Assessing the Efficacy of Multimodal Therapy Alone Versus the Combination of Cognitive Behavioral Therapy Along with Multimodal Therapy in the Treatment of Chronic Low Back Pain Patients
Efficacy of MMT Alone Versus MMT with CBT in CLBP
DOI:
https://doi.org/10.61919/jhrr.v4i3.1588Keywords:
Cognitive Behavioral Therapy, Low Back Pain, Multiomadal therapyAbstract
Background: Chronic Low Back Pain (CLBP) is a major public health concern worldwide, significantly impacting individuals' quality of life and contributing to disability and economic burdens. Traditional treatments often focus on physical aspects, but integrating Cognitive Behavioural Therapy (CBT) with Multimodal Therapy (MMT) has shown promise in addressing both the physical and psychological aspects of CLBP.
Objective: This study aims to compare the effectiveness of MMT alone versus MMT combined with CBT in improving pain, functional ability, and disability levels among CLBP patients.
Methods: A randomized controlled trial was conducted involving male and female participants diagnosed with CLBP. Participants were divided into two groups: one receiving MMT alone and the other receiving MMT combined with CBT. Outcomes were measured using the Knee to Side Bend Test (KSTB), Numeric Pain Rating Scale (NPRS), and Modified Oswestry Disability Index (MODI) before and after the interventions. The study included a total of 108 participants (54 males and 54 females). Statistical analysis was performed to assess between-group and within-group differences.
Results: The findings revealed that the group receiving MMT combined with CBT showed significantly greater improvements across all measured outcomes compared to the MMT alone group. Specifically, participants in the MMT with CBT group exhibited a more substantial reduction in pain levels (NPRS), greater improvements in functional ability (KSTB), and a more pronounced decrease in disability levels (MODI). The differences between the groups were statistically significant (p < 0.001), indicating that the addition of CBT to MMT enhances the treatment's effectiveness.
Conclusion: The study concludes that integrating CBT with MMT is more effective in managing CLBP than MMT alone. The combined approach addresses both the physical and psychological aspects of chronic pain, leading to better overall patient outcomes. These findings support the adoption of a multidisciplinary approach in the treatment of CLBP, particularly for patients with persistent pain. Further research is recommended to explore the long-term benefits and cost-effectiveness of this combined therapy.
Downloads
References
Abbasi-Kangevari, M., et al. (2022). "Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990–2019." PloS one 17(8): e0271284.
Airaksinen, O., et al. (2006). "European guidelines for the management of chronic nonspecific low back pain." European spine journal 15(Suppl 2): s192.
Aneis, M., et al. (2021). "Efect of cognitive behavior therapy in patients with chronic nonspecific low back pain." Turkish Journal of Physiotherapy and Rehabilitation 32: 3.
Ang, D. C., et al. (2010). "Cognitive–behavioral therapy attenuates nociceptive responding in patients with fibromyalgia: a pilot study." Arthritis care & research 62(5): 618-623.
Balagué, F., et al. (2012). "Non-specific low back pain." The lancet 379(9814): 482- 491.
Beck, A. T. (1979). Cognitive therapy of depression, Guilford press.
Beck, J. (1995). "Cognitive therapy: Basics and beyond. New York: Guilford."
Hanscom, D. A., Brox, J. I., & Bunnage, R. (2015). Defining the role of cognitive behavioral therapy in treating chronic low back pain: an overview. Global Spine Journal, 5(6), 496-504.
Pardos-Gascón, E. M., Narambuena, L., Leal-Costa, C., Ramos-Morcillo, A. J., Ruzafa-Martínez, M., & van-der Hofstadt Román, C. J. (2021). Psychological therapy in chronic pain: differential efficacy between mindfulness-based cognitive therapy and cognitive behavioral therapy. Journal of Clinical Medicine, 10(16), 3544.
Akodu, A. K., Ogunbiyi, T. A., & Fapojuwo, O. A. (2020). Cognitive behavioural therapy and core stabilization exercise on pain-related disability and psychological status in patients with non-specific chronic low back pain.
Monticone, M., Ambrosini, E., Rocca, B., Cazzaniga, D., Liquori, V., Lovi, A., & Brayda-Bruno, M. (2020). Multimodal exercises integrated with cognitivebehavioural therapy improve disability of patients with failed back surgery syndrome: a randomized controlled trial with one-year follow-up. Disability and Rehabilitation, 1, 1-8.
Rundell, S. D., & Davenport, T. E. (2010). Patient education based on principles of cognitive behavioral therapy for a patient with persistent low back pain: a case report. journal of orthopaedic & sports physical therapy, 40(8), 494-501.
Linden, M., Scherbe, S., & Cicholas, B. (2014). Randomized controlled trial on the effectiveness of cognitive behavior group therapy in chronic back pain patients. Journal of Back and Musculoskeletal Rehabilitation, 27(4), 563-568.
Johnson, R. E., Jones, G. T., Wiles, N. J., Chaddock, C., Potter, R. G., Roberts, C., ... & Macfarlane, G. J. (2007). Active exercise, education, and cognitive behavioral therapy for persistent disabling low back pain: a randomized controlled trial.
Ólason, M., Andrason, R. H., Jónsdóttir, I. H., Kristbergsdóttir, H., & Jensen, M. P. (2018). Cognitive behavioral therapy for depression and anxiety in an 152 interdisciplinary rehabilitation program for chronic pain: A randomized controlled trial with a 3-year follow-up. International journal of behavioral medicine, 25, 55-66.
Bergström, C., Jensen, I., Hagberg, J., Busch, H., & Bergström, G. (2012). Effectiveness of different interventions using a psychosocial subgroup assignment in chronic neck and back pain patients: a 10-year follow-up. Disability and rehabilitation, 34(2), 110-118.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36, 427-440.
de C Williams, A. C., Fisher, E., Hearn, L., & Eccleston, C. (2020). Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane database of systematic reviews, (8).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Muhammad Mahmood Alam, Suriyakala Perumal Chandran
This work is licensed under a Creative Commons Attribution 4.0 International License.
