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KMID : 1100920220430060367
Korean Journal of Family Medicine
2022 Volume.43 No. 6 p.367 ~ p.373
Efficiency of Associating Therapeutic Patient Education with Rehabilitation in the Management of Chronic Low Back Pain: A Randomized Controlled Trial
Rim Maaoui

Leila Rouached
Aicha Ben Tekaya
Olfa Saidane
Meriem Hfaiedh
Ines Lajnef
Najla Mouhli
Hajer Rahali
Imen Ksibi
Abstract
Background: This study aimed to assess the benefits of associating rehabilitation with therapeutic patient educa-tion (TPE) to decrease fear-avoidance belief and pain and improve function in adults with chronic low back pain (CLBP).

Methods: This randomized controlled study included 100 patients with CLBP according to the CONSORT (Consol-idated Standards of Reporting Trials) guidelines. The patients were divided into two teams: group A that participat-ed in the TPE in association with rehabilitation and group B that received rehabilitation only. Pain and functional amelioration were assessed initially (T0) and at the end of the program (T1) using a visual analog scale at rest, work, and activity, and the Echelle d¡¯Incapacite Fonctionnelle pour l¡¯Evaluation des Lombalgies scale. Psychological and apprehension and avoidance assessments were also conducted, including the evaluation of depression, anxiety, fear-avoidance belief, and kinesiophobia using the Hospital Anxiety and Depression Scale, Fear-Avoidance Beliefs Questionnaire, and Tampa scale of kinesiophobia scale.

Results: The evaluation of progression initially (T0) and then at the end of the program (T1) revealed a significant reduction in pain at rest (P=0.00) and while working (P=0.00) and doing physical activity (P=0.03); a decrease in anxiety (P=0.03), fear-avoidance belief (P=0.03), and kinesiophobia (P=0.02); and an improvement in function (P=0.00) for patients in group A without amelioration of depression (P=0.15). Concerning group B, we identified a significant regression in pain at rest (P=0.001) and while working (P=0.03) and doing physical activity (P=0.00); de-pression (P=0.01); fear-avoidance beliefs (P=0.00); and kinesiophobia (P=0.002). Comparison between the groups revealed that associating TPE with rehabilitation resulted in a more significant improvement in function (P=0.00), anxiety (P=0.00), fear-avoidance belief (P=0.00), and kinesiophobia (P=0.00).

Conclusion: Associating TPE with rehabilitation improved function and reduced fear, false beliefs, and kinesiopho-bia of movement in patients with CLBP.
KEYWORD
Low Back Pain, Chronic, Education, Fear
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