Behavioral Interventions for Low Back Pain - NIH Grant Award Recipients

Behavioral Interventions for Low Back Pain
CRISP (Computer Retrieval of Information on Scientific Projects)

Abstract

Grant Number: 1R03AR051128-01A2
Project Title: Behavioral Interventions for Low Back Pain
PI Information: Name Email Title
GEORGE, STEVEN Z. sgeorge@phhp.ufl.edu

Abstract: DESCRIPTION (provided by applicant). The dominant role that psychosocial factors play in the development of chronic disability from low back pain has been well established in the literature. As a result, the investigation of biopsychosocial models for treatment of low back pain has been advocated by researchers. The Fear-Avoidance Model of Exaggerated Pain Perception (FAMEPP) is a biopsychosocial model that proposes an individual's pain related fear and avoidance is the most important factor in determining whether chronic disability results from an episode of low back pain. In the FAMEPP, individuals with high pain related fear and avoidance are hypothesized to use an avoidance response to low back pain and have deleterious physical and psychological consequences. Individuals with low pain related fear and avoidance are hypothesized to use a confrontation response to low back pain and gradually return to their normal social and physical functioning. Support for the validity of the FAMEPP is found in longitudinal studies that have demonstrated that pain related fear and avoidance significantly predicts future disability after a low back injury. Treatment based on the FAMEPP involves facilitating confrontation in individuals that normally would not use a confrontation response (i.e. those with high pain related fear and avoidance). Two specific behavioral interventions have been used to facilitate confrontation for patients with low back pain. Graded exposure facilitates confrontation by systematically exposing the individual to situations that they are fearful of and gradually increasing their exposure to such situations. Graded exercise facilitates confrontation by systematically increasing the patients' tolerance to activity (graded exercise). Investigations in the literature support the use of these behavioral interventions, but their effectiveness has not been investigated in patients before they have chronic low back pain. Behavioral interventions that effectively reduce future disability before the onset of chronic symptoms could potentially reduce societal and economic costs associated with low back pain. The purpose of this small grant (RO3) research proposal is to determine the efficacy of a graded exposure rehabilitation intervention for reducing future disability from sub-acute low back pain for patients with elevated fear-avoidance beliefs.

Thesaurus Terms:
avoidance behavior, backache, behavior modification, behavior therapy, belief, exercise, fear, human therapy evaluation
behavioral medicine, clinical trial, longitudinal human study, outcomes research, rehabilitation, social psychology
behavioral /social science research tag, clinical research, data collection methodology /evaluation, human subject, questionnaire

Institution: UNIVERSITY OF FLORIDA
219 Grinter Hall
GAINESVILLE, FL 326115500
Fiscal Year: 2005
Department: PHYSICAL THERAPY
Project Start: 01-JUL-2005
Project End: 30-JUN-2008
ICD: NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
IRG: ZAR1