Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain: [RETRACTED]: Results of a Randomized Controlled Trial
Abstract
Objective To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain. Methods Study design parallel-group, randomized, superiority controlled study. Ninety patients were randomly assigned to a multidisciplinary program consisting of cognitive-behavior therapy and exercise training (experimental group, 45 patients) or exercise training alone (control group, 45 patients). Before treatment (T1), 5 weeks later (instructive phase, T2), and 12 (posttreatment analysis, T3) and 24 months after the end of the instructive phase (1-year follow-up, T4), all of the patients completed a booklet containing the Roland-Morris Disability Questionnaire Scale (primary outcome), the Tampa Scale for Kinesiophobia, a pain numerical rating scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used to analyze each outcome measure, and the reliable change index/clinically significant change method was used to assess the clinical significance of the changes. Results The linear mixed model analysis showed a remarkable group, time, and interaction effect for group * time in all of the primary and secondary outcomes (P always Conclusions The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear-avoidance beliefs and pain, and enhancing…
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The review initially included three additional CBT versus AC studies (401 participants) and one CBT versus TAU study (92 participants) in analyses.
“We initially included three additional CBT versus AC studies (401 participants) in our analyses (Monticone 2013; Monticone 2016; Monticone 2017), and one study of 92 participants in CBT versus TAU (Castel 2012)”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
For Monticone 2013, Monticone 2016, and Monticone 2017, no explanations were offered by the authors as to why the data were major outliers from all other studies, why the efficacy estimates were so positive, and why there was no attrition.
“For Monticone 2013, Monticone 2016, and Monticone 2017, no explanations were oFered by the authors as to why the data were major outliers from all other studies in the field and, in particular, why the eFicacy estimates were so positive and why there was no attrition, unlike other studies.”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
The review wrote to the authors for comment on its proposed strategy of exclusion from the main findings; it received no answer from one (Castel 2012), and no satisfactory explanation was given for the anomalous sizes of outcome and completeness of follow-up data in the remaining three (Monticone 2013; Monticone 2016; Monticone 2017).
“We wrote to the authors for comment on our proposed strategy of exclusion from the main findings. We received no answer from one (Castel 2012), and no satisfactory explanation was given for the anomalous sizes of outcome and completeness of follow-up data in the remaining three (Monticone 2013; Monticone 2016; Monticone 2017).”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
For Monticone 2013, selective reporting was judged unclear risk because the trial was not pre-registered.
“Unclear risk Trial not pre-registered”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
For Monticone 2013, blinding of outcome assessment was judged low risk because the Principal Investigator obtaining and assessing outcome data, and the biostatisticians making analyses, were all blinded to treatments.
“Low risk”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
For Monticone 2013, incomplete outcome data was judged low risk because there was no attrition during the study and the method to deal with missing data was not described as not needed.
“Low risk No attrition during study. Method to deal with missing data not described as not needed”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
For Monticone 2013, allocation concealment was judged low risk because after consent, physiatrists emailed the Principal Investigator, who randomized patients using a list previously generated by a biostatistician and delivered with blinded treatment codes.
“Low risk”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
For Monticone 2013, random sequence generation was judged low risk because randomisation used SAS PROC PLAN.
“Low risk Randomised using (SAS PROC PLAN)16”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Monticone 2013
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- Authors
- Monticone, M., Ferrante, S., Rocca, B., Baiardi, P., Farra, F. D., & Foti, C.
- Affiliations
- University of Rome Tor Vergata (IT)
- Politecnico di Milano (IT)
- University of Pavia (IT)
- Corresponding author
- Monticone, Marco
- Ferrante, Simona
- Rocca, Barbara
- Venue
- The Clinical Journal of Pain
- Published
- 2013-11
- Volume
- 29
- Issue
- 11
- Pages
- 929-938
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2017033206
- Cited by
- 124
- References
- 4
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 14 · 2021: 15 · 2020: 9 · 2019: 12 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 20 · 2014: 6 · 2013: 1 · 2012: 1
- FWCI
- 8.09
- Type
- journal article
- Language
- en
- Status
- Retracted
- Update notices
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- 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 › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic low back pain, multidisciplinary pain management, cognitive behavioral therapy, fear-avoidance beliefs, kinesiophobia, disability, exercise training, quality of life, long-term follow-up, pain intensity
- MeSH terms
- Adult, Disability Evaluation, Double-Blind Method, Exercise Therapy, Fear, Female, Persons with Disabilities, Disabled Persons, Humans, Longitudinal Studies, Male, Middle Aged, Pain Measurement, Quality of Life, Surveys and Questionnaires, Retrospective Studies, Cognitive Behavioral Therapy, Treatment Outcome, Low Back Pain
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