Chronic Low Back Pain
Conditions
Keywords
Chronic Low Back Pain, Cognitive-Behavioural Therapy, Exposure, Therapeutic processes, Single-case study
Brief summary
Exploration of treatment processes during exposure and cognitive-behavioral therapy in the context of chronic low back pain in a multiple baseline single-case design.
Detailed description
The present study intends to specifically investigate treatment elements during exposure and cognitive-behavioral therapy, which are especially powerful in electing time contingent therapeutic change. hereby, it is the goal to explore further change processes, which play an important role during psychological treatment of individuals with CLBP and high levels of fear-avoidance.
Interventions
BEHAVIORALExposure in vivo
10 sessions based on an individualized fear hierarchy
BEHAVIORALCognitive Behavioural Psychotherapy
graded activity, relaxation techniques and cognitive interventions
Sponsors
Psychotherapie-Ambulanz Marburg e.V.
Philipps University Marburg
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \> 6 months chronic low back pain * Sufficient level on fear avoidance scores (PCS \> 35, PASS \>20, QBPDS \> 30, PDI \> 20 and Phoda harm ratings of 13 activities \> 50, including 8 \> 80) * German-speaking * Agreeing to participate, verified by completion of informed consent
Exclusion criteria
* Red flags * Pregnancy * Illiteracy * Psychoses * Alcohol addiction * Surgeries during the last 6 months or planed surgeries * Specific medical disorders or cardiovascular diseases preventing participation in physical exercise * Participating in another psychotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Therapeutic changes during the course of treatment compared to baseline | from baseline phase (1-3 weeks) to intervention phase (5 weeks) | Specifically developed questionnaire on therapeutic change processes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain-related anxiety at posttest and follow-up compared to baseline pain-related anxiety | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Pain Anxiety Symptom Scale, PASS- D 20 |
| Pain catastrophizing thoughts at posttest and follow-up compared to baseline pain catastrophizing thoughts | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Pain Catastrophizing Scale, PCS |
| Perceived harmfulness of daily activities at posttest and follow-up compared to baseline perceived harmfulness of daily activities | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Photo Series of Daily Actives, Phoda |
| Pain-related avoidance behavior at posttest and follow-up compared to baseline pain-related avoidance behavior | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Behavioral Avoidance Test, BAT Back |
| Pain severity at posttest and follow-up compared to baseline pain severity | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Brief Pain Inventory, BPI |
| Change from baseline in specific pain disability at posttest and follow-up compared to baseline specific pain disability | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Quebec Back Pain Disability Scale, QBPDS |
| Emotional distress at posttest and follow-up compared to baseline emotional distress | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Hospital Anxiety and Depression Scale, HADS |
| Biological stress markers distress at posttest and follow-up compared to baseline biological stress markers | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | collection of salivary cortisol using SaliCaps during the behavioral test, collection of hair samples |
| Change from baseline in global pain disability at posttest and follow-up compared to baseline global pain disability | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) | Pain Disability Index, PDI |
Countries
Germany
Outcome results
None listed