Exposure-based Treatment for Avoidant Back Pain Patients (ETABP)

Philipps University

Status: Completed

Conditions: Low Back Pain

Treatments: Behavioral: Exposure in vivo; Behavioral: Cognitive Behavioural Psychotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT01484418

DFG-GL 607

Details and patient eligibility

About

Chronic low back pain often results in psychosocial and physical disability. A subgroup of these patients shows fear of (re)injury and avoidance behaviour leading to higher disability. The purpose of this study is to determine whether exposure in vivo is more effective in the treatment of fear avoidant chronic back pain patients than psychological treatment as usual (cognitive behavioural psychotherapy).

Enrollment: 68 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Having at least 3 months back pain
• Sufficient level on fear avoidance scores (TSK, Phoda)
• Being German-speaking
• Agreeing to participate, verified by completion of informed consent

Exclusion criteria

• Red flags
• Pregnancy
• Illiteracy
• Psychoses
• Alcohol addiction
• surgeries during the last 6 months or planed surgeries
• Specific medical disorders or cardiovascular diseases preventing participation in physical exercise
• Participating in another psychotherapy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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68 participants in 3 patient groups

A Exposure long

Experimental group

Description:

Exposure in vivo for fear avoidant chronic low back pain patients. This treatment means that the individual is exposed to movements and tasks that have been avoided due to fear of (re)injury. The treatment begins after three educational lessons including the rational and developing a fear hierarchy. Exposure phase includes 10 exposures sessions which are highly individualized. Behavioral experiments can be included to correct catastrophic misinterpretations. The main purpose of this intervention type is to reduce pain related disability via diminishing fear avoidance.

Treatment:

Behavioral: Exposure in vivo

B Exposure short

Experimental group

Description:

See above exposure long. This treatment comprises 5 exposure sessions.

Treatment:

Behavioral: Exposure in vivo

C Cognitive behavioural psychotherapy

Active Comparator group

Description:

Cognitive behavioural psychotherapy for fear avoidant chronic low back patients. The therapy is modularized in three main parts. The educational lesson is followed by the module graded activity which represents the behavioral part of the program. The second module comprises relaxation. And the last part contains cognitive interventions. Cognitive behavioural intervention techniques are employed to support the patient in the process of coping with chronic pain: i.e. reduction of disability and improving functional ability.

Treatment:

Behavioral: Cognitive Behavioural Psychotherapy