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The Effect of Depressive Emotional State on the Efficacy of Physical Therapy in Patients with Low Back Pain

Year 2016, Volume: 2 Issue: 2, 6 - 13, 25.08.2016
https://doi.org/10.19127/mbsjohs.74107

Abstract

 

Objective: The aim was to investigate the effect of depressive emotional state on the efficacy of physical therapy in patients with chronic mechanical low back pain (LBP).

Methods: Sixty patients with chronic LBP were included in the study. The patients were evaluated by a psychiatrist according to the Hamilton Depression Rating Scale (HAM-D) and separated into 2 groups regarding the cut off score. Group 1 consisted of 31 patients without depressive emotion while group 2 included 29 patients with depressive emotion. An exercise program consisting of lumbar dynamic stabilization exercises was instructed to all of the patients for 8 weeks. Infrared, ultrasound and TENS were applied to both groups for 15 seans. The pain was evaluated by visual analog scale (VAS), disabilite and quality of life was evaluated by Oswestry disability index and the Short-Form 36(SF-36) at baseline and 3rd and 8th weeks.

Results: İmprovement at pain severity during ADL, rest and sitting position was found to be significantly higher in group 2 compared to group 1 patients at the 8th week (p<0.05). Oswestry scores and some subscale of SF-36; physical functioning, general health perception, vitality, mental health scores of group 2 were significantly higher compared to group 1 at baseline and the 8th week (p<0.05). Improvement of oswestry scores between groups was not significantly different at 8th week (p>0.05), but improvement of some SF-36 subscale scores (pain, emotional role functioning, mental health) of groups significantly lower in group 2 compared to group 1 at the 8th weeks (p<0.05).

Conclusions: Patients with chronic LBP and a depressive emotional state are inclined to have more disability and poorer quality of life, while physical therapy and exercises yield to less improvement in scores of pain and some subscales of the SF-36 in these patients than those without depressive affect.

 

References

  • Akdemir A, Örsel S, Dag I, Türkcapar H, Iscan N, Ozbay H. Clinical use and the reliability and validtyy Of the Tuskish version of the Hamilton Depression Rating Scale (HDRS). 3P Derg. 1996;4:251-9.
  • Alkan H, Ardıç F. The role of medication and physical therapy interventions in the management of mechanical low back pain. J PM &R-Special Topics 2011;4: 75-84.
  • Andersson GB. Epidemiological features of chronic low-back pain. Lancet 1999; 354:1-585.
  • Antunes RS, de Macedo BG, AmaralTda S, Gomes Hde A, Pereira LSM, Rocha FL. Pain, kinesiophobia and quality of life in chronic low back pain and depression.ActaOrtop Bras 2013;21:27-9.
  • Bair MJ, Robinson RL, Katon W. Depression and pain comorbidity: a literature review. Arch Intern Med 2003;163: 2433-45.
  • Bean DJ, Johnson MH, Kydd RR. Relationships between psychological factors, pain and disability in complex regional pain syndrome and low back pain.Clin J Pain 2014;30:647-53.
  • Bener A, Verjee M, Dafeeah EE, Falah O, Al-Juhaishi T, Schlogl J, et al. Psychological factors: anxiety, depression, and somatization symptoms in low back pain patients. J Pain Res 2013;6: 95–101.
  • Benjamin S, Morris S, McBeth J, Macfarlane GJ, Silman AJ. The association between chronic widespread pain and mental disorder: a population based study. Arthritis Rheum 2000;43: 561-7.
  • Bigos JS, Müller G: Primary care approach to acute and chronic back problems: definitions and care. Bonica’s management of pain.Edited by Looser JD. Lippincott Wiliams& Wilkins, Philadelphia, 2001, pp. 1509-28.
  • Cecchi F, Pasquini G, Paperini A, Boni R, Castagnoli C, Pistritto S, Macchi C Predictors of response to exercise therapy for chronic low back pain: result of a prospective study with one year follow-up. Eur J PhysRehabil Med 2014;50:143-51.
  • Cohen I, Rainville J. Aggressive Exercise as Treatment for Chronic Low Back Pain. Sports Med 2002;32:75-82.
  • Demyttenaere K, Bonnewyn A, Bruffaerts R. Comorbid painful physical symptoms and depression: prevalance, work loss, and help seeking. J Affect Disord 2006;92:185-93.
  • Demyttenaere K, Bruffaerts R, Lee S, Posada-Villa J, Kovess V, AngermeyerMC,et al. Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain 2007;129: 332-42.
  • Dixon JS, Bird HA. Reproducibility along a 10-cm vertical visual analogue scale. Ann Rheum Dis 1981;40: 87-9,
  • Durmus D, Unal M, Kuru O. How effective a modified exercise program on its own or with back school in chronic low back pain? A randomized-controlled clinical trial.J Back MusculoskeletRehabil. 2014;27(4):553-61.
  • Dworkin RH, Richlin DM, Handlin DS, Brand L. Predicting treatment response in depressed and non-depressed chronic pain patients. Pain 1986;24:343-53.
  • Fairbank JC, Pynsent P. The Oswestry Disability Index. Spine 2000;25: 2940-52.
  • Felson DT. Epidemiology of the rheumatic diseases.Koopman WJ, McCarty DJ, editors.Arthritis and Allied Conditions. Baltimore: Williams & Wilkins; 1997. p. 3-34.
  • Häuser W, Schmutzer G, Brähler E, Schiltenwolf M, Hilbert A. The Impact of body weight and depression on low back pain in a representative population sample. Pain Med. 2014;15:1316-27.
  • Haythornthwaite JA, Sieber WJ, Kerns RD. Depression and the chronic pain experience. Pain 1991;46: 177-84.
  • Jonathan C. Hill and Julie M. Fritz Psychosocial Influences on Low Back Pain, Disability, and Response to Treatment. Physical Therapy 2011;91:712-21.
  • Keller A, Hayden J, Bombardier C, et al. Effect sizes of non-surgical treatments of non-specific low-back pain. Eur Spine J 2007;16(11):1776–88.
  • Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. SF-36’nınTürkçeiçingüvenilirliğivegeçerliliği. İlaçveTedaviDergisi 1999;12: 102-6.
  • KoldaşDoğan S, Sonel Tur B, Kurtaiş Y, Atay MB. Comparison of three different approaches in the treatment of chronic low back pain.ClinRheumatol 2008;27(7):873-81.
  • Korff von M., Simon G. The relationship between pain and depression. Br J Psychiatry 1996;168:101–8
  • Linton SJ. A review of psychological risk factors in back and neck pain. Spine 2000;25: 1145-56.
  • Melloh M, Elfering A, Käser A, Salathé CR, Barz T, Aghayev E, et al. Depression impacts the course of recovery in patients with acute low-back pain. Behav Med 2013;39:80-9.
  • Michaelson P, Sjölander P, Johansson H. Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.Clin J Pain 20: 2004;447-54.
  • Michalski D, Hinz A. Anxiety and depression in chronic back pain patients: effects on beliefs of control and muscular capasity. PsychotherPsychosom Med Psychol 2006;56:30-8.
  • Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res ClinRheumatol 2010;24:193-204.
  • Moraes Vieira EB, Salvetti GM, Damiani LP, PimentaCAM.Self-Efficacy and Fear Avoidance Beliefs in Chronic Low Back Pain Patients: Coexistence and Associated Factors. Pain ManagNurs 2014;15(2):77.
  • Seekatz B, Meng K, Faller H. Depressivity as mediator in the fear-avoidance model: a path analysis investigation of patients with chronic back pain. Schmerz 2013;27:612-8.
  • Silvemark A, Källmén H, Molander C. Improved life satisfaction and pain reduction: Follow-up of a 5-week multidisciplinary long-term pain rehabilitation programme. Ups J Med Sci 2014;119:278-86.
  • Snekkevik H, Eriksen HR, Tangen T, Chalder T, Reme SE. Fatigue and Depression in Sick-Listed Chronic Low Back Pain Patients. Pain Med 2014;15:1163-70.
  • Turhanoglu AD. Chronic low back pain. J PM &R-Special Topics 2011;4: 117-22.
  • Turner JA, Holtzman S, Mancl L. Mediators, moderators, and predictors of therapeutic change in cognitive-behavioral therapy for chronic pain. Pain 2007;127:276–86.
  • Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain.Eur Spine J 2011;20:19-39.
  • Velbaunt JA, Seeelen HA, Vlayen JW, van de Heiden GJ, Heuts PH, Pons K et al. Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain 2003;7:9-21.
  • Weinstein SM, Herring SA, Standaert CJ. Low back pain Delisa J, editor. Physical Medicine and Rehabilitation; principles and practice. Philadelphia: Lippincott Wiliams& Wilkins;2005. p. 653-75.
Year 2016, Volume: 2 Issue: 2, 6 - 13, 25.08.2016
https://doi.org/10.19127/mbsjohs.74107

Abstract

References

  • Akdemir A, Örsel S, Dag I, Türkcapar H, Iscan N, Ozbay H. Clinical use and the reliability and validtyy Of the Tuskish version of the Hamilton Depression Rating Scale (HDRS). 3P Derg. 1996;4:251-9.
  • Alkan H, Ardıç F. The role of medication and physical therapy interventions in the management of mechanical low back pain. J PM &R-Special Topics 2011;4: 75-84.
  • Andersson GB. Epidemiological features of chronic low-back pain. Lancet 1999; 354:1-585.
  • Antunes RS, de Macedo BG, AmaralTda S, Gomes Hde A, Pereira LSM, Rocha FL. Pain, kinesiophobia and quality of life in chronic low back pain and depression.ActaOrtop Bras 2013;21:27-9.
  • Bair MJ, Robinson RL, Katon W. Depression and pain comorbidity: a literature review. Arch Intern Med 2003;163: 2433-45.
  • Bean DJ, Johnson MH, Kydd RR. Relationships between psychological factors, pain and disability in complex regional pain syndrome and low back pain.Clin J Pain 2014;30:647-53.
  • Bener A, Verjee M, Dafeeah EE, Falah O, Al-Juhaishi T, Schlogl J, et al. Psychological factors: anxiety, depression, and somatization symptoms in low back pain patients. J Pain Res 2013;6: 95–101.
  • Benjamin S, Morris S, McBeth J, Macfarlane GJ, Silman AJ. The association between chronic widespread pain and mental disorder: a population based study. Arthritis Rheum 2000;43: 561-7.
  • Bigos JS, Müller G: Primary care approach to acute and chronic back problems: definitions and care. Bonica’s management of pain.Edited by Looser JD. Lippincott Wiliams& Wilkins, Philadelphia, 2001, pp. 1509-28.
  • Cecchi F, Pasquini G, Paperini A, Boni R, Castagnoli C, Pistritto S, Macchi C Predictors of response to exercise therapy for chronic low back pain: result of a prospective study with one year follow-up. Eur J PhysRehabil Med 2014;50:143-51.
  • Cohen I, Rainville J. Aggressive Exercise as Treatment for Chronic Low Back Pain. Sports Med 2002;32:75-82.
  • Demyttenaere K, Bonnewyn A, Bruffaerts R. Comorbid painful physical symptoms and depression: prevalance, work loss, and help seeking. J Affect Disord 2006;92:185-93.
  • Demyttenaere K, Bruffaerts R, Lee S, Posada-Villa J, Kovess V, AngermeyerMC,et al. Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain 2007;129: 332-42.
  • Dixon JS, Bird HA. Reproducibility along a 10-cm vertical visual analogue scale. Ann Rheum Dis 1981;40: 87-9,
  • Durmus D, Unal M, Kuru O. How effective a modified exercise program on its own or with back school in chronic low back pain? A randomized-controlled clinical trial.J Back MusculoskeletRehabil. 2014;27(4):553-61.
  • Dworkin RH, Richlin DM, Handlin DS, Brand L. Predicting treatment response in depressed and non-depressed chronic pain patients. Pain 1986;24:343-53.
  • Fairbank JC, Pynsent P. The Oswestry Disability Index. Spine 2000;25: 2940-52.
  • Felson DT. Epidemiology of the rheumatic diseases.Koopman WJ, McCarty DJ, editors.Arthritis and Allied Conditions. Baltimore: Williams & Wilkins; 1997. p. 3-34.
  • Häuser W, Schmutzer G, Brähler E, Schiltenwolf M, Hilbert A. The Impact of body weight and depression on low back pain in a representative population sample. Pain Med. 2014;15:1316-27.
  • Haythornthwaite JA, Sieber WJ, Kerns RD. Depression and the chronic pain experience. Pain 1991;46: 177-84.
  • Jonathan C. Hill and Julie M. Fritz Psychosocial Influences on Low Back Pain, Disability, and Response to Treatment. Physical Therapy 2011;91:712-21.
  • Keller A, Hayden J, Bombardier C, et al. Effect sizes of non-surgical treatments of non-specific low-back pain. Eur Spine J 2007;16(11):1776–88.
  • Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. SF-36’nınTürkçeiçingüvenilirliğivegeçerliliği. İlaçveTedaviDergisi 1999;12: 102-6.
  • KoldaşDoğan S, Sonel Tur B, Kurtaiş Y, Atay MB. Comparison of three different approaches in the treatment of chronic low back pain.ClinRheumatol 2008;27(7):873-81.
  • Korff von M., Simon G. The relationship between pain and depression. Br J Psychiatry 1996;168:101–8
  • Linton SJ. A review of psychological risk factors in back and neck pain. Spine 2000;25: 1145-56.
  • Melloh M, Elfering A, Käser A, Salathé CR, Barz T, Aghayev E, et al. Depression impacts the course of recovery in patients with acute low-back pain. Behav Med 2013;39:80-9.
  • Michaelson P, Sjölander P, Johansson H. Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.Clin J Pain 20: 2004;447-54.
  • Michalski D, Hinz A. Anxiety and depression in chronic back pain patients: effects on beliefs of control and muscular capasity. PsychotherPsychosom Med Psychol 2006;56:30-8.
  • Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res ClinRheumatol 2010;24:193-204.
  • Moraes Vieira EB, Salvetti GM, Damiani LP, PimentaCAM.Self-Efficacy and Fear Avoidance Beliefs in Chronic Low Back Pain Patients: Coexistence and Associated Factors. Pain ManagNurs 2014;15(2):77.
  • Seekatz B, Meng K, Faller H. Depressivity as mediator in the fear-avoidance model: a path analysis investigation of patients with chronic back pain. Schmerz 2013;27:612-8.
  • Silvemark A, Källmén H, Molander C. Improved life satisfaction and pain reduction: Follow-up of a 5-week multidisciplinary long-term pain rehabilitation programme. Ups J Med Sci 2014;119:278-86.
  • Snekkevik H, Eriksen HR, Tangen T, Chalder T, Reme SE. Fatigue and Depression in Sick-Listed Chronic Low Back Pain Patients. Pain Med 2014;15:1163-70.
  • Turhanoglu AD. Chronic low back pain. J PM &R-Special Topics 2011;4: 117-22.
  • Turner JA, Holtzman S, Mancl L. Mediators, moderators, and predictors of therapeutic change in cognitive-behavioral therapy for chronic pain. Pain 2007;127:276–86.
  • Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain.Eur Spine J 2011;20:19-39.
  • Velbaunt JA, Seeelen HA, Vlayen JW, van de Heiden GJ, Heuts PH, Pons K et al. Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain 2003;7:9-21.
  • Weinstein SM, Herring SA, Standaert CJ. Low back pain Delisa J, editor. Physical Medicine and Rehabilitation; principles and practice. Philadelphia: Lippincott Wiliams& Wilkins;2005. p. 653-75.
There are 39 citations in total.

Details

Journal Section Research articles
Authors

Fatma Tezel Mayalı This is me

Bengi Oz

Demet Gulpek

Ozlem Yoleri This is me

Beyza Taskın Topaloglu This is me

Hikmet Koçyigit This is me

Publication Date August 25, 2016
Published in Issue Year 2016 Volume: 2 Issue: 2

Cite

Vancouver Tezel Mayalı F, Oz B, Gulpek D, Yoleri O, Taskın Topaloglu B, Koçyigit H. The Effect of Depressive Emotional State on the Efficacy of Physical Therapy in Patients with Low Back Pain. Mid Blac Sea J Health Sci. 2016;2(2):6-13.

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