Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis. A randomised controlled trial
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Purpose To evaluate the effect of a rehabilitation programme including the management of catastrophising and kinesiophobia on disability, dysfunctional thoughts, pain, and the quality of life in patients after lumbar fusion for degenerative spondylolisthesis and/or lumbar spinal stenosis.Methods This was a parallel-group, randomised, superiority-controlled study in which 130 patients were randomly assigned to a programme consisting of exercises and cognitive-behavioural therapy (experimental group, 65 subjects) or exercises alone (control group, 65 subjects). Before treatment (T1), 4 weeks later (post-treatment analysis, T2) and 12 months after the end of treatment (follow-up, T3), all the patients completed a booklet containing the Oswestry Disability Index (ODI, primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophising Scale, a pain Numerical Rating Scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used for each outcome measure.Results The ODI linear mixed model revealed significant main effects of group (F(1,122.8) = 95.78, p < 0.001) and time (F(2,120.1) = 432.02, p < 0.001) in favour of the experimental group. There was a significant group × time interaction effect (F(2,120.1) = 20.37, p < 0.001). The analyses of all of the secondary outcome measures revealed a significant effect of time, group and interaction in favour of the experimental group.Conclusion The rehabilitation programme, including the management of catastrophising and kinesiophobia, was superior to the exercise programme in reducing disability, dysfunctional thoughts, and pain, and enhancing the quality of life of patients after lumbar fusion for degenerative spondylolisthesis and/or LSS. The effects lasted for at least 1 year after the intervention ended.
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Twelve studies evaluated (sub)acute outcomes, and all but two evaluated chronic outcomes.
“Twelve studies evaluated (sub)acute outcomes, 2,7,11,12,18,21,29,32,39,44,45,55 and all but 2 studies 2,18 evaluated chronic outcomes.”
Three individual studies showed large effect sizes for all or most of their outcomes.
“When looking at individual studies, 3 of them showed large effect sizes for all or most of their outcomes.7,10,32”
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- Authors
- Monticone, M., Ferrante, S., Teli, M., Rocca, B., Foti, C., Lovi, A., & Brayda Bruno, M.
- Affiliations
- Fondazione Salvatore Maugeri (IT)
- Azienda Ospedaliera Ospedale Civile di Legnano (IT)
- University of Rome Tor Vergata (IT)
- IRCCS Ospedale Galeazzi - Sant'Ambrogio (IT)
- Corresponding author
- Monticone, Marco
- Venue
- European Spine Journal
- Published
- 2013-07-09
- Volume
- 23
- Issue
- 1
- Pages
- 87-95
- ISSN
- 0940-6719 (ISSN-L)
- 1432-0932
- PMC
- PMC3897823
- OpenAlex
- W2026685408
- Cited by
- 119
- References
- 32
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 7 · 2023: 14 · 2022: 13 · 2021: 12 · 2020: 11 · 2019: 18 · 2018: 6 · 2017: 7 · 2016: 10 · 2015: 6 · 2014: 2
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Spine Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Virtual Community of Pathological Anatomy (University of Castilla La Mancha) (submittedVersion, other-oa)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pain catastrophizing, kinesiophobia, lumbar fusion, degenerative spondylolisthesis, lumbar spinal stenosis, cognitive behavioral therapy, exercise therapy, postoperative rehabilitation, disability, pain, quality of life, long-term outcomes
- MeSH terms
- Adult, Exercise Therapy, Female, Persons with Disabilities, Humans, Lumbar Vertebrae, Male, Middle Aged, Movement, Pain Measurement, Phobic Disorders, Quality of Life, Spinal Stenosis, Spondylolisthesis, Cognitive Behavioral Therapy, Treatment Outcome, Outcome Assessment, Health Care, Disease Management, Catastrophization
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