Volume 28, Issue 2 (4-2021)                   RJMS 2021, 28(2): 56-67 | Back to browse issues page

Research code: ندارد
Ethics code: IR.IAU.SRB.REC.1398.076
Clinical trials code: ندارد

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MirzamohammadAlaeini E, AbaspoorAzar Z, AgahHeris M, Baseri A. Comparison of effectiveness of autogenic training and affect regulation training on pain severity of women with chronic low back pain. RJMS 2021; 28 (2) :56-67
URL: http://rjms.iums.ac.ir/article-1-6573-en.html
Payam-e-Noor University, Garmsar, Iran , agah.mojgan@yahoo.com
Abstract:   (1249 Views)
Background and Aims: Low back pain is usually associated with psychological, social, and biological-physical problems. As pain becomes more chronic, the role of psychological and social factors becomes more prominent than biological factors. Following the failure of medical treatments for pain, specialists turned to non-sensory aspects of pain, including psychological factors. Therefore, the use of psychological therapies became part of new therapeutic lines. The aim of this study was to compare the effectiveness of autogenic education and emotion regulation training on pain intensity in women with chronic low back pain.
Musculoskeletal disorders are one of the most common chronic health problems, which is the second leading cause of physical disability in the world that is responsible for a significant portion of health care costs and leads to detrimental effects on personal health, quality of life, job satisfaction and wasted work days. One of the most common and costly disorders, especially among women, is chronic low back pain, which is defined as an unpleasant sensory and psychological experience associated with possible or actual tissue damage. While medical interventions play an important role in reducing pain, their unpleasant side effects have limited the widespread use of drug therapies. On the other hand, some chronic pain problems are difficult to diagnose and their drug treatment has limited effectiveness. Daily life with pain can cause excessive fatigue and thus impair the quality of life of the sufferer, so psychological interventions to reduce the problems caused by chronic pain, expanded. These interventions have many effects in the field of chronic diseases and can help to relieve the pain of patients with chronic pain in addition to medication, as well as alleviate their psychological symptoms that have also been the cause of pain. The two interventions ART and AT regulate the emotions of individuals, reduce cramps and muscle tensions in patients, create a feeling of physical and mental relaxation, and reduce the symptoms of the disease modifying the mind-body relationship. AT is a psychophysiological model of psychotherapy in which the individual uses passive focus and certain combinations of mental and physical stimuli, relying on the establishment of a mind-body relationship to treat the patient's low back pain. ART has also emerged from the integration of techniques from different approaches in a comprehensive training program consisting of 7 skills, which shows the effectiveness of clinical research and relies on the mind-body relationship to affect pain. Therefore, the present study compares the effectiveness of autogenic training and affect regulation training on pain intensity in women with chronic low back pain.
Methods: The present research was semi-experimental study which used a pre-test, post-test and control group design (two experiment and one control groups). The statistical population of this study, included all women with chronic low back pain referring to the Moradi pain clinic in Tehran, in the year 2018. The sample of present study included 33 women with chronic low back pain who were selected by available sampling method and were assigned to two experiment and one control groups (11 persons per groups) by random assignment method. The inclusion criteria of the research included: female gender, being in the age range of 20-50 years, having higher education than a diploma, diagnosis of chronic low back pain by a pain specialist, achieving a score higher than 34.52 in McGill Pain Questionnaire and continuing medication according the physician. The exclusion criteria of the research included: pregnancy or menopause, being in the age range of under 20 or upper 50 years, lack of diploma education, having any organ defect, co-occurrence with other chronic physical diseases such as diabetes, cardiovascular disease, etc. and absence of more than 1 session of group sessions. The data gathering tool was McGill Pain Questionnaire. Both experimental groups attended the sessions once a week for 12 sessions of 90 minutes, the control group did not receive any intervention from therapist. The data was analyzed by univariate analysis of variance (ANOVA), and multivariate analysis of variance (MANOVA), in SPSSv24.
Results: The mean and standard deviation of age for AT group were 40.27±11.49, for ART group were 43.55±8.05, and for control group were 41.45±7.64. Also the mean and standard deviation of sufferance duration for AT group were 1.91±1.30, for ART group were 1.36±0.80, and for control group were 1.45±0.82. In the field of education in AT group, %18.2 had diploma, %72.7 had bachelor degree, %9.1 upper bachelor degree, in ART group, %27.3 diploma, %18.2 bachelor degree, %54.5 upper bachelor degree and in control group, %45.5 diploma, %0 bachelor degree and %54.5 were upper than bachelor degree. Totally, 33 subjects with a mean age of 41 years and 9 months and 4 days and a standard deviation of 9 years and 4 months and 2 days participated in this study. The age range of the subjects has been extended from 25-50 years and the mean of the chronic low back pain sufferance duration was 1.58 year with a standard deviation of 0.708 year; the range of sufferance duration has been extended less than 1-2 years. The mean scores of pain perception and its subscales in the post-test have decreased compared to the pre-test in AT group of 22.09 scores and in ART group of 16.09 scores but in control group these amounts have increased slightly. Also, using MANOVA, the volume effect of the difference between the mean scores of pain perception subscales in the three groups of AT, ART and control in the two measurements in pre-test results of Pillais test showed significant changes in the collective effect of pain perception scores subscales in pre-test and post-test concerning to the AT, ART and control groups (p<0.05) and the effect size of this differences was %44.9. The results of ANOVA test showed significant changes in all 4 subscales of pain perception in both pre-test and post-test according to the groups of AT, ART and control (p<0.05). The effect size of these differences for sensory perception of pain was equal to 71.6%, for emotional perception of pain was equal to 67.1%, for measuring the pain was 67.8% and for various pains was 65.6%. The data show autogenic training and affect regulation training were affective on decreasing patients' pain.
Conclusion: Considering the effectiveness of the trainings, it can be said that ART intervention through techniques of emotion, muscular and respiratory relaxation, awareness without judgment, acceptance and tolerance of affects and AT intervention through autogenic relaxation using heat, weight and respiration exercises, advanced relaxation and autogenic meditation, have controlled negative emotions and closed the gate of pain by teaching cognitive strategies and led to a pain reduction in patients with chronic low back pain. Therefore, according to findings of present research, it is recommended that all specialists in health fields, apply these therapeutic models to relieve chronic pains, muscular tensions and mind-body relaxation.
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Type of Study: Research | Subject: Pathology

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