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manuelletherapie 2005; 9(1): 11-34
DOI: 10.1055/s-2005-857995
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Die Effektivität der Kombination aktiver Physiotherapie mit kognitiven, behavioralen oder kognitiv-behavioralen Behandlungsansätzen bei Patienten mit muskuloskelettalen Schmerzen

Kritischer Überblick über die LiteraturThe Effectiveness of Combined Active Physiotherapy and Cognitive, Behavioural or Cognitive-behavioural Therapy Approaches in Patients with Musculoskeletal PainN. Gärtner-Tschacher
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Publication History

Manuskript eingetroffen: 09.09.2004

Manuskript akzeptiert: 25.10.2004

Publication Date:
03 March 2005 (online)

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Zusammenfassung

Die systematische Übersichtsarbeit untersucht den Effekt aktiver Physiotherapie in Kombination mit kognitiv/behavioralen Ansätzen bei Patienten mit muskuloskelettalen Schmerzen. Die Evidenz für die Verbesserung von Schmerz, Funktion oder Arbeitsfähigkeit reicht von keine Evidenz über eingeschränkte Evidenz bis zu (nur in 1 Studie) moderate Evidenz.

Abstract

The systematic review investigates the effect of physiotherapy in combination with cognitive/behavioural therapy approaches in patients with musculoskeletal pain. The evidence of improvement of pain, function or fitness for work varies from no evidence over restricted evidence up to (only in 1 study) moderate evidence.

Schlüsselwörter

Muskuloskelettaler Schmerz - Physiotherapie - kognitiv/behaviorale Therapie - Evidenz

Key words

Musculoskeletal pain - physiotherapy - cognitive/behavioural therapy - evidence

Literatur

  • 1 Agency for Healthcare Research and Quality [Online]. http://www.ahrq.gov/clinic/epcsums/strengthsum.htm; 18.01.2004. 
  • 2 Arbeitsgemeinschaft zur Förderung der Qualitätssicherung in der Medizin. [Online]. hhtp://www.aqs.de/ivs/glossar.htm#Bias; 08.01.2004. 
  • 3 Bekkering G, Hendriks H, Koes B. et al . Dutch Physiotherapy Guidelines for Low Back Pain.  Physiotherapy. 2003;  89 82-96
    PubMedSearch in Google Scholar
  • 4 Bendix T, Bendix A, Labriola M. et al . Functional restoration versus outpatient physical training in chronic low back pain.  Spine. 2000;  25 2494-2500
    PubMedSearch in Google Scholar
  • 5 Birbaumer N, Schmidt R F. Psychophysiologische Therapie chronischer Schmerzen. Birbaumer N, Schmidt RF Biologische Psychologie Berlin; Springer 1999
    Search in Google Scholar
  • 6 Crombie I K. Appraising review papers. Crombie IK ed Critical Appraisal London; BMJ Publishing Group 1996
    Search in Google Scholar
  • 7 Crombie I K. The complete list for the appraisal of cohort studies. Crombie IK Critical Appraisal London; BMJ Publishing Group 1996
    Search in Google Scholar
  • 8 Crombie I K. The standard appraisal questions. Crombie IK Critical Appraisal London; BMJ Publishing Group 1996
    Search in Google Scholar
  • 9 Discern Project Team .The DISCERN instrument. [Online]. http://www.discern.org.uk/discern_instrument.htm; 23.09.2002. 
  • 10 Doleys D M, Crocker M, Patton D. Response of patients with chronic pain to exercise quotas.  Physical Therapy. 1982;  62 1111-1114
    PubMedSearch in Google Scholar
  • 11 Flor H, Fydrich T, Turk D C. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.  Pain. 1992;  49 221-230
    CrossrefPubMedSearch in Google Scholar
  • 12 Fordyce W E, Brockway J A, Bergman J A. et al . Acute back pain: a control-group comparison of behavioral vs. traditional management methods.  Journal of Behavioral Medicine. 1986;  9 127-140
    CrossrefPubMedSearch in Google Scholar
  • 13 Fritz J M, Delitto A, Erhard R E. Comparison of classification-based physical therapy with therapy based on clinical practice guidelines for patients with acute low back pain.  Spine. 2003;  28 1363-1372
    CrossrefPubMedSearch in Google Scholar
  • 14 Gifford L. Tissue and input related mechanisms. Gifford L ed Topical Issues in Pain 1 Falmouth; CNS Press 1998
    Search in Google Scholar
  • 15 Grahn B, Ekdahl C, Borgquist L. Motivation as a predictor of changes in quality of life and working ability in multidisciplinary rehabilitation: a two-year follow-up of a prospective controlled study in patients with prolonged musculoskeletal disorders.  Disability & Rehabilitation. 2000;  22 639-654
    PubMedSearch in Google Scholar
  • 16 Grimmer K. Evidence Based Research REHB 5032. University of South Australia Lecture Notes [unpublished].  2002; 
    PubMedSearch in Google Scholar
  • 17 Guzmán J, Esmail R, Karjalainen K. et al . Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain (Cochrane review). [Online]. http://www.cochrane.hcn.net.au/CLIB/CLIBINET.EXE?S = 0&Q = 1 033 112 853&U = HC005859&A = 3&B = 0&E = 0&R = 0&F0&H = &D = 1&L = 1&N = 4&M = 4&C = 891&T = (MULTIDISCIPLINARY + and +(BIO-PSYCHO-SOCIAL + and +(REHABILITATION + and +(FOR + and +(CHRONIC + and +(LOW + and +(BACK + and + PAIN))))))).  27.09.202; 
    PubMedSearch in Google Scholar
  • 18 Haldorsen H EM, Kronholm K, Skouen J S. et al . Multimodal cognitive behavioral treatment of patients sicklisted for musculoskeletal pain: a randomized controlled study.  Scandinavian Journal of Rheumatology. 1998;  27 16-25
    CrossrefPubMedSearch in Google Scholar
  • 19 Haldorsen H EM, Grasdal A L, Skouen J S. et al . Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain.  Pain. 2002;  95 49-63
    CrossrefPubMedSearch in Google Scholar
  • 20 Jensen I B, Bergstrom G, Ljungquist T. et al . A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender?.  Pain. 2001;  91 65-78
    CrossrefPubMedSearch in Google Scholar
  • 21 Keefe F, Lefebvre J C. Behavioral therapy. Wall PD, Melzack R Textbook of Pain London; Churchill-Livingstone 1999
    Search in Google Scholar
  • 22 Keel P J, Wittig R, Deutschmann R. et al . Effectiveness of in-patient rehabilitation for sub-chronic and chronic low back pain by an integrative group treatment program (swiss multicentre study). Scandinavian Journal of Rehabilitation Medicine.  1998;  30 211-219
    CrossrefPubMedSearch in Google Scholar
  • 23 Lindström I, Ohlund C, Eek C. et al . Mobility, strength, and fitness after a graded program for patients with subacute low back pain. A randomized prospective clinical study with a behavioral therapy approach.  Spine. 1992;  17 641-652
    PubMedSearch in Google Scholar
  • 24 Lindström I, Ohlund C, Eek C. et al . The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavioral approach.  Physical Therapy. 1992;  72 279-293
    PubMedSearch in Google Scholar
  • 25 Linton S J, Gotestam K G. A controlled study of the effects of applied relaxation and applied relaxation plus operant procedures in the regulation of chronic pain.  The British Journal of Clinical Psychology. 1984;  23 291-299
    PubMedSearch in Google Scholar
  • 26 Linton S. A review of psychological risk factors in back and neck pain.  Spine. 2000;  25 1148-1156
    CrossrefPubMedSearch in Google Scholar
  • 27 Maher C G, Sherrington C, Herbert R D. et al . Reliability of the PEDro Scale for Rating Quality of Randomized Controlled Trials.  Physical Therapy. 2003;  83 713-721
    PubMedSearch in Google Scholar
  • 28 Martinez A, Simmonds M J, Novy D M. Physiotherapy for patients with chronic pain: an operant-behavioural approach.  Physiotherapy Theory & Practice. 1997;  13 97-108
    PubMedSearch in Google Scholar
  • 29 McCracken L M, Gross R T, Eccleston C. Multimethod assessment of treatment process in chronic low back pain: comparison of reported pain-related anxiety with directly measured physical capacity.  Behaviour Research and Therapy. 2002;  40 585-594
    CrossrefPubMedSearch in Google Scholar
  • 30 Mellin G, Harkapaa K, Vanharanta H. et al . Outcome of a multimodal treatment including intensive physical training of patients with chronic low back pain.  Spine. 1993;  18 825-829
    PubMedSearch in Google Scholar
  • 31 Merskey H, Bogduk N. Classification of Chronic Pain. Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. 2nd. ed. Seattle; IASP Press 1994
    Search in Google Scholar
  • 32 Mizel D H. Rehabilitation - a valuable consideration in acute and chronic neck and low back pain in addition to standard chiropractic management: a case study.  Journal of the Canadian Chiropractic Association. 1999;  43 22-30
    PubMedSearch in Google Scholar
  • 33 Nachemson A L. Newest knowledge of low back pain.  Clinical Orthopaedics and Related Research. 1992;  279 8-20
    PubMedSearch in Google Scholar
  • 34 Nicholas M K, Wilson P H, Goyen J. Operant-behavioural and cognitive-behavioural treatment for chronic low back pain.  Behaviour Research & Therapy. 1991;  29 225-238
    PubMedSearch in Google Scholar
  • 35 Nicholas M K, Wilson P H, Goyen J. Comparison of cognitive-behavioral group treatment and an alternative non-psychological treatment for chronic low back pain.  Pain. 1992;  48 339-347
    CrossrefPubMedSearch in Google Scholar
  • 36 PEDro scale .[Online Image]. http://www.cchs.usyd.edu.au/pedro/scaleitems.htm; 23.09.2002. 
  • 37 Pfingsten M, Hildebrandt J. Degenerative und andere nicht-entzündliche Erkrankungen der Bewegungsapparate. Petermann K Rehabilitation Göttingen; Hogrefe 1997
    Search in Google Scholar
  • 38 Pincus T, Vlaeyen J, Kendall N. et al . Cognitive-behavioral therapy and psychosocial factors in low back pain.  Spine. 2002;  27 E133-138
    CrossrefPubMedSearch in Google Scholar
  • 39 Seres J L, Newman R I. Results of treatment of chronic low-back pain at the Portland Pain Center.  Journal of Neurosurgery. 1976;  45 32-36
    PubMedSearch in Google Scholar
  • 40 Shacklock M O. The clinical application of central pain mechanisms in manual therapy.  Australian Journal of Physiotherapy. 1999;  45 215-221
    PubMedSearch in Google Scholar
  • 41 Smith L M. Physiotherapy. Tyrer SP ed Psychology, Psychiatry and Chronic Pain Oxford; Butterworth-Heinemann 1992
    Search in Google Scholar
  • 42 Söderlund A, Lindberg P. An integrated physiotherapy/cognitive-behavioural approach to the analysis and treatment of chronic whiplash associated disorders, WAD.  Disability & Rehabilitation. 2001;  23 436-447
    PubMedSearch in Google Scholar
  • 43 Staples D. Behavioural treatment for chronic pain.  Physiotherapy. 1979;  65 110-113
    PubMedSearch in Google Scholar
  • 44 Stenström C H. Home exercise in rheumatoid arthritis functional class II: goal setting versus pain attention.  Journal of Rheumatology. 1994;  21 627-634
    PubMedSearch in Google Scholar
  • 45 Van Tulder M W, Koes B W, Bouter L M. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions.  Spine. 1997;  22 2128-2156
    CrossrefPubMedSearch in Google Scholar
  • 46 Van Tulder M W, Ostelo R, Vlaeyen J WS. et al . Behavioral treatment for chronic low back pain.  Spine. 2000;  25 2688-2699
    PubMedSearch in Google Scholar
  • 47 Turk D C, Okifuji A. A cognitive-behavioural approach to pain management. Wall PD und Melzack R Textbook of Pain London; Churchill-Livingstone 1999
    Search in Google Scholar
  • 48 Turner J A, Clancy S, McQuade K J. et al . Effectiveness of behavioral therapy for chronic low back pain: a component analysis.  Journal of Consulting & Clinical Psychology. 1990;  58 573-579
    PubMedSearch in Google Scholar
  • 49 Vlaeyen J WS, de Jong J, Geilen M. et al . Graded exposure in vivo in the treatment of pain-related fear: a replicated single-case experimental design in four patients with chronic low back pain.  Behaviour Research and Therapy. 2001;  39 151-166
    CrossrefPubMedSearch in Google Scholar
  • 50 Waddell G. Low back pain: a twentieth-century health care enigma.  Spine. 1996;  21 2820-2825
    CrossrefPubMedSearch in Google Scholar
  • 51 Waddell G. Approaches to chronic low back pain. Waddell G The Back Pain Revolution London; Churchill-Livingstone 1998
    Search in Google Scholar
  • 52 Walsh D A, Radcliffe J C. Pain beliefs and perceived physical disability of patients with chronic low back pain.  Pain. 2002;  97 23-31
    CrossrefPubMedSearch in Google Scholar
  • 53 Watson P. Physical activities program content. Main CJ, Spanswick CC Pain Management: An Interdisciplinary Approach London; Churchill-Livingstone 2000
    Search in Google Scholar
  • 54 Williams D A, Cary M A, Groner K H. et al . Improving physical functional status in patients with fibromyalgia: A brief cognitive behavioral intervention.  Journal of Rheumatology. 2002;  29 1280-1286
    PubMedSearch in Google Scholar

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