Changes in Pain Self-Efficacy, Coping Skills, and Fear-Avoidance Beliefs in a Randomized Controlled Trial of Yoga, Physical Therapy, and Education for Chronic Low Back Pain.
Pain Med
; 23(4): 834-843, 2022 04 08.
Article
en En
| MEDLINE
| ID: mdl-34698869
ABSTRACT
OBJECTIVE:
We evaluated exercise interventions for cognitive appraisal of chronic low back pain (cLBP) in an underserved population.METHODS:
We conducted a secondary analysis of the Back to Health Trial, showing yoga to be noninferior to physical therapy (PT) for pain and function outcomes among adults with cLBP (n = 320) recruited from primary care clinics with predominantly low-income patients. Participants were randomized to 12 weeks of yoga, PT, or education. Cognitive appraisal was assessed with the Pain Self-Efficacy Questionnaire (PSEQ), Coping Strategies Questionnaire (CSQ), and Fear-Avoidance Beliefs Questionnaire (FABQ). Using multiple imputation and linear regression, we estimated within- and between-group changes in cognitive appraisal at 12 and 52 weeks, with baseline and the education group as references.RESULTS:
Participants (mean age = 46 years) were majority female (64%) and majority Black (57%), and 54% had an annual household income <$30,000. All three groups showed improvements in PSEQ (range 0-60) at 12 weeks (yoga, mean difference [MD] = 7.0, 95% confidence interval [CI] 4.9, 9.0; PT, MD = 6.9, 95% CI 4.7 to 9.1; and education, MD = 3.4, 95% CI 0.54 to 6.3), with yoga and PT improvements being clinically meaningful. At 12 weeks, improvements in catastrophizing (CSQ, range 0-36) were largest in the yoga and PT groups (MD = -3.0, 95% CI -4.4 to -1.6; MD = -2.7, 95% CI -4.2 to -1.2, respectively). Changes in FABQ were small. No statistically significant between-group differences were observed on PSEQ, CSQ, or FABQ at either time point. Many of the changes observed at 12 weeks were sustained at 52 weeks.CONCLUSION:
All three interventions were associated with improvements in self-efficacy and catastrophizing among low-income, racially diverse adults with cLBP. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01343927.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Yoga
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Dolor de la Región Lumbar
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Dolor Crónico
Tipo de estudio:
Clinical_trials
Límite:
Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Pain Med
Asunto de la revista:
NEUROLOGIA
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PSICOFISIOLOGIA
Año:
2022
Tipo del documento:
Article