BACKGROUND: Chronic non-specific low back pain is one of the most common conditions, but it remains one of the most complex to manage. It can easily lead to reduced activity and disability. Emphasizing the placebo effect through contextual factors may lead to better outcomes. OBJECTIVE: The aim of this study is to understand whether contextual factors can lead to greater reductions in pain and disability in patients with chronic non-specific low back pain. METHODS: In this case series, 10 patients with chronic non-specific low back pain were recruited and divided into two groups. Participants in the intervention group performed the exercises together with the physiotherapist, while the control group performed them independently at home. They were assessed at the beginning, halfway through the treatment cycle, and at the end, using the Oswestry Disability Index and the Roland Morris Disability Questionnaire for disability, and the Visual Analog Scale for pain. RESULTS: There was a reduction in disability between the initial and final assessments, and between the mid-cycle and final assessments, only in the intervention group (p < 0.05). No statistically significant improvement in perceived pain was observed in either group (p > 0.05). CONCLUSIONS: Conscious use and modulation of contextual factors can induce a greater reduction in disability in patients with chronic low back pain, resulting in a better quality of life even with the same level of pain.
BACKGROUND: Il chronic non-specific low back pain (dolore lombare cronico aspecifico), è una condizione tra le più comuni ma rimane una delle più complesse da gestire, può portare facilmente a riduzioni nelle attività e disabilità. Enfatizzare l’effetto placebo attraverso i fattori contestuali può portare a maggiori risultati. OBIETTIVO: Lo scopo di questo studio è capire se i fattori contestuali possono portare ad una riduzione maggiore di dolore e disabilità in pazienti con chronic non-specific low back pain. METODI: In questo case series sono stati reclutati 10 pazienti con mal di schiena lombare cronico e aspecifico, e divisi in due gruppi. I partecipanti del gruppo di intervento hanno eseguito gli esercizi assieme al fisioterapista, il gruppo di controllo li ha eseguiti nel proprio domicilio in autonomia. Sono stati valutati all’inizio, a metà ciclo di sedute e alla fine utilizzando la Oswestry Disability Index e la Roland Morris Disability Questionaire per la disabilità, e la Visual Analog Scale per il dolore. RISULTATI: C'è stata una riduzione della disabilità tra la valutazione iniziale e l valutazione finale e tra la valutazione a metà ciclo e la valutazione finale solo nel gruppo di intervento (p <0,05). Non è stato evidenziato un miglioramento statisticamente significativo nella percezione del dolore in entrambi in gruppi (p>0,05). CONCLUSIONI: L’uso consapevole e la modulazione dei fattori contestuali può indurre nei pazienti con chronic low back pain una riduzione maggiore della disabilità, tradotto in una miglior qualità della vita anche a parità di dolore.
STUDIO DEI FATTORI CONTESTUALI NEI PAZIENTI CON CHRONIC NON-SPECIFIC LOW BACK PAIN
RAGNETTI, MANUEL
2024/2025
Abstract
BACKGROUND: Chronic non-specific low back pain is one of the most common conditions, but it remains one of the most complex to manage. It can easily lead to reduced activity and disability. Emphasizing the placebo effect through contextual factors may lead to better outcomes. OBJECTIVE: The aim of this study is to understand whether contextual factors can lead to greater reductions in pain and disability in patients with chronic non-specific low back pain. METHODS: In this case series, 10 patients with chronic non-specific low back pain were recruited and divided into two groups. Participants in the intervention group performed the exercises together with the physiotherapist, while the control group performed them independently at home. They were assessed at the beginning, halfway through the treatment cycle, and at the end, using the Oswestry Disability Index and the Roland Morris Disability Questionnaire for disability, and the Visual Analog Scale for pain. RESULTS: There was a reduction in disability between the initial and final assessments, and between the mid-cycle and final assessments, only in the intervention group (p < 0.05). No statistically significant improvement in perceived pain was observed in either group (p > 0.05). CONCLUSIONS: Conscious use and modulation of contextual factors can induce a greater reduction in disability in patients with chronic low back pain, resulting in a better quality of life even with the same level of pain.I documenti in UNITESI sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
https://hdl.handle.net/20.500.12075/23781