之间的关系。
一项为期 3 个月和 6 个月随访的随机对照试验。
门诊康复大学中心。
77 名筛选出的慢性非特异性腰痛患者中，50 名患者符合纳入标准。
患者随机分为 3:2 组，并分为两组（治疗组和对照组）。治疗组参加密集的多学科腰背学校计划（BSG，N=29），而对照组接受医疗援助（CG，N=21）。两组患者的药物治疗相同。然后，根据 MMPI-II 至少有一个量表升高和没有量表升高的情况将患者分组。采用健康状况简表 36 项（SF-36）评估生活质量（主要结局指标）、疼痛视觉模拟量表、Waddel 指数和 Oswestry 残疾指数，在基线、治疗结束时以及 3 个月和 6 个月随访时进行测量。
只有两个接受治疗的亚组在生活质量、残疾和疼痛方面有显著改善。在接受治疗的患者中，只有 MMPI-II 至少有一个量表升高的患者在 SF-36 心理综合评分和相关子评分方面也有显著改善。
这些结果表明，腰背学校计划具有积极的效果，即使在 MMPI-II 量表升高的患者的生活质量的心理成分方面也是如此。可能这些发现是由于其教育和认知行为特征。
由于其教育目的，腰背学校治疗可能对腰痛患者的心理状态产生积极影响，当它影响到他们的心理特征时。
