title: Chronic pain and severe disuse syndrome: long-term outcome of an inpatient multidisciplinary cognitive behavioural programme.
abstract: OBJECTIVE
  Patients with chronic pain and severe disuse syndrome have pain with physiological, psychological and social adaptations. The duration and severity of complaints, combined with previously failed treatments, makes them unsuitable for treatment in primary care.
  
  
  METHODS
  A prospective waiting list controlled study.
  
  
  METHODS
  A total of 32 patients with chronic pain for at least one year and severe disuse syndrome were included in an inpatient multidisciplinary cognitive behavioural treatment.
  
  
  METHODS
  Patients were assessed before the waiting list period, before the clinical phase, after the clinical phase and after follow-ups of 6 months and one year. The visual analogue scale for pain and fatigue were assessed. Muscle strength of the arms and legs, arm endurance and a 6-minute walking test were used to assess physical outcome. The Symptom Checklist-90, RAND-36, pain cognition list and the Tampa scale for kinesiophobia were used to assess psychological outcome.
  
  
  RESULTS
  Long-term significant (p < 0.001) improvements were found for pain, fatigue, walking distance, muscle strength, anxiety, depression, somatization, negative self-efficacy, and catastrophizing in the intervention period.
  
  
  CONCLUSIONS
  An inpatient multidisciplinary cognitive behavioural programme is beneficial for patients with chronic pain and a severe disuse syndrome.
authors.affiliation: Pain Centre, Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. c.p.van.wilgen@sport.umcg.nl
authors.forename: C Paul
authors.initials: CP
authors.lastname: van Wilgen
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.forename: Gerbrig J
authors.initials: GJ
authors.lastname: Versteegen
authors.forename: Marjo J T
authors.initials: MJ
authors.lastname: Fleuren
authors.forename: Roy
authors.initials: R
authors.lastname: Stewart
authors.forename: Marten
authors.initials: M
authors.lastname: van Wijhe
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D020377:Self Efficacy; D013997:Time Factors; D016138:Walking / Q000502:physiology