title: Cognitive treatment of illness perceptions in patients with chronic low back pain: a randomized controlled trial.
abstract: BACKGROUND
  Illness perceptions have been shown to predict patient activities. Therefore, studies of the effectiveness of a targeted illness-perception intervention on chronic nonspecific low back pain (CLBP) are needed.
  
  
  OBJECTIVE
  The purpose of this study was to compare the effectiveness of treatment of illness perceptions against a waiting list for patients with CLBP.
  
  
  METHODS
  This was a prospectively registered randomized controlled trial with an assessor blinded for group allocation.
  
  
  METHODS
  The study was conducted in an outpatient rehabilitation clinic.
  
  
  METHODS
  The participants were 156 patients (18-70 years of age) with CLBP (>3 months).
  
  
  METHODS
  Patients were randomly assigned to either a treatment group or to a waiting list (control) group. Trained physical therapists and occupational therapists delivered 10 to 14 one-hour treatment sessions according to the treatment protocol.
  
  
  METHODS
  The primary outcome measure was change in patient-relevant physical activities (patient-specific complaints questionnaire). The secondary outcome measures were changes in illness perceptions (illness perceptions questionnaire) and generic physical activity level (quebec back pain disability scale). Measurements were taken at baseline (0 weeks) and after treatment (18 weeks).
  
  
  RESULTS
  A baseline-adjusted analysis of covariance showed that there were statistically significant differences between intervention and control groups at 18 weeks for the change in patient-relevant physical activities. This was a clinically relevant change (19.1 mm) for the intervention group. Statistically significant differences were found for the majority of illness perception scales. There were no significant differences in generic physical activity levels.
  
  
  CONCLUSIONS
  Longer-term effectiveness was not studied.
  
  
  CONCLUSIONS
  This first trial evaluating cognitive treatment of illness perceptions concerning CLBP showed statistically significant and clinically relevant improvements in patient-relevant physical activities at 18 weeks.
authors.affiliation: Amsterdam Rehabilitation Research Center-Reade, Amsterdam, The Netherlands. petra.siemonsma@tno.nl
authors.forename: Petra C
authors.initials: PC
authors.lastname: Siemonsma
authors.forename: Ilse
authors.initials: I
authors.lastname: Stuive
authors.forename: Leo D
authors.initials: LD
authors.lastname: Roorda
authors.forename: Joke A
authors.initials: JA
authors.lastname: Vollebregt
authors.forename: Marion F
authors.initials: MF
authors.lastname: Walker
authors.forename: Gustaaf J
authors.initials: GJ
authors.lastname: Lankhorst
authors.forename: Ant T
authors.initials: AT
authors.lastname: Lettinga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010465:Perception; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult