title: Group-based task-oriented exercises aimed at managing kinesiophobia improved disability in chronic low back pain.
abstract: BACKGROUND
  There are still doubts concerning the clinical impact of multidisciplinary cognitive behavioural rehabilitation programmes conducted in group-based settings and about their long-term effects on subjects with chronic low back pain (CLBP). This randomized, parallel-group superiority-controlled trial aimed at evaluating the effect of such a programme on disability, kinesiophobia, catastrophizing, pain and quality of life in CLBP.
  
  
  METHODS
  One hundred and fifty patients were randomly assigned to a 5-week group-based multidisciplinary programme of task-oriented exercises integrated with cognitive behavioural therapy mainly aimed at managing kinesiophobia (experimental group, 75 subjects) or group-based traditional exercises (control group, 75 subjects). Before treatment, 5 weeks later (post-treatment), 12 and 24 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. A linear mixed model for repeated measures was used for each outcome measure.
  
  
  RESULTS
  Significant group (p < 0.001), time (p < 0.001) and time-by-group interaction (p < 0.001) effects were found on disability, with a between-group difference (95% confidence interval) after training in favour of the experimental group of -10 (-12; -8). Also kinesiophobia, catastrophizing, pain, and quality of life improved to a significantly greater extent in the experimental group. The improvements of the experimental group were maintained at follow-ups.
  
  
  CONCLUSIONS
  This light group-based multidisciplinary cognitive behavioural rehabilitation programme was superior to traditional exercises in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life of subjects with CLBP. The effects lasted for at least 2 years after the end of the intervention.
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Institute of Care and Research, Salvatore Maugeri Foundation IRCCS, Lissone, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Monticone
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Institute of Care and Research, Salvatore Maugeri Foundation IRCCS, Lissone, Italy.|Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ambrosini
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Institute of Care and Research, Salvatore Maugeri Foundation IRCCS, Lissone, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Rocca
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Institute of Care and Research, Salvatore Maugeri Foundation IRCCS, Lissone, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Cazzaniga
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Institute of Care and Research, Salvatore Maugeri Foundation IRCCS, Lissone, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Liquori
authors.affiliation: Chair of Physical Medicine and Rehabilitation, University of Rome 'Torvergata', Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Foti
mesh_terms: D058443:Catastrophization / Q000523:psychology / Q000628:therapy*; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D013647:Task Performance and Analysis