ĐÁNH GIÁ HIỆU QUẢ KẾT HỢP LIỆU PHÁP NHẬN THỨC HÀNH VI TRONG PHỤC HỒI CHỨC NĂNG BỆNH NHÂN ĐAU THẮT LƯNG MẠN TÍNH

Abstract

Low back pain is one of the most common disease, in Vietnam now, treatment options include: medications, rehabilitation programs, acupuncture, and acupressure,… while the psychological factors, cognitive therapy not being adequately addressed. Objective: To evaluate the effectiveness of combined cognitive behavioral therapy in rehabilitation programs for patients with chronic low back pain. Methods: Randomised controlled trial on 63 chronic low back pain patients, ≥ 18 years old, examined and treated at the Department of Rehabilitation - Hanoi Medical University Hospital from October 2022 to December 2023 was divided into 2 groups: The control group consisted of 32 patients treated with manual therapy and exercises combined with physiotherapy (thermotherapy, electrotherapy, traction table…); The intervention group consisted of 31 patients who were treated as a control group in combination with cognitive behavioral therapy. Evaluation of pain relief outcomes using the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), the Pain Self-Efficacy Questionnaire (PSEQ), the Tampa scale for movement avoidance, and the stress-anxiety-depression scale DASS-21 at the time before intervention, 4 weeks after intervention and 12 weeks later. Result: The pain level in the intervention group after 12 weeks was 1.16 ± 0.89 compared with the control group was 2.09 ± 1.12 (p<0.001), similar to the improvement in self-confidence daily activities, motor avoidance, and psychological state all improved better in the intervention group than in the control group (p<0,05). Conclusion: Cognitive behavioural therapy combined with the rehabilitation program is more effective in treating pain, psychological status, avoidance of movement as well as daily functioning in patients with chronic low back pain compared with the rehabilitation program only.