Samenvatting

Design
Literature research.
Objective
To find out whether there is a difference in physiotherapeutic interventions related to chronic nonspecific
low back pain if psychological stress is given consideration and if it is not.
Summary of background data
Chronic non-specific low back pain is a disorder of unknown cause that has been present longer than 3
months. It can be maintained by a combination of physical, mental and social factors, which are all of
equal importance to the total functional capacity. The physiotherapy approach is not uniform and
many different interventions, i.e. exercise therapy and back schools, exist to this problem.
Method
An Internet search was performed in English, German, Dutch, and Norwegian. 160 abstract found in
Medline, PubMed, Cinahl, Cochrane Library and PsychLit were looked through and a total of 7
articles were included in this study. 5 articles considered the psychological factors (stress group) and 3
articles did not (no stress group). 1 article was counted twice. The data extraction was related to the 1)
Physiotherapeutic (co-) interventions, 2) Frequency of treatments per week, 3) Time of total treatment,
and 4) Duration of each treatment session. The statements/conclusions concerning the interventions
were extracted from the two guidelines; Philadelphia Guidelines and KNGF-richtlijn Lage-rugpijn.
Results
Different forms of active exercise therapy were used in all researches included. A back school
program was present 3 times in the stress group and not once in the no stress group. The total
treatment time in the no stress group was 12 weeks in 75% of the cases and in app. 43% of the cases in
the stress group. The mean frequency was 2.9 in the no stress group and 1.9 in the stress group. In the
no stress group the treatment sessions lasted 60 minutes in 75% of the cases and in the stress group
app. 43%. There were 2 co-interventions present in the stress group, one directed at the psychological
variables and the other to the physical variables.
Conclusion
There is a small difference in the choice of physiotherapeutic interventions related to chronic nonspecific
low back pain if psychological stress is given consideration and if it is not. Different forms of
exercise therapy are used for these patients. If psychological stress is given consideration emphasis is
also placed on advice and education. No significant difference exists between both groups concerning
the total length of the treatment time and 12 weeks are most often used. There is a clear tendency to a
lower frequency of treatments per week if stress is given consideration. The duration of each treatment
session is most often 60 minutes in both groups. Co-interventions, like motivation sessions and fitness
programs, are only present in the stress group.