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A brief primary care intervention to reduce fear of movement in chronic low back pain patients

  • Case Study
  • Published:
Translational Behavioral Medicine

Abstract

Fear avoidance model of chronic pain-based interventions are effective, but have not been successfully implemented into primary care. It was hypothesized that speed walking times and key measures of the fear avoidance model would improve following the brief intervention delivered in primary care. A brief primary care-based intervention (PCB) that included a single educational session, speed walking (an in vivo desensitization exposure task), and visual performance feedback was designed to reduce fear avoidance beliefs and improve function in 4 patients with chronic low back pain. A multiple baseline across subjects with a changing criterion design indicated that speed walking times improved from baseline only after the PCB intervention was delivered. Six fear avoidance model outcome measures improved from baseline to end of study and five of six outcome measures improved from end of study to follow-up. This study provides evidence for the efficacy of a brief PCB fear avoidance intervention that was successfully implemented into a busy clinic for the treatment of chronic pain.

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Conflict of interest

The authors declare that they have no conflict of interest.

Adherence to ethical standards

All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation at Creighton University and with the Helsinki Declaration of 1975, as revised in 2000.

Author information

Authors and Affiliations

  1. Department of Family Medicine, Creighton University School of Medicine, 1319 Leavenworth Street, Omaha, NE, 68102, USA

    Thomas P Guck PhD, Christopher Rainville MD & Dreylana Hill-Taylor MD

  2. The Prevention Group; Munroe Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA

    Raymond V Burke PhD

  3. Integrative Pain Management, Children’s Mercy Hospitals and Clinics, School of Medicine, University of Kansas City-Missouri, Omaha, NE, USA

    Dustin P Wallace PhD

Authors
  1. Thomas P Guck PhD
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  2. Raymond V Burke PhD
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  3. Christopher Rainville MD
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  4. Dreylana Hill-Taylor MD
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  5. Dustin P Wallace PhD
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Corresponding author

Correspondence to Thomas P Guck PhD.

Additional information

Implications

Practice: A brief fear avoidance model based on cognitive-behavioral intervention can be effectively implemented into primary care.

Policy: Health care reform models and reimbursement policies should include access to integrated biopsychosocial treatments designed to improve function in chronic pain patients treated in primary care settings.

Research: Further research on design and delivery of cognitive behavioral interventions in the primary care setting is urgently needed.

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Guck, T.P., Burke, R.V., Rainville, C. et al. A brief primary care intervention to reduce fear of movement in chronic low back pain patients. Behav. Med. Pract. Policy Res. 5, 113–121 (2015). https://doi.org/10.1007/s13142-014-0292-x

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  • DOI: https://doi.org/10.1007/s13142-014-0292-x

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