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A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study

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Abstract

Purpose

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.

Conclusion

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.

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Acknowledgments

This study was supported by the EuroSpine Task Force on Research (year of funding: 2012).

Ethical standards

Our Institutional Review Board approved the study, which was conducted in conformity with ethical and humane principles of research.

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Authors and Affiliations

  1. 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, Emilia Ambrosini, Barbara Rocca, Silvia Magni & Flavia Brivio

  2. Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy

    Emilia Ambrosini & Simona Ferrante

Authors
  1. Marco Monticone
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  2. Emilia Ambrosini
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  3. Barbara Rocca
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  4. Silvia Magni
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  5. Flavia Brivio
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  6. Simona Ferrante
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Correspondence to Marco Monticone.

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Monticone, M., Ambrosini, E., Rocca, B. et al. A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study. Eur Spine J 23, 2105–2113 (2014). https://doi.org/10.1007/s00586-014-3478-5

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  • DOI: https://doi.org/10.1007/s00586-014-3478-5

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