RESEARCH REPORT POSTER DISPLAY

SELF EFFICACY, DISABILITY AND PHYSICAL OUTCOMES OF PATIENTS WITH CHRONIC PAIN FOLLOWING A PROGRAM OF GRADED PHYSICAL EXERCISES AND CBT. Abd Aziz K¹, Mohd Hashim A; ¹Physiotherapy Department, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia

PURPOSE: The study is to define the characteristics of chronic pain patients attending a chronic pain clinic and to investigate whether a program of graded physical exercise and CBT have effect on self efficacy, functional disabilities and physical outcome. RELEVANCE: Chronic pain is a complex in nature and results from many factors not solely a function of pain or pathology.A physiotherapist must take into account the psychological variables such as self-efficacy when treating patients with chronic persistance pain. PARTICIPANTS: 77 patients with persisting pain more than 6 months. METHODS: A prospective study. Data were collected from 77 patients attending pain management programs from 2002-2006. The management program consists of cognitive behavioral therapy, relaxation and physiotherapy in the form of program of exercise to improve flexibility, strength and endurance. Self efficacy was measured using Pain Self Efficacy Questionnaires (PSEQ), functional disability was measured using Roland Morris disability questionnaires. DASS questionnaires was used to measure the level of anxiety, stress and depression. Physical function measurement was 20 m timed walk and numbers of stairs climbed in 2 minutes. Data were collected at the beginning, and the end of program and at one month after the program. ANALYSIS: SPSS version 11.0 RESULTS: Data obtained from 32 males (41.6%) and 45 females (58.4%) were analysed. Pain self efficacy were significantly but negatively correlated with functional disability (r = 0.27, p < 0.05), stress (r = 0.31, p < 0.05), depression (r = 0.24, p < 0.05) and showed positive correlation with active coping (r= 0.55, p < 0.05). Pain self efficacy measurement improved from 26% to 67.5% (PSEQ score>40) one month after the program. There were also significant changes in physical function in the form of 20 m timed walked and numbers of stairs climbed CONCLUSIONS: Self efficacy improved after a graded exercise program and CBT. Improvement of self efficacy was also associated with improvement of in functional disability measurement and physical outcomes. IMPLICATIONS: Self efficacy can be driven by the reinforcement that comes from engaging successfully in a given task. Graded exposure to physical exercise can be a positive reinforcement on self-efficacy. This was shown by the changes in self-efficacy measurement after the program. KEYWORDS: chronic pain, self efficacy, pain management program. FUNDING ACKNOWLEDGEMENTS: the work is unfunded. CONTACT: zaimah2005@yahoo.com