title: A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study.
abstract: OBJECTIVE
  To evaluate the effect of a multidisciplinary rehabilitation programme on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic low back pain (CLBP).
  
  
  METHODS
  This was a parallel-group, randomised, superiority-controlled pilot study in which 20 patients were randomly assigned to a programme consisting of motor training (spinal stabilising exercises plus usual-care) and cognitive-behavioural therapy (experimental group, 10 subjects) or usual-care alone (control group, 10 subjects). Before treatment, 8 weeks later (post-treatment), and 3 months after the end of treatment, the Oswestry Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale, and the Short-Form Health Survey were assessed. Spatio-temporal gait parameters were also measured by means of an electronic walking mat. A linear mixed model for repeated measures was used for each outcome measure.
  
  
  RESULTS
  The programme had significant group (p = 0.027), time (p < 0.001), and time-by-group interaction (p < 0.001) effects on disability, with the experimental group showing an improvement after training of about 61 % (25 % in the control group). The analyses of kinesiophobia, catastrophizing, and the quality of life also revealed significant time, group, and time-by-group interaction effects in favour of the experimental group, and there was a significant effect of time on pain. Both groups showed a general improvement in gait parameters, with the experimental group increasing cadence significantly more.
  
  
  CONCLUSIONS
  The multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to the exercise programme in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life and gait cadence of patients with CLBP.
authors: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone (Milan), Institute of Care and Research (IRCCS), Salvatore Maugeri Foundation IRCCS, Via Monsignor Bernasconi 16, 20035, Lissone, MI, Italy, marco.monticone@fsm.it.
authors: Marco
authors: M
authors: Monticone
authors: Emilia
authors: E
authors: Ambrosini
authors: Barbara
authors: B
authors: Rocca
authors: Silvia
authors: S
authors: Magni
authors: Flavia
authors: F
authors: Brivio
authors: Simona
authors: S
authors: Ferrante
mesh_terms: D000328:Adult; D000368:Aged; D058443:Catastrophization / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D059350:Chronic Pain / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000458:organization & administration; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods* / Q000458:organization & administration; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010348:Patient Care Team; D010865:Pilot Projects; D015397:Program Evaluation; D011788:Quality of Life; D016896:Treatment Outcome; D016138:Walking