Primena individualno koncipiranog kineziterapijskog tretmana i kognitivno-bihejvioralne terapije u lečenju hroničnog bolnog lumbalnog sindroma

Abstract

Introduction. Chronic low back pain (CLBP) is a complex medical problem. Therapy involves adequately composed and conducted exercises and cognitive-behavioral therapy for chronic pain. Objective. Evaluation of the significance of the individually designed exercises and cognitive-behavioral therapy application in the treatment of patients with CLBP and their combined effect on pain, functional and psychosocial status. Method. The study included 130 patients divided into four groups. One group had individually designed strengthening and stretching exercises with a set of stabilization exercises and cognitive-behavioral treatment for chronic pain. The second group had the same exercises without CBT. The third had a standard protocol, without stabilization exercises. The control group had no treatment. Before, after therapy and 3 months later, the patients completed questionnaires: SF-36, ODQ, RDQ, NPRS, HSCL, FABQ, TSK, BDI, BAI, PHQ, WHOQOL-BREF. Results. After completion of therapy and three months later, all the parameters improved significantly in groups that had the individually designed stabilization exercise program, with better results in the group that had the cognitive-behavioral treatment in addition. The pain was reduced by 2.77±1.31/3.77±1.77 and disability (ODS) decreased by 12.91±8.06/ 14.46±7.97. A significant improvement in symptoms of depression and anxiety, reduction of fear avoidance and kinesiophobia parameters, as well as improvement of the overall quality of life, was evidented. Conclusion. Individually designed exercises and cognitive-behavioral therapy for chronic pain were effective in the treatment of patients with CLBP and should be introduced into everyday clinical practice.