Changes in functional outcomes following activity management training in individuals with chronic low back pain: associations with cognitive functions, body awareness, and fatigue

Abstract

Aims This study investigated changes in activity patterns, cognitive functions, and fatigue following activity management training in individuals with chronic low back pain (CLBP).Patients and methods Thirty-four individuals with CLBP completed a six-week training program covering ergonomics, pacing, energy conservation, and relaxation. Assessments included the Canadian Occupational Performance Measure (COPM), Body Awareness Questionnaire, Patterns of Activity Measure-Pain, Cognitive Failures Questionnaire (CFQ), Fatigue Severity Scale, Stroop Test, and selected Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) subtests.Results Significant improvements were observed in COPM performance and satisfaction (p < 0.001). Body awareness and adaptive activity regulation behaviors increased, while pain-related avoidance behaviors decreased (p < 0.05). Cognitive performance also improved, as indicated by lower CFQ scores and better performance on selected Stroop and LOTCA measures (p < 0.05). Fatigue severity did not change significantly (p > 0.05). Regression models were significant for activity performance (R2 = 0.366, p = 0.008) and satisfaction (R2 = 0.347, p = 0.013). Body awareness and visuomotor organization were associated with activity performance, while fatigue was associated with activity satisfaction (p < 0.05). Conclusions Activity management training may be considered a supportive approach for addressing activity-related difficulties in individuals with chronic low back pain.ClinicalTrials.gov Identifier www.clinicaltrials.gov identifier is NCT07061743.