Augmenting conventional treatment of non-specific low back pain with progressive goal attainment programme

Abstract

Background: Prospective studies on the effects of progressive goal attainment programme (PGAP) on treatment outcomes and specifically psychosocial variables in individuals with non-specific low back pain (NSLBP) are scarce. The study was aimed at investigating the effects of a 10-week PGAP adjunct therapy on selected pain and psychosocial characteristics in patients with NSLBP.

Methods: The quasi-experimental study involved consecutive 70 (42 females; 28 males) patients with NSLBP. Participants were alternately assigned into experimental and control groups. Both groups received conventional treatment of back education, soft tissue mobilisation, transcutaneous electrical nerve stimulation, flexibility, coordination and isometric trunk muscle strengthening exercises thrice a week for 10 weeks but the experimental group had PGAP in addition. Participants’ pain intensity, pain catastrophising, kinesiophobia, perceived disability and self-efficacy were assessed at baseline, end of 5th and 10th week of intervention and 22nd week (follow-up) using Visual Analogue Scale, Pain Catastrophising Scale, Tampa Scale for Kinesiophobia, Revised Oswestry Disability Questionnaire and Self-Efficacy for Rehabilitation Outcome Scale, respectively.

Results: Between-group comparison at the end of intervention did not reveal significant difference (p > 0.05) between experimental and control groups in all five measures. There were significant reductions (p < 0.05) in pain intensity, pain catastrophising, kinesiophobia, perceived disability and increase in self-efficacy scores for both groups from baseline to 10th week. At follow-up (22nd week), experimental group had significantly lower scores of pain intensity (p = 0.031), pain catastrophising (p = 0.050), kinesiophobia (p < 0.001), perceived disability (p = 0.001) and higher self-efficacy (p = 0.016) than the controls.

Conclusion: Addition of PGAP to conventional treatment is effective for achieving sustained improvement in pain and psychosocial characteristics of patients with NSLBP having psychosocial overlay.

Keywords:

• CBT
• Low back pain
• Physiotherapy
• Psychosocial
• Perceived disability