Article type
Abstract
Objective: This review assesses the effectiveness of Cognitive Behavioral Therapy (CBT) in enhancing the occupational performance of individuals with Low Back Pain (LBP) versus conservative pain management.
Introduction: LBP is a growing concern, predicted to affect 843 million by 2050, significantly impacting economy and work productivity. CBT, targeting maladaptive thoughts and behaviors, represents an evolving approach for chronic pain, addressing the gap on its impact on LBP sufferers’ occupational performance.
Inclusion Criteria: The review focused on CBT's impact on adults with musculoskeletal-origin LBP, covering acute to chronic conditions. It included RCTs, cohort, case-control, and quasi-experimental studies evaluating CBT's effect on occupational performance, self-care, work, leisure, rest, and sleep.
Methods: Through independent review, relevant studies were identified across databases like PubMed, CINAHL, and Cochrane Library, employing meta-analysis with a random-effects model. The GRADE approach determined evidence certainty.
Results: From 1,410 articles, five RCTs involving 918 participants were eligible. These studies compared CBT against usual care, interactive voice response CBT, pain neuroscience education, and graded activity, focusing on work-related outcomes, pain experience, and occupational performance, with follow-ups between 8 weeks and 12 months. Despite effective randomization, performance and detection bias were noted. Moderate-quality evidence showed no significant CBT advantage over other treatments in improving sleep quality (MD: -0.07; 95% CI: -0.39 to 0.29) or work participation (MD: -5.99; 95% CI: -12.18 to 0.20), with very low-quality evidence on occupational performance, indicating uncertain effectiveness.
Conclusion: We found no significant difference between CBT and conservative treatments in improving sleep quality, work participation, and occupational performance in LBP patients. While CBT may aid in pain and functional improvement, its impact on occupational outcomes and overall quality of life warrants further consideration. Healthcare professionals should recognize these nuances when integrating CBT into LBP treatment plans, with future research needed to elucidate CBT's efficacy in specific patient contexts.
Introduction: LBP is a growing concern, predicted to affect 843 million by 2050, significantly impacting economy and work productivity. CBT, targeting maladaptive thoughts and behaviors, represents an evolving approach for chronic pain, addressing the gap on its impact on LBP sufferers’ occupational performance.
Inclusion Criteria: The review focused on CBT's impact on adults with musculoskeletal-origin LBP, covering acute to chronic conditions. It included RCTs, cohort, case-control, and quasi-experimental studies evaluating CBT's effect on occupational performance, self-care, work, leisure, rest, and sleep.
Methods: Through independent review, relevant studies were identified across databases like PubMed, CINAHL, and Cochrane Library, employing meta-analysis with a random-effects model. The GRADE approach determined evidence certainty.
Results: From 1,410 articles, five RCTs involving 918 participants were eligible. These studies compared CBT against usual care, interactive voice response CBT, pain neuroscience education, and graded activity, focusing on work-related outcomes, pain experience, and occupational performance, with follow-ups between 8 weeks and 12 months. Despite effective randomization, performance and detection bias were noted. Moderate-quality evidence showed no significant CBT advantage over other treatments in improving sleep quality (MD: -0.07; 95% CI: -0.39 to 0.29) or work participation (MD: -5.99; 95% CI: -12.18 to 0.20), with very low-quality evidence on occupational performance, indicating uncertain effectiveness.
Conclusion: We found no significant difference between CBT and conservative treatments in improving sleep quality, work participation, and occupational performance in LBP patients. While CBT may aid in pain and functional improvement, its impact on occupational outcomes and overall quality of life warrants further consideration. Healthcare professionals should recognize these nuances when integrating CBT into LBP treatment plans, with future research needed to elucidate CBT's efficacy in specific patient contexts.