Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis. A randomised controlled trial

Marco Monticone, Simona Ferrante, Marco Teli, Barbara Rocca, Calogero Foti, Alessio Lovi, Marco Brayda Bruno

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the effect of a rehabilitation programme including the management of catastrophising and kinesiophobia on disability, dysfunctional thoughts, pain, and the quality of life in patients after lumbar fusion for degenerative spondylolisthesis and/or lumbar spinal stenosis. Methods: This was a parallel-group, randomised, superiority-controlled study in which 130 patients were randomly assigned to a programme consisting of exercises and cognitive-behavioural therapy (experimental group, 65 subjects) or exercises alone (control group, 65 subjects). Before treatment (T1), 4 weeks later (post-treatment analysis, T2) and 12 months after the end of treatment (followup, T3), all the patients completed a booklet containing the Oswestry Disability Index (ODI, primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophising Scale, a pain Numerical Rating Scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used for each outcome measure. Results: The ODI linear mixed model revealed significant main effects of group (F(1,122.8) = 95.78, p <0.001) and time (F(2,120.1) = 432.02, p <0.001) in favour of the experimental group. There was a significant group x time interaction effect (F(2,120.1) = 20.37, p <0.001). The analyses of all of the secondary outcome measures revealed a significant effect of time, group and interaction in favour of the experimental group. Conclusion: The rehabilitation programme, including the management of catastrophising and kinesiophobia, was superior to the exercise programme in reducing disability, dysfunctional thoughts, and pain, and enhancing the quality of life of patients after lumbar fusion for degenerative spondylolisthesis and/or LSS. The effects lasted for at least 1 year after the intervention ended.

Original languageEnglish
Pages (from-to)87-95
Number of pages9
JournalEuropean Spine Journal
Volume23
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • Kinesiophobia
  • Lumbar fusion
  • Lumbar stenosis
  • Rehabilitation
  • Spondylolisthesis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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