Rim Maaoui, Leila Rouached, Aicha Ben Tekaya, Olfa Saidane, Meriem Hfaiedh, Ines Lajnef, Najla Mouhli, Hajer Rahali, Imen Ksibi
Department of Physical and Rehabilitation Medicine, Military Tunis Hospital, Tunis, Tunisia.
Faculté de Médecine de Tunis, Tunis El Manar University, Tunis, Tunisia.
Korean J Fam Med. 2022 Nov;43(6):367-373. doi: 10.4082/kjfm.21.0223. Epub 2022 Nov 20.
This study aimed to assess the benefits of associating rehabilitation with therapeutic patient education (TPE) to decrease fear-avoidance belief and pain and improve function in adults with chronic low back pain (CLBP).
This randomized controlled study included 100 patients with CLBP according to the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The patients were divided into two teams: group A that participated in the TPE in association with rehabilitation and group B that received rehabilitation only. Pain and functional amelioration were assessed initially (T0) and at the end of the program (T1) using a visual analog scale at rest, work, and activity, and the Echelle d'Incapacité Fonctionnelle pour l'Évaluation des Lombalgies scale. Psychological and apprehension and avoidance assessments were also conducted, including the evaluation of depression, anxiety, fear-avoidance belief, and kinesiophobia using the Hospital Anxiety and Depression Scale, Fear-Avoidance Beliefs Questionnaire, and Tampa scale of kinesiophobia scale.
The evaluation of progression initially (T0) and then at the end of the program (T1) revealed a significant reduction in pain at rest (P=0.00) and while working (P=0.00) and doing physical activity (P=0.03); a decrease in anxiety (P=0.03), fear-avoidance belief (P=0.03), and kinesiophobia (P=0.02); and an improvement in function (P=0.00) for patients in group A without amelioration of depression (P=0.15). Concerning group B, we identified a significant regression in pain at rest (P=0.001) and while working (P=0.03) and doing physical activity (P=0.00); depression (P=0.01); fear-avoidance beliefs (P=0.00); and kinesiophobia (P=0.002). Comparison between the groups revealed that associating TPE with rehabilitation resulted in a more significant improvement in function (P=0.00), anxiety (P=0.00), fear-avoidance belief (P=0.00), and kinesiophobia (P=0.00).
Associating TPE with rehabilitation improved function and reduced fear, false beliefs, and kinesiophobia of movement in patients with CLBP.
本研究旨在评估康复与治疗性患者教育（TPE）相结合对减轻慢性下腰痛（CLBP）成人患者的恐惧回避信念和疼痛并改善功能的益处。
根据CONSORT（试验报告统一标准）指南，这项随机对照研究纳入了100例CLBP患者。患者被分为两组：A组参与TPE并结合康复治疗，B组仅接受康复治疗。在初始阶段（T0）和项目结束时（T1），使用静息、工作和活动时的视觉模拟量表以及用于评估腰痛的功能障碍量表来评估疼痛和功能改善情况。还进行了心理、担忧和回避评估，包括使用医院焦虑抑郁量表、恐惧回避信念问卷和坦帕运动恐惧量表评估抑郁、焦虑、恐惧回避信念和运动恐惧。
初始阶段（T0）和项目结束时（T1）的进展评估显示，A组患者静息时（P = 0.00）、工作时（P = 0.00）和进行体育活动时（P = 0.03）的疼痛显著减轻；焦虑（P = 0.03）、恐惧回避信念（P = 0.03）和运动恐惧（P = 0.02）降低；功能改善（P = 0.00），但抑郁无改善（P = 0.15）。对于B组，我们发现静息时（P = 0.001）、工作时（P = 0.03）和进行体育活动时（P = 0.00）的疼痛显著减轻；抑郁（P = 0.01）；恐惧回避信念（P = 0.00）；运动恐惧（P = 0.002）。两组之间的比较显示，将TPE与康复相结合在功能（P = 0.00）、焦虑（P = 0.00）、恐惧回避信念（P = 0.00）和运动恐惧（P = 0.00）方面有更显著的改善。
将TPE与康复相结合可改善CLBP患者的功能，减少其对运动的恐惧、错误信念和运动恐惧。
