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Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis. A randomised controlled trial

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Abstract

Purpose

To evaluate the effect of a rehabilitation programme including the management of catastrophising and kinesiophobia on disability, dysfunctional thoughts, pain, and the quality of life in patients after lumbar fusion for degenerative spondylolisthesis and/or lumbar spinal stenosis.

Methods

This was a parallel-group, randomised, superiority-controlled study in which 130 patients were randomly assigned to a programme consisting of exercises and cognitive-behavioural therapy (experimental group, 65 subjects) or exercises alone (control group, 65 subjects). Before treatment (T1), 4 weeks later (post-treatment analysis, T2) and 12 months after the end of treatment (follow-up, T3), all the patients completed a booklet containing the Oswestry Disability Index (ODI, primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophising Scale, a pain Numerical Rating Scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used for each outcome measure.

Results

The ODI linear mixed model revealed significant main effects of group (F(1,122.8) = 95.78, p < 0.001) and time (F(2,120.1) = 432.02, p < 0.001) in favour of the experimental group. There was a significant group × time interaction effect (F(2,120.1) = 20.37, p < 0.001). The analyses of all of the secondary outcome measures revealed a significant effect of time, group and interaction in favour of the experimental group.

Conclusion

The rehabilitation programme, including the management of catastrophising and kinesiophobia, was superior to the exercise programme in reducing disability, dysfunctional thoughts, and pain, and enhancing the quality of life of patients after lumbar fusion for degenerative spondylolisthesis and/or LSS. The effects lasted for at least 1 year after the intervention ended.

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Acknowledgments

The authors would like to thank Kevin Smart for his help in preparing the English version of this paper.

Conflict of interest

None of the authors has any potential conflict of interest.

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Authors and Affiliations

  1. Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone (Milan), Institute of Care and Research (IRCCS), Salvatore Maugeri Foundation IRCCS, Via Monsignor Bernasconi, 16, Lissone, 20851, Milan, Italy

    Marco Monticone, Simona Ferrante & Barbara Rocca

  2. Neuroengineering and Medical Robotics Laboratory, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy

    Simona Ferrante

  3. Department of Orthopaedics, Regional Hospital, Legnano, Milan, Italy

    Marco Teli

  4. Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy

    Calogero Foti

  5. Department of Spinal Surgery, Galeazzi Orthopedic Institute, Milan, Italy

    Alessio Lovi & Marco Brayda Bruno

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  1. Marco Monticone
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  2. Simona Ferrante
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  3. Marco Teli
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  4. Barbara Rocca
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  5. Calogero Foti
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  6. Alessio Lovi
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  7. Marco Brayda Bruno
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Correspondence to Marco Monticone.

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Monticone, M., Ferrante, S., Teli, M. et al. Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis. A randomised controlled trial. Eur Spine J 23, 87–95 (2014). https://doi.org/10.1007/s00586-013-2889-z

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  • DOI: https://doi.org/10.1007/s00586-013-2889-z

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