skip to page content
Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Treatment monitoring as a component of psychologically informed physical therapy: A case series of patients at high risk for persistent low back pain related disability.

Beneciuk JM, Ballengee LA, George SZ. Treatment monitoring as a component of psychologically informed physical therapy: A case series of patients at high risk for persistent low back pain related disability. Musculoskeletal science & practice. 2019 Jun 1; 41:36-42.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


BACKGROUND: Psychologically Informed Physical Therapy (PIPT) aims to identify individuals at high risk for transitioning to chronicity and merge impairment-focused physical therapy with cognitive behavioral therapy principles. Treatment monitoring is an important part of PIPT and involves identifying changes in clinical measures to inform clinical decision making. OBJECTIVES: The purpose of this case series is to describe treatment monitoring using psychological and physical impairment measures for patients identified as ''high-risk'' for persistent low back pain (LBP) related disability. DESIGN: Secondary analysis of patients (n? = 23) identified as ''high-risk'' using the STarT Back Tool and enrolled in two-phased, sequential study that evaluated feasibility and generated preliminary PIPT treatment effects for 4-week clinical outcomes. METHOD: Physical therapists (n? = 5) used psychological [Fear-Avoidance Beliefs Questionnaire (FABQ-PA, FABQ-W), Tampa Scale for Kinesiophobia (TSK-11), Pain Catastrophizing Scale (PCS) and Fear of Daily Activities Questionnaire (FDAQ)] and the Physical Impairment Index (PII) measures for PIPT treatment monitoring. Clinical outcome measures [Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI)] were administered at intake and 4-weeks later. Linear regression models evaluated independent contribution of intake and 4-week changes in psychological measures and PII scores as predictors of 4-week NPRS and ODI scores. RESULTS: FABQ-PA and PCS changes provided largest contributions to prediction of 4-week ODI scores. Treatment monitoring measures did not explain additional variability in 4-week NPRS scores after baseline scores were considered. CONCLUSIONS: For patients at high risk for persistent LBP psychological measures consistently performed better as treatment monitoring variables compared to physical impairment measures. Treatment monitoring for PIPT with psychological measures provides opportunities to refine prediction of disability outcomes. Findings from this exploratory case series should be interpreted with caution based on its small sample size and lack of statistical power which prohibits definitive conclusions to be made on any of the treatment monitoring measures.

Questions about the HSR&D website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.