Rose M J, Reilly J P, Pennie B, Bowen-Jones K, Stanley I M, Slade P D
Back Pain Rehabilitation program, Wirral Hospital Trust, England.
Spine (Phila Pa 1976). 1997 Oct 1;22(19):2246-51; discussion 2252-3. doi: 10.1097/00007632-199710010-00009.
Eighty-four patients with chronic low back pain were treated using cognitive behavioral principles on a pain management program. Outcome data were collected at four points: 10 weeks before treatment, immediately before and immediately after treatment, and 6 months after treatment. In part 1 of the study, patients were assigned randomly to group or individual treatment contexts. In part 2 of the study, patients were assigned randomly to programs of 15, 30, or 60 hours duration.
To identify the differences in outcome between programs that treated patients as part of a group and those that treated patients individually and the effects of duration of treatment on outcome.
Cognitive behavioral programs have been shown to be an effective means of managing chronic low back pain. The literature is concerned with group programs, however, the duration of which vary widely.
Psychological and functional variables were measured before and after treatment and at the 6-month follow-up visit. Changes in these variables were measured, and comparisons were made between group and individual programs and between 15-, 30-, and 60-hour programs.
Data analysis showed a significant, beneficial effect of intervention in terms of the majority of variables; however, these changes were generally independent of whether patients were treated as part of a group or individually and whether patients completed a 15-, 30-, or 60-hour program.
Cognitive behavioral rehabilitation programs have been demonstrated to be an effective means of reducing psychological distress, of changing cognition, and of improving the function of patients with chronic low back pain; however, the length of program and whether patients were treated individually or as part of a group did not affect outcome. This finding has clinical and economic implications.
84名慢性腰痛患者采用认知行为原则接受疼痛管理项目治疗。在四个时间点收集结果数据：治疗前10周、治疗前即刻、治疗后即刻以及治疗后6个月。在研究的第1部分，患者被随机分配到团体或个体治疗环境中。在研究的第2部分，患者被随机分配到为期15小时、30小时或60小时的项目中。
确定将患者作为团体一部分进行治疗的项目与个体治疗项目在结果上的差异，以及治疗时长对结果的影响。
认知行为项目已被证明是管理慢性腰痛的有效手段。然而，文献关注的是团体项目，其时长差异很大。
在治疗前后以及6个月随访时测量心理和功能变量。测量这些变量的变化，并对团体和个体项目之间以及15小时、30小时和60小时项目之间进行比较。
数据分析显示，就大多数变量而言，干预具有显著的有益效果；然而，这些变化通常与患者是作为团体一部分接受治疗还是个体治疗以及患者完成的是15小时、30小时还是60小时的项目无关。
认知行为康复项目已被证明是减轻慢性腰痛患者心理困扰、改变认知和改善功能的有效手段；然而，项目时长以及患者是接受个体治疗还是团体治疗并不影响结果。这一发现具有临床和经济意义。
