Graded exposure for fear of pain and movement avoidance belief in chronic low back pain patients

Abstract

BACKGROUND AND OBJECTIVES: Fear of pain and move-ment avoidance is a belief contributing to increase disability and mood changes in chronic low back pain patients. Exposure is a technique used for such belief, however there is still no consensus about the best way to perform it in low back pain patients. This study aimed at evaluating graded exposure for fear of pain and movement avoidance belief in chronic low back pain patients. CONTENTS: The following databases were queried for the pe-riod from 2000 to 2015: Pubmed, PsycInfo, Web of Science, Ci-nahl and LILACS. Eligibility criteria were established for studies selection. Studies were first selected by title and abstract. Then they were read in full. The search has resulted in 91 studies. From these, 38 were selected to be read in full. Among selected studies, 10 were excluded and 19 were repeated. Applying eligibility cri-teria, nine studies were included: for are before and after studies, one is a case report, one is a quasi-experimental study and three are randomized clinical trials. CONCLUSION: Most studies of this review have compared in vivo exposure and graded activity, however they have not specified how this was done. There is still no clarity about the advantages or methods to perform graded exposure in low back pain patients and further intervention studies on the subject are needed. Keywords: Exposure, Fear of pain and movement avoidance, Low back pain. RESUMO JUSTIFICATIVA E OBJETIVOS: Medo da dor e evitação do movimento é uma crença que contribui para o aumento da inca-pacidade e alterações do humor em pacientes com lombalgia crô-nica. A exposição é uma técnica utilizada para essa crença, porém ainda não há um consenso sobre a melhor forma de executá-la