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[Impact of functional restoration programs on fears, avoidance and beliefs in chronic low back pain patients]
K Chaory1, F Rannou, J Fermanian
1Département de médecine physique et rééducation, hôpital Cochin, AP-HP, université René-Descartes, 27, rue du Faubourg-Saint-Jacques, 75014 Paris cedex 14, France.
Objective:
To assess the impact of functional restoration programs on fears, avoidance and beliefs in chronic low back pain.
Methods:
Open prospective study in eight spine centers. Seventy patients enrolled in several restoration programs were evaluated before and at the end of the program. Variables recorded were pain (VAS), disability (Quebec back pain disability scale), handicap (VAS), anxiety and depression (HAD scale), and fears, avoidance and beliefs (FABQ).
Results:
All variables recorded significantly improved at the end of the programs except for fears about professional activities (FABQ1) and lumbar mobility. Fears about physical activities (FABQ2) significantly decreased after these programs. Variations in FABQ1 and FABQ2 scores were not correlated with variations in scores of outcome measures assessing impairment, disability, and handicap.
Conclusion:
Functional restoration programs in their current form in France do not decrease fears and beliefs about professional activities in chronic low back pain patients. Adding psychosocial intervention at the work place to the functional restoration programs may lead to a better impact on fears about work thus reducing work loss.
