Improving Function and Reducing Fear in Chronic Low Back Pain: A Study on Cognitive Functional Therapy and Relaxation Techniques

INTERVENTION: Intervention1: cognitive functional therapy and Jacobsons relaxation technique: 12 direct sessions and 12 On call session 8 week training intervention of 3 non consecutive days a week Duration is 60 min per session The intervention consists of the following 3 main stages:A. Making sense of pain that is completely reflective, where physical therapist could use the context of the patient s own story to provide a new understanding of their condition and question their old beliefs . B. Exposure with control which is designed to normalize maladaptive or provocative movement and posture related to activities of daily living that is integrated into each patient s functional impairments, including teaching how to rela Xtrunk muscles, how to have normal body posture while sitting, lying, bending, lifting, moving, and standing, and how to avoid pain behaviors, which aims to break poor postural habits; and C.Lifestyle change which is investigating the influence of unhealthy lifestyles in the patient s pain context. JACOBSON S RELAXATION TECHNIQUE 20 min per session For both group A and group B a. To sit on a chair as comfortably as possible. Keep your body loose light and free. b. Be calm and comfortable. c. Keep your eye closed. d. Avoid stray thoughts. e. Avoid extra movements of the body. f. During the part of the exercise cycle tense the muscle tightly and hold for slow count of 5 seconds. g. During the relation part of exercise cycle relaxes the muscle quickly and completely .let your mind rela Xand appreciate how relaxed the muscle is feeling for 10 seconds. h. Try to keep all other muscles relaxed as you exercise specific muscle group. i. As you exercise from head to toe.Observe changes like tightness and the development of light and soothing sensations. j. Rela Xby tak CONDITION: Health Condition 1: M00‐M99‐ Diseases of the musculoskeletal system and connective tissue PRIMARY OUTCOME: TUG test,Fear Avoidance Belief s Questionnaire ,Pain Catastrophising scale ; Timepoint: 8 weeks ; SECONDARY OUTCOME: Lumbar Range of Motion,Corset Effect with pressure biofeedback unit(PBFU) ; Timepoint: 8 weeks INCLUSION CRITERIA: Patients with non specific chronic low back pain Duration of pain atleast 12 weeks,Moderate pain ( more than or equal to 4 NPRS ),Independently mobile,Patients who can communicate in Hindi or English language,Medical clearance able to participate in an exercise program as confirmed by a physician or orthopaedician