Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy

Background. The biopsychosocial mechanism by which exercise leads to improvement in chronic low back pain (CLBP) remains unstudied. This prospective cohort study was performed to examine the effectiveness of exercise on pain, disability, and psychological status for CLBP. We also tested path analyti...

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Main Authors: Yuta Shinohara, Kenta Wakaizumi, Aiko Ishikawa, Mari Ito, Reiko Hoshino, Chisato Tanaka, Saki Takaoka, Michiyuki Kawakami, Osahiko Tsuji, Daisuke Fujisawa, Toshiyuki Fujiwara, Tetsuya Tsuji, Hiroshi Morisaki, Shizuko Kosugi
Format: Article
Language:English
Published: Hindawi Limited 2022-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2022/4203138
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author Yuta Shinohara
Kenta Wakaizumi
Aiko Ishikawa
Mari Ito
Reiko Hoshino
Chisato Tanaka
Saki Takaoka
Michiyuki Kawakami
Osahiko Tsuji
Daisuke Fujisawa
Toshiyuki Fujiwara
Tetsuya Tsuji
Hiroshi Morisaki
Shizuko Kosugi
author_facet Yuta Shinohara
Kenta Wakaizumi
Aiko Ishikawa
Mari Ito
Reiko Hoshino
Chisato Tanaka
Saki Takaoka
Michiyuki Kawakami
Osahiko Tsuji
Daisuke Fujisawa
Toshiyuki Fujiwara
Tetsuya Tsuji
Hiroshi Morisaki
Shizuko Kosugi
author_sort Yuta Shinohara
collection DOAJ
description Background. The biopsychosocial mechanism by which exercise leads to improvement in chronic low back pain (CLBP) remains unstudied. This prospective cohort study was performed to examine the effectiveness of exercise on pain, disability, and psychological status for CLBP. We also tested path analytic models in which changes in these variables were included. Methods. CLBP patients who visited the Interdisciplinary Pain Center of Keio University Hospital from July 2018 to April 2020 were included. The propensity score matching was performed between patients who underwent exercise (the exercise group) and those who did not (the control group). At the first visit and at the 3-month follow-up, pain (Numerical Rating Scale (NRS)), disability (Pain Disability Assessment Scale (PDAS)), and psychological status (Pain Self-Efficacy Questionnaire (PSEQ), and Pain Catastrophizing Scale (PCS)) were assessed. Changes in pain and disability at the follow-up were compared between the groups. The relationships between changes in pain, disability, and psychological variables were examined using Pearson’s correlation and mediation analysis. Results. A significantly larger decrease in the PDAS was observed in the exercise group (N = 49) than in the control (N = 49) (p<0.05). Increased PSEQ scores were significantly correlated with decreased NRS scores in both groups. In the exercise group, decreased PDAS fully mediated the relationship between increased PSEQ and decreased NRS (P<0.05). Conclusion. Exercise improved disability, and the improved disability by exercise mediated the effect of increased self-efficacy on pain relief in CLBP patients.
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spelling doaj.art-08873f8e5bb34ee99319a7f7d4398da52022-12-22T04:26:09ZengHindawi LimitedPain Research and Management1918-15232022-01-01202210.1155/2022/4203138Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise TherapyYuta Shinohara0Kenta Wakaizumi1Aiko Ishikawa2Mari Ito3Reiko Hoshino4Chisato Tanaka5Saki Takaoka6Michiyuki Kawakami7Osahiko Tsuji8Daisuke Fujisawa9Toshiyuki Fujiwara10Tetsuya Tsuji11Hiroshi Morisaki12Shizuko Kosugi13Department of AnesthesiologyDepartment of AnesthesiologyInterdisciplinary Pain CenterInterdisciplinary Pain CenterDepartment of AnesthesiologyInterdisciplinary Pain CenterDepartment of AnesthesiologyInterdisciplinary Pain CenterInterdisciplinary Pain CenterDepartment of NeuropsychiatryDepartment of Rehabilitation MedicineDepartment of Rehabilitation MedicineDepartment of AnesthesiologyDepartment of AnesthesiologyBackground. The biopsychosocial mechanism by which exercise leads to improvement in chronic low back pain (CLBP) remains unstudied. This prospective cohort study was performed to examine the effectiveness of exercise on pain, disability, and psychological status for CLBP. We also tested path analytic models in which changes in these variables were included. Methods. CLBP patients who visited the Interdisciplinary Pain Center of Keio University Hospital from July 2018 to April 2020 were included. The propensity score matching was performed between patients who underwent exercise (the exercise group) and those who did not (the control group). At the first visit and at the 3-month follow-up, pain (Numerical Rating Scale (NRS)), disability (Pain Disability Assessment Scale (PDAS)), and psychological status (Pain Self-Efficacy Questionnaire (PSEQ), and Pain Catastrophizing Scale (PCS)) were assessed. Changes in pain and disability at the follow-up were compared between the groups. The relationships between changes in pain, disability, and psychological variables were examined using Pearson’s correlation and mediation analysis. Results. A significantly larger decrease in the PDAS was observed in the exercise group (N = 49) than in the control (N = 49) (p<0.05). Increased PSEQ scores were significantly correlated with decreased NRS scores in both groups. In the exercise group, decreased PDAS fully mediated the relationship between increased PSEQ and decreased NRS (P<0.05). Conclusion. Exercise improved disability, and the improved disability by exercise mediated the effect of increased self-efficacy on pain relief in CLBP patients.http://dx.doi.org/10.1155/2022/4203138
spellingShingle Yuta Shinohara
Kenta Wakaizumi
Aiko Ishikawa
Mari Ito
Reiko Hoshino
Chisato Tanaka
Saki Takaoka
Michiyuki Kawakami
Osahiko Tsuji
Daisuke Fujisawa
Toshiyuki Fujiwara
Tetsuya Tsuji
Hiroshi Morisaki
Shizuko Kosugi
Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy
Pain Research and Management
title Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy
title_full Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy
title_fullStr Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy
title_full_unstemmed Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy
title_short Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy
title_sort improvement in disability mediates the effect of self efficacy on pain relief in chronic low back pain patients with exercise therapy
url http://dx.doi.org/10.1155/2022/4203138
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