Faculty of Kinesiology and Rehabilitation Science, KU Leuven, Leuven, Belgium.
Disabil Rehabil. 2013 Jan;35(1):1-10. doi: 10.3109/09638288.2012.683848. Epub 2012 May 21.
The primary purpose was to detect randomized controlled trials investigating cognitive behaviour therapy-based (CBT) treatments applied in acute/sub-acute low back pain (LBP). The secondary purpose was to analyse the methodological properties of the included studies, and to identify theory-based treatment strategies that are applicable for physiotherapists.
A systematic literature search was conducted using four databases. Risk of bias of included studies was assessed and the methodological properties summarized. In addition, content and treatment theory of detected CBT-based strategies were systematically analysed and classified into three distinctive concepts of CBT: operant, cognitive and respondent treatment. Finally, applicability of treatment strategies in physiotherapy practice was discussed.
Eight studies were included in the present systematic review. Half of the studies suffered from high risk of bias, and study characteristics varied in all domains of methodology, particularly in terms of treatment design and outcome measures. Graded activity, an operant treatment approach based on principles of operant conditioning, was identified as a CBT-based strategy with traceable theoretical justification that can be applied by physiotherapists.
Operant conditioning can be integrated in ambulant physiotherapy practice and is a promising CBT-based strategy for the prevention of chronic LBP.
主要目的是检测基于认知行为疗法（CBT）的治疗方法在急性/亚急性腰痛（LBP）中的随机对照试验。次要目的是分析纳入研究的方法学特性，并确定适用于物理治疗师的基于理论的治疗策略。
使用四个数据库进行了系统的文献检索。评估了纳入研究的偏倚风险，并总结了方法学特性。此外，还对检测到的基于 CBT 的策略的内容和治疗理论进行了系统分析，并将其分为 CBT 的三个不同概念：操作性、认知和反应性治疗。最后，讨论了治疗策略在物理治疗实践中的适用性。
本系统评价纳入了 8 项研究。其中一半的研究存在较高的偏倚风险，研究特征在方法学的所有领域都存在差异，特别是在治疗设计和结果测量方面。分级活动是一种基于操作性条件反射原理的操作性治疗方法，被确定为具有可追溯的理论依据的基于 CBT 的策略，物理治疗师可以应用。
操作性条件反射可以整合到门诊物理治疗实践中，是预防慢性腰痛的一种有前途的基于 CBT 的策略。
