Houngbedji GM1,2, Bonkongou J1, Alagnide E1,3, Kpadonou TG1,3
1Universite d'Abomey-Calavi, Ecole Superieure de Kinesithherapie - Facute des Sciences de la Sante, Cotonou, Benin, 2Centre de Kinésithérapie et Réadaptation Médicale de Fidjrosse, Cotonou, Benin, 3Clinique Universitaire de Medecine Physique et Readaptation, CNHU-HKM, Cotonou, Benin
Background: Chronic low back pain is multifactorial and its management has changed with the evolution of conceptual models. The biopsychosocial model values an integrated approach to clinical, psychological and social factors leading to multidisciplinary strategies. Psychosocial factors combine with inappropriate fears and beliefs, anxiety or depression, fears of return to work, or inappropriate coping strategies. Fear of pain is associated with avoidance behaviors that increase apprehension and long-term functional impact. It is therefore important to know the patient´s adjustment strategies in order to better management is functional rehabilitation
Purpose: To evaluate the behavioral strategy used by patients to adapt to pain
Methods: This is a prospective cross-sectional descriptive and analytical study of 241 eligible chronic low back pain patients followed in the physical therapy clinics of CNHU-HKM, Army Instructional Hospital of Camp GUEZO, Bethesda Hospital, Suru-Lere Area Hospital and St Luc Hospital in Cotonou. The study took place from May to December 2017. Each patient was asked to fulfil a questionnaire include the French version of the Coping strategy questionnaire
Results: The mean age was 46.02 ± 13.90 years; women are in the majority (56.43%). The mean duration of evolution was 32.85 ± 46.34 months. The averages of distraction, dramatization, ignorance of painful sensations, reinterpretation of pain, and prayer were 13.75 ± 2.61, respectively; 8.73 ± 2.01; 10.38 ± 3.14; 8.95 ± 2 and 10.44 ± 1.78. The difference between woman and man is significant only for the reinterpretation of the pain (X2=19.18, p=0.038). Several sociodemographic and clinical factors influenced CSQ domains. Indeed, the distraction was significantly associated by parity (p = 0.04); the dramatization by monthly income (p = 0.03), lifestyle (X2 = 7.32, p = 0.029), and pain intensity (X2 = 10.55, p = 0, 03); the reinterpretation of pain by BMI (X2 = 11.07, p = 0.02), surgical history on the hip (X2 = 10.30, p = 0.01); the prayer by BMI (X2 = 2.99, p = 0.048), work stoppages (X2 = 10.07, p = 0.01); lifestyle (X2 = 7.32, p = 0.03), history of surgery on the abdomen (X2 = 7.37, p = 0.03) or lower limb (X2 = 8.41 p = 0.02) and back hygiene information (X2 = 8.27, p = 0.02). However, no factor was, associated with the ignorance of pain
Conclusion(s): Prayer and dramatization are the main strategies adopted by patients in our study. Our results are similar to those found by Genet et al. (2009) in their studies in Côte d´Ivoire but differ from their results in France, Tunisia and Morocco. The dramatization of pain leads to the avoidance of all activities which leads to the latter a psychological and physical deconditioning. Several factors are significantly associated with patients´ strategies for coping with their pain and deserve to be considered for better care management
Implications: To contribute to the therapeutic decision in the patients with chronic low back pain
Keywords: Chronic Low back pain, coping strategy, Rehabilitation
Funding acknowledgements: No funding. No conflict of interest
Purpose: To evaluate the behavioral strategy used by patients to adapt to pain
Methods: This is a prospective cross-sectional descriptive and analytical study of 241 eligible chronic low back pain patients followed in the physical therapy clinics of CNHU-HKM, Army Instructional Hospital of Camp GUEZO, Bethesda Hospital, Suru-Lere Area Hospital and St Luc Hospital in Cotonou. The study took place from May to December 2017. Each patient was asked to fulfil a questionnaire include the French version of the Coping strategy questionnaire
Results: The mean age was 46.02 ± 13.90 years; women are in the majority (56.43%). The mean duration of evolution was 32.85 ± 46.34 months. The averages of distraction, dramatization, ignorance of painful sensations, reinterpretation of pain, and prayer were 13.75 ± 2.61, respectively; 8.73 ± 2.01; 10.38 ± 3.14; 8.95 ± 2 and 10.44 ± 1.78. The difference between woman and man is significant only for the reinterpretation of the pain (X2=19.18, p=0.038). Several sociodemographic and clinical factors influenced CSQ domains. Indeed, the distraction was significantly associated by parity (p = 0.04); the dramatization by monthly income (p = 0.03), lifestyle (X2 = 7.32, p = 0.029), and pain intensity (X2 = 10.55, p = 0, 03); the reinterpretation of pain by BMI (X2 = 11.07, p = 0.02), surgical history on the hip (X2 = 10.30, p = 0.01); the prayer by BMI (X2 = 2.99, p = 0.048), work stoppages (X2 = 10.07, p = 0.01); lifestyle (X2 = 7.32, p = 0.03), history of surgery on the abdomen (X2 = 7.37, p = 0.03) or lower limb (X2 = 8.41 p = 0.02) and back hygiene information (X2 = 8.27, p = 0.02). However, no factor was, associated with the ignorance of pain
Conclusion(s): Prayer and dramatization are the main strategies adopted by patients in our study. Our results are similar to those found by Genet et al. (2009) in their studies in Côte d´Ivoire but differ from their results in France, Tunisia and Morocco. The dramatization of pain leads to the avoidance of all activities which leads to the latter a psychological and physical deconditioning. Several factors are significantly associated with patients´ strategies for coping with their pain and deserve to be considered for better care management
Implications: To contribute to the therapeutic decision in the patients with chronic low back pain
Keywords: Chronic Low back pain, coping strategy, Rehabilitation
Funding acknowledgements: No funding. No conflict of interest
Topic: Musculoskeletal: spine; Human movement analysis; Non-communicable diseases (NCDs) & risk factors
Ethics approval required: No
Institution: CNHU-HKM, Army Instructional Hospital, Hospital of Bethesda, Suru-Lere, St-Luc.
Ethics committee: authorities or scientific committees
Reason not required: Investigation Without Intervention - Voluntary Membership - Informed Consent - Anonymous Investigation Sheet
All authors, affiliations and abstracts have been published as submitted.
