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

Pain Manag. 2026 Oct 15:1-10. doi: 10.1080/17581869.2026.2748301. Online ahead of print.

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.

PMID:42876320 | DOI:10.1080/17581869.2026.2748301