title: The efficacy of a multidisciplinary group program for patients with refractory chronic pain.
abstract: BACKGROUND
  Chronic pain is a major problem because it can result in not only a reduction in activities of daily living and quality of life but also requires initiation of social assistance. Seeking only to eliminate pain itself would appear to be too narrow an objective, in addition to often being unachievable; therefore, a multifaceted, comprehensive approach with multiple objectives is needed.
  
  
  OBJECTIVE
  To describe the effects of a program (the 'Chronic Pain Class') offering cognitive behavioural therapy to small groups of individuals with refractory chronic pain in Japan. Exercise was an important feature of the program.
  
  
  METHODS
  A total of 46 patients who were experiencing treatment difficulties and decreased activity participated in the program. The programs were conducted in groups of five to seven patients who met weekly for nine weeks. Weekly sessions, which were approximately 2 h in duration, combined lectures with exercise. Several measures related to pain and physical function were administered at the beginning and the conclusion of the program.
  
  
  RESULTS
  Nine patients dropped out during the program. A number of measures (eg, pain intensity, disability, catastrophizing thoughts) showed significant improvements after intervention (P<0.002 after Bonferroni correction). Furthermore, most measures of physical function showed substantial improvement, especially seated forward bends, zig-zag walking, self-care and 6 min walk test (P<0.001).
  
  
  CONCLUSIONS
  The results of the present study provide evidence that a combination of cognitive behavioural therapy and exercise should be recommended to patients with refractory chronic pain.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Inoue
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Inoue
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Ikemoto
authors.forename: Young-Chang P
authors.initials: YC
authors.lastname: Arai
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nakata
authors.forename: Atsuko
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Nishihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawai
authors.forename: Noboru
authors.initials: N
authors.lastname: Hatakeyama
authors.forename: Setsuko
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shimo
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Miyagawa
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohmichi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ushida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged