A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study
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Purpose To evaluate the effect of a multidisciplinary rehabilitation programme on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic low back pain (CLBP).Methods This was a parallel-group, randomised, superiority-controlled pilot study in which 20 patients were randomly assigned to a programme consisting of motor training (spinal stabilising exercises plus usual-care) and cognitive-behavioural therapy (experimental group, 10 subjects) or usual-care alone (control group, 10 subjects). Before treatment, 8 weeks later (post-treatment), and 3 months after the end of treatment, the Oswestry Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale, and the Short-Form Health Survey were assessed. Spatio-temporal gait parameters were also measured by means of an electronic walking mat. A linear mixed model for repeated measures was used for each outcome measure.Results The programme had significant group (p = 0.027), time (p < 0.001), and time-by-group interaction (p < 0.001) effects on disability, with the experimental group showing an improvement after training of about 61 % (25 % in the control group). The analyses of kinesiophobia, catastrophizing, and the quality of life also revealed significant time, group, and time-by-group interaction effects in favour of the experimental group, and there was a significant effect of time on pain. Both groups showed a general improvement in gait parameters, with the experimental group increasing cadence significantly more.Conclusion The multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to the exercise programme in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life and gait cadence of patients with CLBP.
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Kinesiophobia is a strong predictor for long-term pain disability and pain chronicity, and is associated with higher rates of sick leave, pain vigilance, disability, and decreased physical activity.
“It has been demonstrated that kinesiophobia has shown to be a strong predictor for pain disability and pain chronicity in the longer term [73] associated with higher rates of sick-leaves [74], pain vigilance and disability as well as decreased physical activity levels [75–77].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [76]
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- Authors
- Monticone, M., Ambrosini, E., Rocca, B., Magni, S., Brivio, F., & Ferrante, S.
- Affiliations
- Fondazione Salvatore Maugeri (IT)
- Politecnico di Milano (IT)
- Corresponding author
- Monticone, Marco
- Venue
- European Spine Journal
- Published
- 2014-07-27
- Volume
- 23
- Issue
- 10
- Pages
- 2105-2113
- ISSN
- 0940-6719 (ISSN-L)
- 1432-0932
- OpenAlex
- W1967577185
- Cited by
- 107
- References
- 33
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 9 · 2023: 5 · 2022: 6 · 2021: 12 · 2020: 9 · 2019: 8 · 2018: 6 · 2017: 11 · 2016: 13 · 2015: 7 · 2014: 1
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- European Spine Journal (publishedVersion)
- PubMed (publishedVersion)
- Virtual Community of Pathological Anatomy (University of Castilla La Mancha) (submittedVersion, other-oa)
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- chronic low back pain, multidisciplinary rehabilitation, cognitive behavioral therapy, kinesiophobia, pain catastrophizing, disability, quality of life, gait cadence, exercise therapy
- MeSH terms
- Adult, Aged, Disability Evaluation, Exercise Therapy, Female, Persons with Disabilities, Humans, Male, Middle Aged, Pain Measurement, Patient Care Team, Pilot Projects, Quality of Life, Program Evaluation, Cognitive Behavioral Therapy, Walking, Treatment Outcome, Low Back Pain, Catastrophization, Chronic Pain
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