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Use of cognitive-behavioral therapy with usual physical therapy intervention for individuals who are unemployed secondary to chronic low back pain: A case series

Musculoskeletal Care Aug 08, 2019

Walston Z, et al. - Through a case series, experts investigated the use of cognitive-behavioral therapy (CBT) with physical therapy (PT) for the treatment of fear-avoidance behaviors in patients with chronic low back pain (LBP, a principal cause of work absence and may affect the development of fear-avoidance behaviours) who were disabled or in a period of work absence. Patients were treated until the attainment of functional goals and normalized movement patterns. Using a numerical pain rating scale, the Oswestry Disability Index and Focus on Therapeutic Outcomes, pain, disability, and function were calculated. For these measures, all patients attained a minimally clinically significant variation. As noted by an average 15-point change in Fear-Avoidance Behaviour Questionnaire (Physical Activity) outcomes, fear-avoidance behaviors declined. Patients on work absence came back to work. Hence, for the treatment of high-irritability, fear-avoidant people who were on disability or in a phase of work absence, this case series illustrated the application of CBT in combination with a traditional PT intervention. Moreover, the outcomes exhibited that CBT may be a beneficial and feasible adjunct to PT and may positively impact a return to work.
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