Clinical Application of Physiotherapy with a Cognitive?behavioural Approach in Low Back Pain

Abstract

The aim of this study was to investigate the effects of an integrated physiotherapy and cognitive-behavioural programme for a patient with persistent low back pain and disability. Outcome as well as comparison to a physiotherapy exercise programme was made in a controlled single-case format. The participant was a 41-year-old woman with an 18-month history of low back pain and increasing disability. The assessment involved physical function and exercise performance, disability, self-efficacy, life satisfaction and coping strategies. There were considerable improvements in performance of exercises as well as in resumed everyday activities during the integrated programme, as compared to the exercise programme. There were also marked improvements in standardized measures of disability, functional self-efficacy, and life satisfaction. All results were maintained at the 1-year follow-up. The results suggest that clinical integration of physiotherapeutic and cognitive-behavioural interventions was more effective than exercise only for this subject. The comprehensive assessment of and subsequent focus on cognitive and behavioural factors such as fear-avoidance and coping strategies may have contributed to the results.

• Assessment Disability Exercise Single-CASE Design