Evaluation of the impact of a behavioral task schedule on functionnal incapacity while structuring a therapeutic educational program for chronic low back pain patients : prospective interventionnal trial.

Dr Charles COWANa, Dr André GUEYRAUDb, Dr Cyril MANZANERAc, Dr Vianney JOUHETd, Dr Gauthier BOUCHEe, Dr Thierry DABBADIEb

a CH Dax, b CSSR Les Glamots, c CHU Montpellier, d ISPED Bordeaux, e CHU Poitiers

Objectives. - Evaluation of the impact of a Behavioral Task Schedule (BTS), established according to a method of cognitive behavioural therapy, on functionnal incapacity in chronic low back pain patients during a functional restoration program.

Material and methods. - Prospective interventional trial « Before- After » use of BTS in chronic low back pain patients (N=71). The evaluation of the functionnal incapacity (Dallas Pain Questionnaire), the fear-advoidance beliefs (Fear-Avoidance Beliefs Questionnaire) and the psychologic aspect (Hospital Anxiety and Depression scale) were assessed during a Multidisciplinary Evaluation Day (MED), during hospitalisation and at 3 months folllow-up.

Results. - The different parameters were improved in the two groups during the trial but without a significative difference between them. The group with BTS had better improvement at 3 months than the group without it. The global Dallas score improved from the MED (51,2%+/-16,9 without BTS vs 50,4%+/-12,3 with), at discharge (30,0%+/-19,8 without BTS vs 31,9%+/-14,9 with) and at 3 months (28,7%+/-21,2 without BTS vs 23,3%+/-15,5 with).

Conclusion. - Functional restoration programs improve chronic low back pain patients in multidimensional ways (physically, psychologically and socially). The use of a BTS does not improve significativally our patients during our trial but seems to improve them at a distance.

Keywords : Chronic low back pain, Cognitive behavioural therapy, Dallas Pain Questionnaire, Fear-Advoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale.