A REHABILITATION APPROACH TO CHRONIC LOw BACK PAIN DISABILITy PRISTOP PRI ZMANJŠANI ZMOŽNOSTI ZARADI KRONIČNE BOLEČINE

When low back pain (LBP) permanently interferes with daily activities or employment, patients experience chronic low back pain disability (CLBPD). This is a syndrome that in addition to chronic pain includes depression, anxiety, and difficulties in domestic and social life, in the performance of daily tasks, and in integration at work. In contrast to other types of treatment tried for chronic LBP, the rehabilitation approach to CLBPD considers primarily the disability. According to the principles of this approach, the various components of the CLBPD syndrome are treated in parallel by a multidisciplinary team, and the rehabilitation process includes task performance assessment, pain reduction, cognitive, behavioral, social and ergonomic interventions, and exposure to functional and physical training of gradually increasing difficulty, irrespective of pain perception. Outcomes of functional restoration programs for CLBPD vary. The program at Loewenstein Rehabilitation Hospital is offered to inpatients with a high level of disability and reduced performance on primary ADL tasks. Rehabilitation is carried out in an environment that encourages functioning and denies secondary gain. The Spinal Pain Independence Measure (SPIM) and its modified version (SPIM – Mod) are used for quantitative functional assessment. The program was found effective, especially for CLBPD patients with more severe functional deficit.