preliminary study into the components of the fear-avoidance model of lbp change after an initial chiropractic visit and influence on outcome初步研究枸杞多糖的fear-avoidance模型变化的组件在最初按摩访问和对结果的影响.pdfVIP

Field et al. Chiropractic Osteopathy 2010, 18:21 /content/18/1/21 RESEARCH Open Access Preliminary study into the components of the fear-avoidance model of LBP: change after an initial chiropractic visit and influence on outcome 1* 2 3 Jonathan R Field , Dave Newell , Peter W McCarthy Abstract Background: In the last decade the sub grouping of low back pain (LBP) patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the wider LBP population psychosocial factors have been identified that are significantly prognostic. This study investigated changes in the components of the LBP fear-avoidance beliefs model in patients pre- and post- their initial visit with a chiropractor to determine if there was a relationship with outcomes at 1 month. Methods: Seventy one new patients with lower back pain as their primary complaint presenting for chiropractic care to one of five clinics (nine chiropractors) completed questionnaires before their initial visit (pre-visit) and again just before their second appointment (post-visit). One month after the initial consultation, patient global impression of change (PGIC) scores were collected. Pre visit and post visit psychological domain scores were analysed for any association with outcomes at 1 month. Results: Group mean scores for Fear Avoidance Beliefs (FAB), catastrophisation and self-efficacy were all improved significantly within a few days of a patient’s initial chiropractic consultation. Pre-visit catastrophisation as well as post-visit scores for catastrophisation