Interventions such as supervised or individualised exercise therapy and self-management techniques may enhance exercise adherence .
BACKGROUND Chronic musculoskeletal pain ( CMP ) is a major health problem , accounting for approximately one-quarter of general practice ( GP ) consultations in the United Kingdom ( UK ) .
Exercise and physical activity is beneficial for the most common types of CMP , such as back and knee pain .
However , poor adherence to exercise and physical activity may limit long-term effectiveness .
OBJECTIVES To assess the effects of interventions to improve adherence to exercise and physical activity for people with chronic musculoskeletal pain .
Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain.
UNLABELLED The aim of this study was to examine whether treatments based on different theories change pain catastrophizing and internal control of pain , and whether changes in these factors mediate treatment outcome . Participants were 211 patients with nonspecific chronic low back pain ( CLBP ) participating in a r and omized controlled trial , attending active physical treatment ( APT , n = 52 )  , cognitive-behavioral treatment ( CBT , n = 55 ) , treatment combining the APT and CBT ( CT , n = 55 ) , or waiting list ( WL , n = 49 ) . Pain catastrophizing decreased in all 3 active treatment groups and not in the WL . There was no difference in the change in internal control across all 4 groups . In all the active treatment groups , patients improved regarding perceived disability , main complaints , and current pain at post-treatment , and no changes were observed in the WL group . Depression only changed significantly in the APT group . Change in pain catastrophizing mediated the reduction of disability , main complaints , and pain intensity . In the APT condition , pain catastrophizing also mediated the reduction of depression . Not only cognitive-behavioral treatments but also a physical treatment produced changes in pain catastrophizing that seemed to mediate the outcome of the treatment significantly . The implication s and limitations of these results are discussed . PERSPECTIVE This article shows that treatment elements that do not deliberately target cognitive factors can reduce pain catastrophizing . Reduction in pain catastrophizing seemed to mediate the improvement of functioning in patients with chronic low back pain . The results might contribute to the development of more effective interventions
Interventions such as supervised or individualised exercise therapy and self-management techniques may enhance exercise adherence .
BACKGROUND Chronic musculoskeletal pain ( CMP ) is a major health problem , accounting for approximately one-quarter of general practice ( GP ) consultations in the United Kingdom ( UK ) .
Exercise and physical activity is beneficial for the most common types of CMP , such as back and knee pain .
However , poor adherence to exercise and physical activity may limit long-term effectiveness .
OBJECTIVES To assess the effects of interventions to improve adherence to exercise and physical activity for people with chronic musculoskeletal pain .