OVERCOMING FEAR AVOIDANCE BEHAVIORS AND KINESIOPHOBIA IN PATIENTS WITH CHRONIC LOW BACK PAIN

Abstract

Chronic low back pain (CLBP) is a very complex medical, social and economic problem. Long duration and variability of symptoms can be frustrating for patients and lead to various psychological and behavioral changes, which can be expressed as an over-powering fear of movement and lead to avoidance behavior. The aim of this study was to highlight  the importance of individually designed exercises (IDE) and cognitive-behavioral treatment (CBT) in the treatment of patients with CLBP who have signs of fear-avoidance behavior and kinesiophobia. One hundred and thirty patients were included in a prospective randomized study. Group 1 (G1; n = 35) had a combined IDE and CBT program. Group 2 (G2; n = 35) had IDE, without CBT. Group 3 (G3; n = 30) had standard group exercises for CLBP. Group 4 (G4; n = 30) was a control, patients did not have IDE or CBT. Waddel's Fear Avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK), were used for monitoring and evaluation. Patients completed them at the beginning, at the end of the therapy, and also after 3 months. After therapy and three months later, a statistically significant reduction in symptoms in G1 and G2 was recorded, with better results in G1: FABQph = 4.77±3.83/5.51±4.02; FABQw = 2.31±3.69/2.94±4.19; TSK = 5.63±4.56/5.69 ± 4.55. (p <0.001). The combination of IDE and CBT is an effective therapy for CLBP patients with fear avoidance behaviour and kinesiophobia.