D Claus1, E Coudeyre2, J Chazal3, B Irthum3, A Mulliez4, P Givron5. 1. Service de médecine physique et de réadaptation, centre hospitalier Jacques-Lacarin, 03100 Vichy, France. 2. Université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service de médecine physique et de réadaptation, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France. Electronic address: ecoudeyre@chu-clermontferrand.fr. 3. Service de neurochirurgie, CHU Clermont-Ferrand, université Clermont-Auvergne, 63003 Clermont-Ferrand Cedex 1, France. 4. Délégation Recherche Clinique & Innovation, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France. 5. Université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service de médecine physique et de réadaptation, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France.
Abstract
OBJECTIVE: We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy. METHODS: In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content. Patients were blinded to treatment group. The main outcome was disability at 2 months (measured by the Quebec back-pain disability scale [QBPDS]). Secondary outcomes were fear and avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire (FABQ). All data were collected by self-reporting questionnaires. RESULTS: At 2 months, disability did not differ between the 2 groups (QBPDS score 32.4±22.8 vs 36.1±18.7, P=0.36). FABQ physical activity score was lower with the evidenced-based booklet as compared with controls (8.0±7.14 vs 11.2±6.3, P=0.008). CONCLUSIONS: Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. CLINICALTRIALS. GOV IDENTIFIER: NCT00761111.
RCT Entities:
OBJECTIVE: We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy. METHODS: In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content. Patients were blinded to treatment group. The main outcome was disability at 2 months (measured by the Quebec back-pain disability scale [QBPDS]). Secondary outcomes were fear and avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire (FABQ). All data were collected by self-reporting questionnaires. RESULTS: At 2 months, disability did not differ between the 2 groups (QBPDS score 32.4±22.8 vs 36.1±18.7, P=0.36). FABQ physical activity score was lower with the evidenced-based booklet as compared with controls (8.0±7.14 vs 11.2±6.3, P=0.008). CONCLUSIONS: Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. CLINICALTRIALS. GOV IDENTIFIER: NCT00761111.
Authors: Christopher M Bono; Dana A Leonard; Thomas D Cha; Joseph H Schwab; Kirkham B Wood; Mitchel B Harris; Andrew J Schoenfeld Journal: Eur Spine J Date: 2016-11-02 Impact factor: 3.134