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SAT0589 Therapeutic education in the management of fears and beliefs in patients with chronic low back pain
  1. R Maaoui1,
  2. A Khezami1,
  3. I Ksibi1,
  4. I Lajnef1,
  5. H Rahali1,
  6. R Dhahri2,
  7. I Gharsallah2,
  8. L Metoui2,
  9. F Lajili2,
  10. S Othmani2
  1. 1Physical and Rehabilitation Medicine
  2. 2Internal Medicine, military hospital Tunis, tunis, Tunisia


Background The notions of apprehension-avoidance and beliefs are among the psychosocial factors associated with the occurrence, maintenance and strengthening of the chronic painful process.

Therapeutic education is increasingly described in the literature as a means to manage these factors in order to limit the transition to a chronic stage.

Objectives The aim of this study is to examine the effect of therapeutic education on fears and beliefs in chronic low back pain.

Methods A prospective, comparative study was conducted with two groups of 50 patients each one having chronic low back pain. Both groups had benefited from the same physical rehabilitation program. The second group concurrently attended therapeutic education sessions.

Fears and beliefs of patients and their kinesiophobia were evaluated with the FABQ: Fear-Avoidance beliefs questionnaire and the TSK: Tampa scale of kinesiophobia for the evaluation of kinesiophobia index.

Results The initial evaluation of apprehension-avoidance showed a high FABQ score in two groups. Management that was limited to physical rehabilitation demonstrated no effect on the apprehension-avoidance indices evaluated by the FABQ scale. However, there was a clear improvement in apprehension and avoidance in the G2 and with a statically significant difference (P=0.03).

An initial and high kinesiophobic score (≥48) was noted in two groups. G1 patients showed no significant improvement in their TSK scores after the end of the program. G2 patients who benefited from a therapeutic education workshop improved their TSK scores significantly after the program completion compared to G2.

Conclusions The integration of the patient into the therapeutic education workshops improved the behavior of apprehension and kinesiophobia. This further supports the usefulness of applying cognitive therapy to our patients when restructuring of preconceived ideas about movement and physical activities.


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  3. Fritz JM, George SZ, Delitto A.The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status.Pain. 2000;94:7–15


Disclosure of Interest None declared

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