Short-term effect of back school based on cognitive behavioral therapy involving multidisciplinary collaboration

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  • Motoya Ryo
    Department of Clinical Psychology, School of Psychological Science, Health Sciences University of Hokkaido
  • Otani Koji
    Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University
  • Nikaido Takuya
    Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University
  • Ono Yoko
    Rehabilitation Center, Fukushima Medical University Hospital
  • Matsumoto Takatomo
    Department of Neuropsychiatry, School of Medicine, Fukushima Medical University
  • Yamagishi Ryohei
    System Division, S.B.C. Co., Ltd.
  • Yabuki Shoji
    Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University Rehabilitation Center, Fukushima Medical University Hospital
  • Konno Shin-Ichi
    Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University
  • Niwa Shin-Ichi
    Department of Neuropsychiatry, School of Medicine, Fukushima Medical University The Executive Administrator, Prefectural Hospital Bureau of Fukushima
  • Yabe Hirooki
    Department of Neuropsychiatry, School of Medicine, Fukushima Medical University

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<p>Objectives</p><p>The purpose of this study was to develop a comprehensive back school program that included elements of CBT (Cognitive Behavioral Therapy), implement this through multidisciplinary collaboration, and ascertain its effectiveness as a pilot study. </p><p>Design</p><p>This school was implemented in the form of five 90-minute group sessions held every other week.</p><p>Methods</p><p>Participants comprised 7 chronic low back pain patients with poor improvement in the usual treatment. Practitioners were orthopaedic surgeon, physical therapist, and a clinical psychologist. </p><p>This school contents were patient education, self-monitoring, back exercise, relaxation, stress management, cognitive restructuring, activity pacing, and exposure. </p><p>Results</p><p>From the Wilcoxon signed-rank test, each score of four scales or items (sense of control, PCS (pain catastrophizing), PASS-20 (escape/avoidance), FFD (finger-floor distance)) after this program significantly improved. Results of calculating the effect size, sense of control (d=0.55) is ‘moderate’, the PCS (d=1.12) and the PASS-20 (d=1.64) were ‘large’.</p><p>Conclusions</p><p>This back school may be useful for physical function and psychological variables which much related to pain management and daily disabilities in patients with poor respond to standard orthopaedic treatment.</p>

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