array:23 [ "pii" => "S0211563818300865" "issn" => "02115638" "doi" => "10.1016/j.ft.2018.07.002" "estado" => "S300" "fechaPublicacion" => "2018-09-01" "aid" => "498" "copyright" => "Asociación Española de Fisioterapeutas" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Fisioterapia. 2018;40:257-64" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 98 "formatos" => array:2 [ "HTML" => 49 "PDF" => 49 ] ] "itemSiguiente" => array:18 [ "pii" => "S0211563818300646" "issn" => "02115638" "doi" => "10.1016/j.ft.2018.04.001" "estado" => "S300" "fechaPublicacion" => "2018-09-01" "aid" => "491" "copyright" => "Asociación Española de Fisioterapeutas" "documento" => "article" "crossmark" => 1 "subdocumento" => "ssu" "cita" => "Fisioterapia. 2018;40:265-72" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 145 "formatos" => array:2 [ "HTML" => 82 "PDF" => 63 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">REVISIÓN</span>" "titulo" => "Efectividad de la terapia acuática en pacientes con accidente cerebrovascular: una revisión sistemática" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "265" "paginaFinal" => "272" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Effectiveness of aquatic therapy in stroke patients: A systematic review" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2459 "Ancho" => 2504 "Tamanyo" => 271462 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo PRISMA<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">31</span></a>.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.A. Lozano-Puertas, I. Torres-Sánchez, I. Cabrera-Martos, A. Ortiz-Rubio, L. López-López, M.C. Valenza" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.A." "apellidos" => "Lozano-Puertas" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Torres-Sánchez" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Cabrera-Martos" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Ortiz-Rubio" ] 4 => array:2 [ "nombre" => "L." "apellidos" => "López-López" ] 5 => array:2 [ "nombre" => "M.C." "apellidos" => "Valenza" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211563818300646?idApp=UINPBA00004N" "url" => "/02115638/0000004000000005/v1_201808250414/S0211563818300646/v1_201808250414/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S021156381830049X" "issn" => "02115638" "doi" => "10.1016/j.ft.2018.03.006" "estado" => "S300" "fechaPublicacion" => "2018-09-01" "aid" => "490" "copyright" => "Asociación Española de Fisioterapeutas" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Fisioterapia. 2018;40:249-56" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 139 "formatos" => array:2 [ "HTML" => 90 "PDF" => 49 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>" "titulo" => "Efectividad de los miniplatos inestables para la mejora del equilibrio en pacientes geriátricos institucionalizados con síndrome de desequilibrio posterior. Ensayo clínico aleatorizado" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "256" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Effectiveness of unstable mini-boards to improve balance in institutionalised elderly people diagnosed with backward disequilibrium syndrome. Randomised controlled trial" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 678 "Ancho" => 1254 "Tamanyo" => 65769 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Vista superior e inferior de los miniplatos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Moure Romero, L. Guitard Sein-Echaluce, X. Aguado Jódar, L. Llurda Almuzara, J. Casaña Granell, R. Aiguadé Aiguadé" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Moure Romero" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Guitard Sein-Echaluce" ] 2 => array:2 [ "nombre" => "X." "apellidos" => "Aguado Jódar" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Llurda Almuzara" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Casaña Granell" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Aiguadé Aiguadé" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021156381830049X?idApp=UINPBA00004N" "url" => "/02115638/0000004000000005/v1_201808250414/S021156381830049X/v1_201808250414/es/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Effects of a combined lumbar stabilization exercise and cognitive behavioral therapy on selected variables of individuals with non-specific low back pain: A randomized clinical trial" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "257" "paginaFinal" => "264" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F.Y. Aliyu, A.A. Wasiu, B. Bello" "autores" => array:3 [ 0 => array:3 [ "nombre" => "F.Y." "apellidos" => "Aliyu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "A.A." "apellidos" => "Wasiu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "B." "apellidos" => "Bello" "email" => array:1 [ 0 => "nurubash@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Physiotherapy Department, Aminu Kano Teaching Hospital, Kano, Nigeria" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Physiotherapy Department, Faculty of Allied Health Sciences, Bayero University Kano, Nigeria" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectos de la combinación de ejercicios de estabilización lumbar y la terapia cognitivo-conductual en personas con dolor lumbar crónico inespecífico: ensayo clínico aleatorizado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2593 "Ancho" => 2483 "Tamanyo" => 200860 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the study.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic low back pain (CLBP) affects more than half of the general population<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a> and affects millions of Americans each year.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">2</span></a> Financial burden of low back pain (LBP) was estimated to be up to 2.8 billion pounds per annum in direct costs in the UK.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a> In a one year prevalence in Africa, LBP accounted for 14–72% of all musculoskeletal injuries.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">2</span></a> A Nigerian study<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">3</span></a> indicated LBP is linked to trauma, heavy lifting, obesity, pregnancy and sedentary lifestyle. A systematic review on the prevalence of low back pain in Nigeria, showed a high prevalence (36–73) % among workers.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Many treatment options are available from medications to surgery for individual with non-specific chronic low back pain (NSCLBP). However, recent emphases are on conservative therapies for LBP including different forms of exercises and spinal manipulative therapy.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">5</span></a> The efficacy of interventions that are less time consuming and less costly is still inconclusive and as such LBP has continued to be a researched area.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a> In addition, chronic pain is now best viewed as an interactive, psycho-physiological behavior pattern that cannot be separated into distinct, independent psychosocial and physical component.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">6,7</span></a> Therefore, NSCLBP being a form of chronic pain is now considered to be multi-factorial in nature<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">7</span></a> and there interventions should be multi-factorial, having the potential to impact on both physical and cognitive factors affecting pain.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Recently, there has been focus on exercises that maintain/improve lumbar spine stability. Lumbar stabilization exercises (LSE) have been found to be very effective in improving pain and disability<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">5,8</span></a> but may have no effect on biopsychosocial components of chronic pain. This projects the need to incorporate other approaches that will address other aspects in the management of NSCLBP rather than considering the pathoanatomy alone.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Targeting beliefs and behaviors of individuals with NSCLBP has been said to be effective in managing their symptoms.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a> One of such interventions that target beliefs and behaviors is cognitive behavioral therapy (CBT). Cognitive behavioral therapy is based on the cognitive behavioral model of pain which postulates that pain is a complex experience which is not only caused by its underlying pathophysiology, but also by an individuals’ cognitions, and behavior.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">9</span></a> CBT have been shown to be effective in the management of cognitive aspects of chronic pain.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">10</span></a> Although, some studies<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">11,12</span></a> have shown CBT not to have any benefit in the management of NSCLBP. It was therefore, hypothesized that combination of CBT and LSE may give additional benefits in the treatment of individuals with NSCLBP.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material/methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This study employed a single blinded randomized controlled clinical trial design, registered with Pan Africa Clinical Trial Registry PACTR201705002241375. Consecutive sampling technique was used to recruit participants for the study as they become available. The subjects were screened to determine whether they met the inclusion criteria for the study. Participants were recruited from the Aminu Kano Teaching Hospital, Kano.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Participants</span><p id="par0030" class="elsevierStylePara elsevierViewall">After receiving ethical approval from the Research Ethics Committee of Aminu Kano Teaching Hospital (NHREC/21/08/2008/AKTH/EC/1630). A signed informed consent was requested from all the participants. Fifty three (53) patients were evaluated between July 2014 to September, 2015 using the following criteria: (1) NSCLBP individuals who were between 18 and 55 years (2) moderate case of back pain with VAS score between 4 and 8 points (3) patients who were able to comprehend instruction in English or Hausa language, as well as not involved in any other treatment during the course of the study.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The following categories of patients were excluded from the study: (1) Patients with history of a prior surgery to the lumbosacral spine; (2) patients with evidence of systemic disease, carcinoma or organ diseases; (3) patients with signs of Lumbar radiculopathy (4) patients with evidence of pregnancy. The consented participants were randomly allocated into two groups: CBT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LSE; group A (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23) and LSE only; group B (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Randomization</span><p id="par0040" class="elsevierStylePara elsevierViewall">Individuals who met the inclusion criteria were randomly allocated to Group A or Group B, using chit method without replacement. The allocation was conducted by the primary investigator prior to the baseline assessment. Group A underwent cognitive behavioral therapy with lumbar stabilization exercise, whereas Group B received lumbar stabilization exercise only directed on the Multifidus muscle, and other stabilizers of the back.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Outcome measures</span><p id="par0045" class="elsevierStylePara elsevierViewall">Pain and functional disability were assessed at the baseline and repeated at the end of intervention period (6 weeks). Test–retest reliability of VAS has been shown to be good, but higher among literate (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.94) than illiterate patients (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.71) before and after attending a rheumatology outpatient clinic. VAS is thus considered a reliable and valid tool for measuring the pain level.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The Oswestry Disability Index (ODI) is considered the gold standard for measuring disability in patients with back pain. It has a pivotal role in research and clinical settings and is interpreted to have good reliability.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">13</span></a><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">i.</span><p id="par0055" class="elsevierStylePara elsevierViewall">Intensity of back pain was measured on a 10-cm visual analogue scale (VAS) where 0 indicates no pain and 10 indicates very severe pain.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">ii.</span><p id="par0060" class="elsevierStylePara elsevierViewall">The patients’ cognition level was measured with the Fear Avoidance Beliefs Questionnaire (FABQ).</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">iii.</span><p id="par0065" class="elsevierStylePara elsevierViewall">Patients’ functional ability measured using the Oswestry Disability Index (ODI).</p></li></ul></p><p id="par0070" class="elsevierStylePara elsevierViewall">Physiotherapists who were blinded to group allocation, collected the baseline and post-test measurements. The investigator, collected information on demographic and anthropometric indices of the participants as well administered the interventions.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Procedure</span><p id="par0075" class="elsevierStylePara elsevierViewall">All subjects in both groups received supervised lumbar stabilization exercise, which lasted for 30<span class="elsevierStyleHsp" style=""></span>min per session and 3 sessions per week from the same Physiotherapist.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The LSE was carried out based on McGill<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a> protocol. The exercise began with a motion exercise (cat-camel motion exercise). This consisted of six-to-eight cycles of spinal flexion and extension in a quadruped position. Five–eight cycles have been shown to be sufficient to reduce most viscous-frictional stresses.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The cat-camel exercise was followed by the curl-up exercises, in which the participant was instructed to flex one knee to 90° while keeping the other straight. A rolled towel was placed under the lumbar spine to preserve a neutral spine posture. The participant was then instructed to raise both shoulders and the head up of the pillow.</p><p id="par0090" class="elsevierStylePara elsevierViewall">This position was sustained and maintained for 7<span class="elsevierStyleHsp" style=""></span>s. The exercise was repeated 10 times with a 1<span class="elsevierStyleHsp" style=""></span>min rest between repetitions. As the subjects’ endurance improves, the exercise variant was progressed to a more difficult position where the participant was instructed to lift the already extended lower limb together with both shoulders and the head. The position was also maintained for 7<span class="elsevierStyleHsp" style=""></span>s.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The curl-up exercise was followed by the side-bridge exercise. The participant was positioned as follows: lying on the side supported on his/her elbow and hip, the knees were bent to 90°. The free hand was placed on the opposite hip. The participant was instructed to raise his/her trunk until the body was supported on the elbow and the knee. This position was sustained and maintained for 7<span class="elsevierStyleHsp" style=""></span>s. The exercise was repeated 10 times with a 1<span class="elsevierStyleHsp" style=""></span>min rest between repetitions. As the subjects’ endurance improves, the exercise variant was progressed to a more difficult position. Here the participant was instructed to move the pelvis in that suspended position back and forth gently and rhythmically for 7<span class="elsevierStyleHsp" style=""></span>s before resting.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Upon successful performance of the side bridge exercise, the ‘bird-dog’ exercise was carried out. In this exercise, the opposite arm and leg were extended in the quadruped position. The position was sustained and maintained for 7<span class="elsevierStyleHsp" style=""></span>s. The exercise was repeated 10 times with a 1<span class="elsevierStyleHsp" style=""></span>min rest between repetitions. As the subjects’ endurance improves, the exercise variant was progressed to a more difficult position which involved dynamic movement of the extended upper and lower limbs. Participants performed one set of 10 repetitions for each LSE, with a 1<span class="elsevierStyleHsp" style=""></span>min rest between each set during every exercise session. All isometric holds were not allowed to last longer than 7<span class="elsevierStyleHsp" style=""></span>s as recent evidence from near infrared spectroscopy has indicated rapid loss of available oxygen in the back muscles when contracting isometrically beyond 7<span class="elsevierStyleHsp" style=""></span>s.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">In addition to LSE, the intervention group received CBT, 2 sessions per week. CBT therapy was administered based on the CBT manual by Murphy et al.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> The CBT intervention is designed to cover 12 sessions as shown below:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 1:</span> Interview and Assessment. This refers to the clinical pain evaluation and baseline assessment, including administration of questionnaires and investigations.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">•</span><p id="par0115" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 2:</span> Treatment Orientation. This includes compilation of investigations and findings on questionnaires. Pain education and familiarization with the CBT approach to treatment.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">•</span><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 3:</span> Assessment, Feedback and Goal Setting. This involves discussing with the participants the clinical implications of assessment and development of treatment goals.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">•</span><p id="par0125" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 4:</span> Exercise and Pacing. Importance of movement and thoughtful approach to physical activities is emphasized to the patient and exercises are introduced to the participants.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">•</span><p id="par0130" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 5:</span> Relaxation Training. Relaxation benefits and techniques are carried out with the participants.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">•</span><p id="par0135" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 6:</span> Pleasant Activities I. Identification of meaningful pleasant activities that each participant enjoy.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">•</span><p id="par0140" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 7:</span> Pleasant Activities II. Implementation of the selected enjoyable activities that were identified during the previous session.</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">•</span><p id="par0145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 8:</span> Cognitive Coping I. Understand automatic negative thoughts and how they impact pain experience.</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">•</span><p id="par0150" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 9:</span> Cognitive Coping II. Monitor and challenge automatic thoughts. The therapist provided ways of adaptation to unhealthy thoughts.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">•</span><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 10:</span> Sleep. Strategies for improving sleep despite pain.</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">•</span><p id="par0160" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 11:</span> Discharge Planning. Plan for flare ups and review of CBT skills, including re-administration of questionnaires.</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">•</span><p id="par0165" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Session 12:</span> Booster Session. Evaluate implementation of CBT skills.</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analyses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Data was analyzed using the Statistical Package for Social Sciences (SPSS Version 20). PASS version 13.0 was used to calculate sample size and power estimate at 80% power and 5% significance based on a previous study.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a> Thus, a total of 46 individuals were recruited in this study out 53 participants evaluated. However, only 37 participants completed the study. See <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">The baseline data for both groups were shown to have no any significant difference and were normally distributed as tested by the Shapiro–Wilk test. Inferential analysis was used to obtain within and between group differences using the Paired and Independent <span class="elsevierStyleItalic">t</span>-test respectively.</p><p id="par0180" class="elsevierStylePara elsevierViewall">Statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05. The end-points were changes in visual analogue scale scores (VAS scores), change in disability index scores (ODI scores) and FABQ scores after 8 weeks of interventions for both groups.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Characteristics of participants</span><p id="par0185" class="elsevierStylePara elsevierViewall">This study assessed 53 NSCLBP subjects in which 37 completed the study. See <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> for flow chart of participants.</p><p id="par0190" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the socio-demographic and clinical indices of participants in both groups. The mean age for participants in group A was 44.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.11 years while that of the group B was 40.28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.80. There were more female participants in both groups 52.6% and 61.2% respectively than the males. The result also indicated in terms of occupation; most participants in both groups were civil servants 84.2% and 77.6% respectively and only small percentage were doing business. The baseline socio-demographic and clinical characteristics of the groups are illustrated in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. No statistically significant differences were observed between the groups except in FABW. In group A, after the intervention, statistically significant improvements were observed in pain and disability (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05). There was no significant improvement in FABP and FABW (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05) while in group B, all the parameters showed statistically significant improvement except in FABP (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows there was no statistically significant improvement observed in pain, ODI, FABP, and FABW between the groups (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05) after 8 weeks of intervention. A one-way ANCOVA analysis was conducted to control the pre-intervention scores between the groups. After controlling for the pre-existing group difference, gender, and types of occupation, there was no significant difference between the two groups on post-intervention scores on pain, ODI, FABP, and FABW. However, a marginal significant differences was observed between types of occupation and FABP as indicated by a partial Eta squared of 0.11 at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.07 (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0195" class="elsevierStylePara elsevierViewall">This present study was carried out to determine whether CBT plus LSE has a beneficial effect on pain, disability and fear avoidance of patients with NSCLBP. All subjects in this study were educated on pain, activity and posture with LSE for 6 weeks. However, the intervention group received an additional intervention based on CBT. The findings of this study showed that participants in both groups showed significant improvements in pain, disability and FAB scores post-intervention, indicating effectiveness of both interventions.</p><p id="par0200" class="elsevierStylePara elsevierViewall">Findings of the result revealed there was no significant difference between the mean ages of participants in both groups at baseline. There was equally no significant difference in the socio-demographic indices of participants in both groups. The baseline clinical characteristics of the participants in both groups showed no statistically significant differences between the groups except in FABW. This indicates that the two groups were comparable in sociodemographic and selected clinical indices at baseline and thus, any effect produced following the intervention may not be due to chance.</p><p id="par0205" class="elsevierStylePara elsevierViewall">The changes in mean score of pain, disability and FAB in the CBT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LSE group of this study found improvements with significant difference between baseline and post-intervention for pain intensity and disability. However, there was no significant difference in the fear avoidance beliefs of participants in this group showing that the participants in this group may have improved due to the effect of the LSE as it primarily targets pain and disability. There is a possibility that individuals in this group do not necessarily have any behavioral problem that might affect their thought, beliefs and attitude toward their pain. Thus, CBT may not have any additional impact in the management of NSCLBP in these patients.</p><p id="par0210" class="elsevierStylePara elsevierViewall">Results of this study was contrasted by findings of a previous study by Johnson et al.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">10</span></a> which found that CBT and active exercises have additional benefit but overall they found no significant difference between the two groups after a one year follow-up.</p><p id="par0215" class="elsevierStylePara elsevierViewall">Similarly, changes in mean score of pain, disability and FAB scores in the LSE group showed there was an improvement with a significant within group difference for all outcomes (pain intensity, disability and fear avoidance) measured. These results are in line with previous research findings<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">8,17,18</span></a> which demonstrate that LSE are effective in the management of chronic mechanical LBP.</p><p id="par0220" class="elsevierStylePara elsevierViewall">Lumbar stabilization exercises are shown to activate most stabilizers of the back, which often are responsible for first episode or recurrence LBP. A previous study<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a> also postulated that inhibition of the core muscles is responsible for the recurrence of LBP. This may account for the improvements recorded in this group of participants.</p><p id="par0225" class="elsevierStylePara elsevierViewall">Additionally, the fear of pain leads to reduce functional ability and subsequent vicious circle of more pain, more fear and less functional activity.</p><p id="par0230" class="elsevierStylePara elsevierViewall">Although, there was a significant within group difference in most outcomes measured. There was however, no any significant difference between groups for all the outcomes. This shows that adding CBT to LSE was not really beneficial as hypothesized for individuals with NSCLBP. This result is also in conformity with a systematic review findings which shows that, in the intermediate- to long-term, there is little or no difference between behavioral therapy and group exercises for pain or depressive symptoms.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">20</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">This present study shows that reduction of pain scores is associated with positive change in function and fear-avoidance in CLBP patients in both treatment groups. These findings are in agreement with Klaber Moffett et al.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">21</span></a> study in which active exercises consisting of McKenzie techniques and CBT treatments were clinically effective in the management of CLBP. However, McKenzie showed slightly better results in as compared to CBT.</p><p id="par0240" class="elsevierStylePara elsevierViewall">Cognitive behavioral intervention requires special training. Thus, clinicians who are not formally trained are likely to face problems in administering the concept and as such may not report any favorably outcome. The investigator who administered the CBT intervention in this study has a formal training in CBT, and therefore, any changes seen may not be due to incompetency of the person administering the intervention.</p><p id="par0245" class="elsevierStylePara elsevierViewall">Cognitive behavioral intervention is based on changing patient's perception, enhance empowerment and teach coping strategies. It concentrates on motor processing there by helping patients to distract their memory from the experience of pain using pacing based activities and return to previous normal activity level.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> Poor coping strategies, self-efficacy and fear-avoidance have been shown as strong predictors of disability in low back pain.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">5</span></a> However, this present study did not assess if these aforementioned factors were present in all participants before administering the intervention. Thus, this may be responsible for lack of effect between the groups.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limitation of the study</span><p id="par0250" class="elsevierStylePara elsevierViewall">Considering the recurrent nature of non-specific low back pain, long term follow-up would be important to determine whether the intervention was effective in preventing or decreasing recurrence. Also, the small sample size may not allow for generalizability of the study findings. In relation to the participants’ pain and pain threshold as regards different working activities it will be advisable to carry out adequate evaluation of participants’ pain and pain threshold as regards time of occurrence of pain, types of activity that leads to or worsen the pain. This may clearly show the actual effects of the interventions.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusion</span><p id="par0255" class="elsevierStylePara elsevierViewall">Sequel to the findings of this study it was concluded that addition of CBT to LSE have no any additional benefit in the management of individuals with non-specific chronic low back pain. Hence, individuals with NSCLBP should adequately screened to identify those who will specifically benefit from CBT and those that may benefit from both therapies at the same time.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflict of interests</span><p id="par0260" class="elsevierStylePara elsevierViewall">The authors declare they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1074921" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1021244" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1074922" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1021245" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material/methods" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Participants" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Randomization" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Outcome measures" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Procedure" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Statistical analyses" ] ] ] 6 => array:3 [ "identificador" => "sec0040" "titulo" => "Results" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Characteristics of participants" ] ] ] 7 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Limitation of the study" ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Conclusion" ] 10 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflict of interests" ] 11 => array:2 [ "identificador" => "xack363992" "titulo" => "Acknowledgments" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-01-29" "fechaAceptado" => "2018-07-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1021244" "palabras" => array:5 [ 0 => "Cognitive behavioral therapy" 1 => "Chronic pain" 2 => "Low back pain" 3 => "Physical Therapy Modalities" 4 => "Exercise Therapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1021245" "palabras" => array:5 [ 0 => "Terapia cognitivo conductual" 1 => "Dolor crónico" 2 => "Lumbalgia" 3 => "Modalidades de Fisioterapia" 4 => "Terapia de ejercicio" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine whether combination of cognitive behavioral therapy (CBT) along with Lumbar Stabilization Exercise (LSE) has more benefit in terms of reduction in pain, disability and fear avoidance beliefs of persons with non-specific chronic low back pain (NSCLBP) as compared to LSE alone.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Forty-six individuals, with NSCLBP participated in this single blind randomized clinical trial. Participants were randomly assigned into one of two groups: CBT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LSE; (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23) and LSE only; (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23). Treatment was applied twice a week for 6 weeks. Outcomes assessed pre- and post-interventions were pain intensity (PI) using visual analogue scale (VAS), functional disability (FD) using Oswestry Disability Index (ODI) and Fear Avoidance Beliefs (FAB) using Fear-Avoidance Beliefs questionnaire (FABQ). Data were analyzed using descriptive statistics, paired and independent <span class="elsevierStyleItalic">t</span>-tests as well as ANCOVA at <span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Participants in both groups were comparable in age and at all baseline values. The results showed no significant difference between the two groups for pain intensity (3.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.24 vs 3.33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.41, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), FD (27.16<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.14 vs 30.22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.98, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), physical activity related fear avoidance beliefs (13.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.60 vs 16.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.73, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05) and work related fear avoidance beliefs (24.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.86 vs 28.72<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.405, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05). However, there was a significant difference within each group in all the outcomes measured, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Combined intervention of CBT plus LSE was not more effective than LSE alone in the management of non-specific chronic low back pain.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Determinar si la combinación de terapia cognitiva conductual (TCC) junto con el ejercicio de estabilización lumbar (EEL) tiene más beneficios en términos de reducción del dolor, discapacidad y creencias, para evitar el miedo de personas con dolor lumbar crónico inespecífico (DLCI) en comparación con el EEL solo.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cuarenta y seis personas, con DLCI participaron en este ensayo clínico aleatorizado simple ciego. Los participantes fueron asignados aleatoriamente en uno de 2 grupos: TCC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EEL (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23) y EEL solamente (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23). El tratamiento se aplicó 2 veces por semana durante 6 semanas. Los resultados evaluados fueron la intensidad del dolor (ID) usando la escala analógica visual (EVA), la discapacidad funcional (DF) utilizando el índice de discapacidad de Oswestry (IDO) y el cuestionario de las creencias de evitación de miedo (FABQ). Los datos se analizaron mediante estadística descriptiva, pruebas t pareadas e independientes y ANCOVA, para p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los participantes en ambos grupos fueron comparables en edad y en todos los valores basales. Los resultados no mostraron diferencias significativas entre los 2 grupos para la intensidad del dolor (3,11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,24 vs. 3,33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,41; p<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,05), DF (27,16<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9,14 vs. 30,22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11,98; p<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,05), creencias de evitación del miedo relacionadas con la actividad física (13,63 ± 7,60 vs. 16,11 ± 5,73, p > 0,05) y creencias de evitación del miedo relacionadas con el trabajo (24,47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10,86 vs. 28,72<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9,405, p<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,05). Sin embargo, hubo una diferencia significativa en cada grupo en todos los resultados medidos; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La intervención combinada de TCC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EEL no fue más efectiva que la aplicación de EEL en el tratamiento del dolor lumbar crónico inespecífico.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2593 "Ancho" => 2483 "Tamanyo" => 200860 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the study.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Group A (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19)<br><span class="elsevierStyleItalic">M</span><span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Group B (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>18)<br><span class="elsevierStyleItalic">M</span><span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Significance \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40.28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.330 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Gender (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (47.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (38.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (52.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11(61.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Occupation (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Civil service \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 (84.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (77.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Business \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (15.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (22.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Pain (VAS)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.21<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Disability (ODI)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43.53<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.31 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fear avoidance (PA)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.89<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fear avoidance (W)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.21<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1834431.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Comparison of pre-treatment socio-demographic and clinical outcomes between the groups.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Keys</span>: PI – pain intensity, FD – functional disability, FABPA – Fear Avoidance Beliefs Questionnaire, Physical Activity related scores, FABW – Fear Avoidance Beliefs Questionnaire, Work related scores.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group A</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">t</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span> value \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group B</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">t</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span> value \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pretest \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post-test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pretest \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post-test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.21<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a>0.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a>0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.53<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.16<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a>0.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a>0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FABPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.89<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a>0.025 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FABW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.21<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.72<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a>0.006 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1834433.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Significant difference at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Comparison of mean values of pain, disability, FABP, and FABW after the treatment within the groups.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Keys</span>: PI – pain intensity, FD – functional disability, FABPA – Fear Avoidance Beliefs Questionnaire, Physical Activity related scores, FABW – Fear Avoidance Beliefs Questionnaire, Work related scores.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcomes \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Group A<br>CBT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LSE \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Group B<br>LSE \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">t</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.16<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FABPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.11<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.27 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FABW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.72<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1834434.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Comparison of mean values of pain, disability, FABP, and FABW after the treatment between the groups.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Keys</span>: PI – pain intensity, FD – functional disability, FABPA – Fear Avoidance Beliefs Questionnaire, Physical Activity related scores, FABW – Fear Avoidance Beliefs Questionnaire, Work related scores.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean square \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">F</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sig \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Partial Eta squared \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pain (VAS)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.975 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.935 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Occupation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.662 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.824 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.372 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.029 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Disability (ODI)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.266 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.948 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.988 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Occupation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.352 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.558 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">FABP</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.693 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.015 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.904 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.152 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.955 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Occupation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">155.62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.357 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">FABW</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.138 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.308 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.584 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.711 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.037 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.850 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Occupation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">153.83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.519 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.228 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.051 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1834432.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Comparison of pre-test and post-test outcomes controlling for pre-existing differences between the groups, gender, and type of occupation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0110" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effectiveness of cognitive behavioural treatment for non-specific low back pain: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Richmond" 1 => "A.M. Hall" 2 => "B. Copsey" 3 => "Z. Hansen" 4 => "E. Williamson" 5 => "N. Hoxey-Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0134192" "Revista" => array:5 [ "tituloSerie" => "PLoS One" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "1" "paginaFinal" => "20" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0115" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of low back pain in Africa: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Q.A. Louw" 1 => "L.D. Morris" 2 => "K. Grimmer-Somers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2474-8-105" "Revista" => array:6 [ "tituloSerie" => "BMC Musculoskelet Disord" "fecha" => "2007" "volumen" => "8" "paginaInicial" => "1" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17204151" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0120" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<a class="elsevierStyleInterRef" target="_blank" id="intr0005" href="https://www.ajol.info/index.php/njotra/article/view/100949">https://www.ajol.info/index.php/njotra/article/view/100949</a> [accessed 26.01.18]" "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Eyichukwu" 1 => "P. Ogugua" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2003" "editorial" => "Olabisi Onabanjo University" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0125" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[review]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review on the prevalence of low back pain in Nigeria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Bello" 1 => "H.B. Adebayo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5812/mejrh.45262" "Revista" => array:5 [ "tituloSerie" => "Middle East J Rehabil Health Stud" "fecha" => "2017" "volumen" => "4" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0130" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<a class="elsevierStyleInterRef" target="_blank" id="intr0010" href="http://www.ncbi.nlm.nih.gov/pubmed/11317112">http://www.ncbi.nlm.nih.gov/pubmed/11317112</a> [accessed 26.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active therapy for chronic low back pain. Part 1. Effects on back muscle activation, fatigability, and strength" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.F. Mannion" 1 => "S. Taimela" 2 => "M. Müntener" 3 => "J. Dvorak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Spine (Phila Pa 1976)" "fecha" => "2001" "volumen" => "26" "paginaInicial" => "897" "paginaFinal" => "908" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0135" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<a class="elsevierStyleInterRef" target="_blank" id="intr0015" href="https://www.guilford.com/books/Psychological-Approaches-to-Pain-Management/Turk-Gatchel/9781572306424/reviews">https://www.guilford.com/books/Psychological-Approaches-to-Pain-Management/Turk-Gatchel/9781572306424/reviews</a> [accessed 27.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psychological approaches to pain management: a practitioner's handbook" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.C. Turk" 1 => "R.J. Gatchel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2002" "editorial" => "The Guilford Press" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0140" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. O'Sullivan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.math.2005.07.001" "Revista" => array:6 [ "tituloSerie" => "Man Ther" "fecha" => "2005" "volumen" => "10" "paginaInicial" => "242" "paginaFinal" => "255" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16154380" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0145" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.J. Moon" 1 => "K.H. Choi" 2 => "D.H.K. Kim" 3 => "J.C. Ha" 4 => "K.L. Young" 5 => "H. Kwang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5535/arm.2013.37.1.110" "Revista" => array:6 [ "tituloSerie" => "Ann Rehabil Med" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "110" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23525973" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0150" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<a class="elsevierStyleInterRef" target="_blank" id="intr0020" href="http://www.ncbi.nlm.nih.gov/pubmed/3794021">http://www.ncbi.nlm.nih.gov/pubmed/3794021</a> [accessed 27.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Behavioral concepts in the analysis of chronic pain syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.J. Keefe" 1 => "K.M. Gil" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Consult Clin Psychol" "fecha" => "1986" "volumen" => "54" "paginaInicial" => "776" "paginaFinal" => "783" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3794021" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0155" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active exercise, education, and cognitive behavioral therapy for persistent disabling low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.E. Johnson" 1 => "G.T. Jones" 2 => "N.J. Wiles" 3 => "C. Chaddock" 4 => "R.G. Potter" 5 => "C. Roberts" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/BRS.0b013e318074f890" "Revista" => array:5 [ "tituloSerie" => "Spine (Phila Pa 1976)" "fecha" => "2007" "volumen" => "32" "paginaInicial" => "1578" "paginaFinal" => "1585" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0160" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of physical treatments versus a brief pain-management programme for back pain in primary care: a randomised clinical trial in physiotherapy practice" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Hay" 1 => "R. Mullis" 2 => "M. Lewis" 3 => "K. Vohora" 4 => "C. Main" 5 => "P. Watson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(05)66696-2" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2005" "volumen" => "365" "paginaInicial" => "2024" "paginaFinal" => "2030" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15950716" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0165" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.J. Smeets" 1 => "J.W. Vlaeyen" 2 => "A. Hidding" 3 => "A.D. Kester" 4 => "G.J. van der Heijden" 5 => "A.C. van Geel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2474-7-5" "Revista" => array:5 [ "tituloSerie" => "BMC Musculoskelet Disord" "fecha" => "2006" "volumen" => "7" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16426449" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0170" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "discussion 2952; <a class="elsevierStyleInterRef" target="_blank" id="intr0025" href="http://www.ncbi.nlm.nih.gov/pubmed/11074683">http://www.ncbi.nlm.nih.gov/pubmed/11074683</a> [accessed 26.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Oswestry Disability Index" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.C. Fairbank" 1 => "P.B. Pynsent" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Spine (Phila Pa 1976)" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "2940" "paginaFinal" => "2952" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0175" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Background perspective" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B.S.M. Mcgill" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2003" "paginaInicial" => "3" "paginaFinal" => "6" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0180" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Murphy JL, McKellar JD, Raffa SD, Clark ME, Kerns RD, Karlin BE. Cognitive behavioral therapy for chronic pain among veterans: Therapist manual. Washington, DC: U.S. Department of Veterans Affairs." ] ] ] 15 => array:3 [ "identificador" => "bib0185" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<a class="elsevierStyleInterRef" target="_blank" id="intr0030" href="http://web.b.ebscohost.com/abstract?direct=true%26profile=ehost%26scope=site%26authtype=crawler%26jrnl=1011601X%26AN=101833375%26h=VuIT0dGKiDMwqmWImTTXPw55e4qnIKWqFAMPGe3yAV4P8dJw0fhN20K%2FqLCxeXKeCkVNNpv786%2FDBR0VrUekQg%3D%3D%26crl=c%26resultNs=AdminWebAuth%26resultLocal">http://web.b.ebscohost.com/abstract?direct=true≺ofile=ehost≻ope=site&authtype=crawler&jrnl=1011601X&AN=101833375&h=VuIT0dGKiDMwqmWImTTXPw55e4qnIKWqFAMPGe3yAV4P8dJw0fhN20K%2FqLCxeXKeCkVNNpv786%2FDBR0VrUekQg%3D%3D&crl=c&resultNs=AdminWebAuth&resultLocal</a> [published 2014; accessed 26.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EBSCOhost | 101833375 | The effectiveness of Cognitive Behavioral Therapy (CBT) with general exercises versus general exercises alone in the management of chronic low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Khan" 1 => "S. Akhter" 2 => "R. Rani Soomro" 3 => "S. Shahzad Ali" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Pak J Pharm Sci" "fecha" => "2018" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0190" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of lumbar stabilization exercise and lumbar extension exercise in the treatment of chronic low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Chitra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Sci J" "fecha" => "2014" "volumen" => "10" "paginaInicial" => "123" "paginaFinal" => "131" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0195" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stabilisation exercises for low back pain: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. May" 1 => "R. Johnson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.physio.2007.08.010" "Revista" => array:5 [ "tituloSerie" => "Physiotherapy" "fecha" => "2008" "volumen" => "94" "paginaInicial" => "179" "paginaFinal" => "189" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0200" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<a class="elsevierStyleInterRef" target="_blank" id="intr0035" href="http://www.ncbi.nlm.nih.gov/pubmed/8979323">http://www.ncbi.nlm.nih.gov/pubmed/8979323</a> [accessed 26.01.18]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Hides" 1 => "C.A. Richardson" 2 => "G.A. Jull" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Spine (Phila Pa 1976)" "fecha" => "1996" "volumen" => "21" "paginaInicial" => "2763" "paginaFinal" => "2769" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0205" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "CD002014" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Behavioural treatment for chronic low-back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Henschke" 1 => "R.W. Ostelo" 2 => "M.W. van Tulder" 3 => "J.W. Vlaeyen" 4 => "S. Morley" 5 => "W.J. Assendelft" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD002014.pub3" "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2010" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0210" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: “McKenzie” vs brief physiotherapy pain management" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Klaber Moffett" 1 => "D.A. Jackson" 2 => "E.D. Gardiner" 3 => "D.J. Torgerson" 4 => "S. Coulton" 5 => "S. 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Original
Effects of a combined lumbar stabilization exercise and cognitive behavioral therapy on selected variables of individuals with non-specific low back pain: A randomized clinical trial
Efectos de la combinación de ejercicios de estabilización lumbar y la terapia cognitivo-conductual en personas con dolor lumbar crónico inespecífico: ensayo clínico aleatorizado