ABSTRACT
BACKGROUND: This study aimed to assess the benefits of associating rehabilitation with therapeutic patient education (TPE) to decrease fear-avoidance belief and pain and improve function in adults with chronic low back pain (CLBP). METHODS: This randomized controlled study included 100 patients with CLBP according to the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The patients were divided into two teams: group A that participated in the TPE in association with rehabilitation and group B that received rehabilitation only. Pain and functional amelioration were assessed initially (T0) and at the end of the program (T1) using a visual analog scale at rest, work, and activity, and the Echelle d'Incapacité Fonctionnelle pour l'Évaluation des Lombalgies scale. Psychological and apprehension and avoidance assessments were also conducted, including the evaluation of depression, anxiety, fear-avoidance belief, and kinesiophobia using the Hospital Anxiety and Depression Scale, Fear-Avoidance Beliefs Questionnaire, and Tampa scale of kinesiophobia scale. RESULTS: The evaluation of progression initially (T0) and then at the end of the program (T1) revealed a significant reduction in pain at rest (P=0.00) and while working (P=0.00) and doing physical activity (P=0.03); a decrease in anxiety (P=0.03), fear-avoidance belief (P=0.03), and kinesiophobia (P=0.02); and an improvement in function (P=0.00) for patients in group A without amelioration of depression (P=0.15). Concerning group B, we identified a significant regression in pain at rest (P=0.001) and while working (P=0.03) and doing physical activity (P=0.00); depression (P=0.01); fear-avoidance beliefs (P=0.00); and kinesiophobia (P=0.002). Comparison between the groups revealed that associating TPE with rehabilitation resulted in a more significant improvement in function (P=0.00), anxiety (P=0.00), fear-avoidance belief (P=0.00), and kinesiophobia (P=0.00). CONCLUSION: Associating TPE with rehabilitation improved function and reduced fear, false beliefs, and kinesiophobia of movement in patients with CLBP.
ABSTRACT
BACKGROUND: Osteoarthris represents one of the most frequent degenerative pathologies. Its prevalence increases with the age as well as the functional consequences which are more considerable at the elderly population. aim : study the epidemiology and clinical features of knee osteoarthritis of older patient. methods: retrospective study made in the department of physical and rehabilitation medicine of the military Tunis hospital, on a sample of 60 patients having osteoarthritis, divided in two groups, the one is constituted by 30 subjects of 65 and more years old, other one of 30 adults aged between 30 and 55 years old. All the patients had a clinical and functional evaluation. results: the comparison between both groups showed a statistically significant difference (P < 0.05) in the following items: the severity of the pain, the bilateral hydarthrosis, the muscular strength of quadriceps, hamstrings and their retraction, the severe reduction of walking perimeter, and the bicompartimental lesion of both knees. CONCLUSION: clinical and sociofunctional features of knee osteoarthritis in the elderly patient require adapted and multidisciplinary management, in order to avoid the potential impact of knee osteoarthritis on the function and quality of life of the patient.
