The effects of psychologically informed physical therapy on kinesiophobia, pain, disability, depression, and anxiety in patients with chronic low back pain: an intervention study focusing on graded exposure

[Purpose] This study investigated the effectiveness of psychologically informed practice (PIP) combined with progressive exposure techniques in managing fear, pain, disability, depression, and anxiety among patients with chronic low back pain. It also examined the need for customized psychological interventions for these patients. [Participants and Methods] Nineteen patients with chronic low back pain participated in this study. The experimental group (n=9) received progressive exposure-based PIP combined with physical therapy, while the control group (n=10) received only physical therapy. The primary evaluation measures were fear (Tampa Scale for Kinesiophobia), perceived harmfulness (Photo Series of Daily Activities), pain (visual analogue scale), disability (Oswestry Disability Index), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory). Changes in these measures before and after the intervention were compared. [Results] The experimental group exhibited significant decreases in fear, pain, disability, and depression, with significant between-group differences observed for pain and depression. No significant change in anxiety was noted. [Conclusion] PIP combined with progressive exposure effectively reduced fear, pain, disability, and depression in patients with chronic low back pain, underscoring the importance of integrating psychological factors into treatment. Multidisciplinary approaches may improve long-term treatment outcomes and quality of life.