{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T20:40:08Z","timestamp":1771706408902,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,8,1]]},"abstract":"<jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Fear of movement is a risk factor for poor postoperative outcomes in patients following spine surgery. The purposes of this case series were: (1) to describe the effects of a cognitive-behavioral\u2013based physical therapy (CBPT) intervention in patients with high fear of movement following lumbar spine surgery and (2) to assess the feasibility of physical therapists delivering cognitive-behavioral techniques over the telephone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Description<\/jats:title><jats:p>Eight patients who underwent surgery for a lumbar degenerative condition completed the 6-session CBPT intervention. The intervention included empirically supported behavioral self-management, problem solving, and cognitive restructuring and relaxation strategies and was conducted in person and then weekly over the phone. Patient-reported outcomes of pain and disability were assessed at baseline (6 weeks after surgery), postintervention (3 months after surgery), and at follow-up (6 months after surgery). Performance-based outcomes were tested at baseline and postintervention. The outcome measures were the Brief Pain Inventory, Oswestry Disability Index, 5-Chair Stand Test, and 10-Meter Walk Test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>Seven of the patients demonstrated a clinically significant reduction in pain, and all 8 of the patients had a clinically significant reduction in disability at 6-month follow-up. Improvement on the performance-based tests also was noted postintervention, with 5 patients demonstrating clinically meaningful change on the 10-Meter Walk Test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The findings suggest that physical therapists can feasibly implement cognitive-behavioral skills over the telephone and may positively affect outcomes after spine surgery. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the CBPT intervention. Clinical implications include broadening the availability of well-accepted cognitive-behavioral strategies by expanding implementation to physical therapists and through a telephone delivery model.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20120426","type":"journal-article","created":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T03:11:12Z","timestamp":1366341072000},"page":"1130-1139","source":"Crossref","is-referenced-by-count":32,"title":["Cognitive-Behavioral\u2013Based Physical Therapy to Improve Surgical Spine Outcomes: A Case Series"],"prefix":"10.1093","volume":"93","author":[{"given":"Kristin R.","family":"Archer","sequence":"first","affiliation":[{"name":"K.R. Archer, PT, DPT, PhD, Department of Orthopaedic Surgery & Rehabilitation, School of Medicine, Vanderbilt University, Medical Center East\u2013South Tower, Suite 4200, Nashville, TN 37232 (USA)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Motzny","sequence":"additional","affiliation":[{"name":"N. Motzny, PT, DPT, Department of Orthopaedic Surgery & Rehabilitation, School of Medicine, Vanderbilt University."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Abraham","sequence":"additional","affiliation":[{"name":"C.M. Abraham, MA, Department of Orthopaedic Surgery & Rehabilitation, School of Medicine, Vanderbilt University."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Yaffe","sequence":"additional","affiliation":[{"name":"D. Yaffe, PhD, Chase Brexton Health Services Inc, Baltimore, Maryland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caryn L.","family":"Seebach","sequence":"additional","affiliation":[{"name":"C.L. Seebach, PsyD, Department of Neurology, Washington DC Veterans Affairs Medical Center, Washington, DC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clinton J.","family":"Devin","sequence":"additional","affiliation":[{"name":"C.J. Devin, MD, Department of Orthopaedic Surgery & Rehabilitation, School of Medicine, Vanderbilt University."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan M.","family":"Spengler","sequence":"additional","affiliation":[{"name":"D.M. Spengler, MD, Department of Orthopaedic Surgery & Rehabilitation, School of Medicine, Vanderbilt University."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"McGirt","sequence":"additional","affiliation":[{"name":"M.J. 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