Article

OBJECTIVE: To assess the effect of back school integrated with core-strengthening
exercises on back-specific disability and pain-coping strategies and to examine
how reactions to pain affect the outcomes of back school in patients with chronic
low back pain. DESIGN: A single-center prospective trial was conducted with 142
participants with chronic low-back pain (38 men and 104 women) who completed a
back school program at the spine center of a university hospital. The subjects
participated in a 4-wk program integrated with core-strengthening exercises.
Back-specific disabilities were measured as a primary outcome before and after
the program. Secondary outcomes were pain, Chronic Pain Coping Inventory, general
health status assessed by the SF-36, and quantitative functional evaluations of
factors, such as trunk muscle strength, endurance, and the back performance
scale. A subgroup of 28 subjects (12 men and 16 women) of the total sample of 142
subjects was used to analyze the longitudinal association between coping
strategies and the primary outcome in a long-term follow-up study. These
participants were divided into three groups (much improved, slightly improved,
and unimproved) based on changes in back-specific disability scores. RESULTS:
Participants improved significantly in terms of back-specific disability, pain,
general health, and quantitative functional tests according to the short-term
evaluation. They used more relaxation and exercise/stretching techniques as
coping strategies. Of the groups participating in the longer-term follow-up (T3),
the much-improved group showed significant improvement between T1 (before back
school) and T2 (after back school) in scores for relaxation (1.6 +/- 1.0 vs. 2.6
+/- 1.1), task persistence (2.9 +/- 1.2 vs. 3.7 +/- 1.2), and exercise (3.3 +/-
1.1 vs. 5.2 +/- 1.9), but the coping strategies of those in the slightly improved
and unimproved groups did not change significantly at T2. CONCLUSIONS: Our back
school program may help patients with chronic low back pain reduce back-specific
disability and pain and develop wellness-focused coping strategies such as
exercise and stretching.

Langue : ANGLAIS