Saturday, February 27, 2010

Group therapy to relieve back pain without the use of pills. British doctors cheap method proposed."BBC Mundo"

Back pain "talking cures"El dolor de espalda "se cura hablando"

BBC Science
Psychotherapy-specifically a form based on cognitive behavioral therapy (CBT) - a cheaper and effective method that medication and exercise to heal the pain in your lower back, a study suggests.
Patients receiving cognitive behavioral therapy recovered better.
This positive effect was seen even a year after a program of six short sessions of therapy, say scientists in the journal The Lancet

BBC Ciencia
La psicoterapia -específicamente una forma basada en la terapia cognitivo conductual (TCC)- es un método más barato y efectivo que los medicamentos y el ejercicio para curar el dolor de la parte baja de la espalda, revela un estudio.
Los pacientes sometidos a terapia cognitivo conductual se recuperaron mejor.
Este efecto positivo fue visto incluso un año después de un programa de seis sesiones cortas de terapia, dicen los científicos en la revista The Lancet.
Tuántǐ zhìliáo, yǐ jiǎnqīng bèi tòng bù shǐyòng yàopiàn.Yīngguó yīshēng liánjià de fāngfǎ jiànyì.

Yāo bèi tòng “huì shuōhuà de zhìliáo”
Yīngguó guǎngbò gōngsī kēxué
Xīnlǐ zhìliáo, tèbié shì yīgè xíngshì de jīchǔ shàng rènzhī xíngwéi zhìliáo (CBT) de - liánjià ér yǒuxiào de fāngfǎ, yàowù hé yùndòng yīzhì téngtòng, yāobù, yī xiàng yánjiū biǎomíng.
Bìngrén jiēshòu rènzhī xíngwéi zhìliáo huīfù jiào hǎo.
Zhè zhǒng jījí de zuòyòng bèi rènwéi shènzhì yī nián hòu, jìhuà 6 gè duǎn huì zhìliáo, kēxuéjiā men shuō, zài zázhì liǔyè dāo.

A terapia de grupo para aliviar a dor nas costas, sem o uso de pílulas. Médicos britânicos método barato proposto.

Dor nas costas "falar" curas
BBC Science
Psicoterapia especificamente um formulário baseado na terapia cognitivo-comportamental (TCC) - um método barato e eficaz que a medicação e exercício, para curar a dor na parte inferior das costas, um estudo sugere.
Os pacientes que recebem terapia comportamental cognitiva recuperar melhor.
Este efeito positivo foi observado até um ano após um programa de seis sessões de terapia de curto prazo, dizem os cientistas na revista The Lancet.
SOURCE: The Lancet, Early Online Publication, 26 February 2010doi:10.1016/S0140-6736(09)62164-4Cite or Link Using DOIGroup cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis

Original Text
Prof Sarah E Lamb DPhil a b , Zara Hansen MCSP a, Ranjit Lall PhD a, Emanuela Castelnuovo MSc a, Emma J Withers a, Vivien Nichols MRes a, Rachel Potter MSc a, Prof Martin R Underwood MD a, on behalf of the Back Skills Training Trial investigators‡
Summary
Background
Low-back pain is a common and costly problem. We estimated the effectiveness of a group cognitive behavioural intervention in addition to best practice advice in people with low-back pain in primary care.
Methods
In this pragmatic, multicentre, randomised controlled trial with parallel cost-effectiveness analysis undertaken in England, 701 adults with troublesome subacute or chronic low-back pain were recruited from 56 general practices and received an active management advisory consultation. Participants were randomly assigned by computer-generated block randomisation to receive an additional assessment and up to six sessions of a group cognitive behavioural intervention (n=468) or no further intervention (control; n=233). Primary outcomes were the change from baseline in Roland Morris disability questionnaire and modified Von Korff scores at 12 months. Assessment of outcomes was blinded and followed the intention-to-treat principle, including all randomised participants who provided follow-up data. This study is registered, number ISRCTN54717854.
Findings
399 (85%) participants in the cognitive behavioural intervention group and 199 (85%) participants in the control group were included in the primary analysis at 12 months. The most frequent reason for participant withdrawal was unwillingness to complete questionnaires. At 12 months, mean change from baseline in the Roland Morris questionnaire score was 1·1 points (95% CI 0·39—1·72) in the control group and 2·4 points (1·89—2·84) in the cognitive behavioural intervention group (difference between groups 1·3 points, 0·56—2·06; p=0·0008). The modified Von Korff disability score changed by 5·4% (1·99—8·90) and 13·8% (11·39—16·28), respectively (difference between groups 8·4%, 4·47—12·32; p<0·0001). The modified Von Korff pain score changed by 6·4% (3·14—9·66) and 13·4% (10·77—15·96), respectively (difference between groups 7·0%, 3·12—10·81; p<0·0001). The additional quality-adjusted life-year (QALY) gained from cognitive behavioural intervention was 0·099; the incremental cost per QALY was £1786, and the probability of cost-effectiveness was greater than 90% at a threshold of £3000 per QALY. There were no serious adverse events attributable to either treatment.
Interpretation
Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider.
Funding
National Institute for Health Research Health Technology Assessment Programme.

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