Investigation of the effectiveness of biopsychosocial based exercise model and core stabilization exercise training in working individuals with chronic low back pain

This study was conducted to investigate the effectiveness of Cognitive Exercise Therapy Approach training compared to core stabilization exercise training and conventional treatment in patients with chronic low back pain. The 49 patients with low back pain who participated in the study were divided into three groups: Cognitive Exercise Therapy Approach group, core stabilization exercise group and conventional treatment group. Patients in the Cognitive Exercise Therapy Approach group were applied the Cognitive Exercise Therapy Approach treatment protocol, which included information management in pain, function-oriented body stabilization exercises, dance therapy and authentic movements, and information management in sexuality, 3 times a week for 12 weeks. The core stabilization exercise training group received conventional treatment 3 days a week for 12 weeks, and then core stability exercises including M. Transversus abdominis and M. Multifidus muscle activation were applied. Conventional TENS, US and hotpack applications were applied to the conventional treatment group 3 days a week for 12 weeks and an additional home exercise program was given. All patients participating in the study were evaluated before starting and at the end of treatment. Patients whose demographic information was collected were given the McGill Pain Scale Short Form for pain assessment, the algometer (J-Tect Baseline) for pressure pain threshold measurement, the Oswesrty Disability Index for functional status assessment, the Tampa Kinesiophobia Scale for kinesiophobia assessment, the Cognitive Exercise Therapy Approach- biopsychosocial scale for biopsychosocial status assessment. The Multidimensional Work Motivation Scale was applied to measure work motivation. When the treatments were completed, more improvement was detected in the Cognitive Exercise Therapy Approach group's biopsychosocial status and kinesiophobia values than the core stabilization exercise group and conventional treatment group. (p<0.05). Similar changes were detected in the pain status, pressure pain threshold, functionality and work motivation values in the Cognitive Exercise Therapy Approach group and core stabilization exercise group after the treatment, and more improvement was observed compared to the conventional treatment group (p<0.05). It was concluded that Cognitive Exercise Therapy Approach training can be used as an effective approach to reduce pain, kinesiophobia, and increase biopsychosocial status, functionality and pressure pain threshold in patients with chronic low back pain. This result was interpreted as contributing to the international literature on the effects of Cognitive Exercise Therapy Approach, a biopsychosocial-based exercise model, on individuals with chronic low back pain.