faculte mixte de medecine et de pharmacie … de la tcc dans la prise en … · faculte mixte de...

FACULTE MIXTE DE MEDECINE ET DE PHARMACIE DE ROUEN

ANNEE 2013

THESE POUR LE

DOCTORAT EN MEDECINE

Thèse de Médecine Générale

Marie NABAN

NEE LE 10 mai 1985 A PONT-AUDEMER

PRESENTEE ET SOUTENUE PUBLIQUEMENT LE 26 SEPTEMBRE 2013

PLACE DE LA THERAPIE COGNITIVO COMPORTEMENTALE

DANS LA PRISE EN CHARGE DES PATIENTS LOMBALGIQUES

CHRONIQUES EN SOINS PRIMAIRES : Enquête auprès d’un

échantillon de 105 médecins généralistes Haut Normands

PRESIDENT DU JURY : Mme le Professeur P. GERARDIN

DIRECTEUR DE THESE : Mme le Docteur MF. ARMANGAU-TURCK

ANNEE UNIVERSITAIRE 2012 - 2013

U.F.R. DE MEDECINE-PHARMACIE DE ROUEN

-------------------------

DOYEN : Professeur Pierre FREGER

ASSESSEURS : Professeur Michel GUERBET

Professeur Benoit VEBER

Professeur Pascal JOLY

Professeur Bernard PROUST

DOYENS HONORAIRES : Professeurs J. BORDE - Ph. LAURET - H. PIGUET – C. THUILLEZ

PROFESSEURS HONORAIRES : MM. M-P AUGUSTIN - J.ANDRIEU-GUITRANCOURT M.BENOZIO-

J.BORDE - Ph. BRASSEUR - R. COLIN - E. COMOY - J. DALION -.

DESHAYES - C. FESSARD – J.P FILLASTRE - P.FRIGOT -J.

GARNIER - J. HEMET - B. HILLEMAND - G. HUMBERT - J.M.

JOUANY - R. LAUMONIER – Ph. LAURET - M. LE FUR – J.P.

LEMERCIER - J.P LEMOINE - Mle MAGARD - MM. B. MAITROT -

M. MAISONNET - F. MATRAY - P.MITROFANOFF - Mme A. M.

ORECCHIONI - P. PASQUIS - H.PIGUET - M.SAMSON – Mme

SAMSON-DOLLFUS – J.C. SCHRUB - R.SOYER - B.TARDIF -

.TESTART - J.M. THOMINE – C. THUILLEZ - P.TRON -

C.WINCKLER - L.M.WOLF

I - MEDECINE

PROFESSEURS

M. Frédéric ANSELME HCN Cardiologie

Mme Isabelle AUQUIT AUCKBUR HCN Chirurgie Plastique

M. Bruno BACHY HCN Chirurgie pédiatrique

M. Fabrice BAUER HCN Cardiologie

Mme. Soumeya BEKRI HCN Biochimie et Biologie Moléculaire

M. Jacques BENICHOU HCN Biostatistiques et informatique médicale

M. Jean-Paul BESSOU HCN Chirurgie thoracique et cardio-vasculaire

Mme Françoise BEURET-BLANQUART CRMPR Médecine physique et de réadaptation

M. Guy BONMARCHAND HCN Réanimation médicale

M. Olivier BOYER UFR Immunologie

M. Jean-François CAILLARD (surnombre) HCN Médecine et santé au Travail

M. François CARON HCN Maladies infectieuses et tropicales

M. Philippe CHASSAGNE HB Médecine interne (Gériatrie)

M. Vincent COMPERE HCN Anesthésiologie et Réanimation chirurgicale

M. Alain CRIBIER (surnombre) HCN Cardiologie

M. Antoine CUVELIER HB Pneumologie

M. Pierre CZERNICHOW HCH Epidémiologie, économie de la santé

M. Jean - Nicolas DACHER HCN Radiologie et Imagerie Médicale

M. Stéphan DARMONI HCN Informatique Médicale/Techniques de communication

M. Pierre DECHELOTTE HCN Nutrition

Mme Danièle DEHESDIN HCN Oto-Rhino-Laryngologie

M. Jean DOUCET HB Thérapeutique/Médecine – Interne - Gériatrie.

M. Bernard DUBRAY CB Radiothérapie

M. Philippe DUCROTTE HCN Hépato – Gastro - Entérologie

M. Frank DUJARDIN HCN Chirurgie Orthopédique - Traumatologique

M. Fabrice DUPARC HCN Anatomie - Chirurgie Orthopédique et Traumatologique

M. Bertrand DUREUIL HCN Anesthésiologie et réanimation chirurgicale

Mle Hélène ELTCHANINOFF HCN Cardiologie

M. Thierry FREBOURG UFR Génétique

M. Pierre FREGER HCN Anatomie/Neurochirurgie

M. Jean François GEHANNO HCN Médecine et Santé au Travail

M. Emmanuel GERARDIN HCN Imagerie médicale

Mme Priscille GERARDIN HCN Pédopsychiatrie

M. Michel GODIN HB Néphrologie

M. Philippe GRISE HCN Urologie

M. Didier HANNEQUIN HCN Neurologie

M. Fabrice JARDIN CB Hématologie

M. Luc-Marie JOLY HCN Médecine d’urgence

M. Pascal JOLY HCN Dermato - vénéréologie

M. Jean-Marc KUHN HB Endocrinologie et maladies métaboliques

Mme Annie LAQUERRIERE HCN Anatomie cytologie pathologiques

M. Vincent LAUDENBACH HCN Anesthésie et réanimation chirurgicale

M. Joël LECHEVALLIER HCN Chirurgie infantile

M. Patrick LE DOSSEUR HCN Radiopédiatrie

M. Hervé LEFEBVRE HB Endocrinologie et maladies métaboliques

M. Thierry LEQUERRE HB Rhumatologie

M. Eric LEREBOURS HCN Nutrition

Mle Anne-Marie LEROI HCN Physiologie

M. Hervé LEVESQUE HB Médecine interne

Mme Agnès LIARD-ZMUDA HCN Chirurgie Infantile

M. Pierre Yves LITZLER HCN Chirurgie Cardiaque

M. Bertrand MACE HCN Histologie, embryologie, cytogénétique

M. Eric MALLET (surnombre) HCN Pédiatrie

M. Christophe MARGUET HCN Pédiatrie

Mle Isabelle MARIE HB Médecine Interne

M. Jean-Paul MARIE HCN ORL

M. Loïc MARPEAU HCN Gynécologie - obstétrique

M. Stéphane MARRET HCN Pédiatrie

Mme Véronique MERLE HCN Epidémiologie

M. Pierre MICHEL HCN Hépato - Gastro - Entérologie

M. Francis MICHOT HCN Chirurgie digestive

M. Bruno MIHOUT (surnombre) HCN Neurologie

M. Jean-François MUIR HB Pneumologie

M. Marc MURAINE HCN Ophtalmologie

M. Philippe MUSETTE HCN Dermatologie - Vénéréologie

M. Christophe PEILLON HCN Chirurgie générale

M. Jean-Marc PERON HCN Stomatologie et chirurgie maxillo-faciale

M. Christian PFISTER HCN Urologie

M. Jean-Christophe PLANTIER HCN Bactériologie-Virologie

M. Didier PLISSONNIER HCN Chirurgie vasculaire

M. Bernard PROUST HCN Médecine légale

M. François PROUST HCN Neurochirurgie

Mme Nathalie RIVES HCN Biologie et médecine du développement et de la

reproduction

M. Jean-Christophe RICHARD (Mise en disponibilité) HCN Réanimation Médicale, Médecine d’urgence

M. Horace ROMAN HCN Gynécologie Obstétrique

M. Jean-Christophe SABOURIN HCN Anatomie – Pathologie

M. Guillaume SAVOYE HCN Hépato Gastroentérologie

Mme Céline SAVOYE COLLET HCN Imagerie médicale

M. Michel SCOTTE HCN Chirurgie digestive

Mme Fabienne TAMION HCN Thérapeutique

Mle Florence THIBAUT HCN Psychiatrie d’adultes

M. Luc THIBERVILLE HCN Pneumologie

M. Christian THUILLEZ HB Pharmacologie

M. Hervé TILLY CB Hématologie et transfusion

M. François TRON (surnombre) UFR Immunologie

M. Jean-Jacques TUECH HCN Chirurgie digestive

M. Jean-Pierre VANNIER HCN Pédiatrie génétique

M. Benoît VEBER HCN Anesthésiologie Réanimation chirurgicale

M. Pierre VERA C.B Biophysique et traitement de l’image

M. Eric VERIN CRMPR Médecine Physique et de Réadaptation

M. Eric VERSPYCK HCN Gynécologie obstétrique

M. Olivier VITTECOQ HB Rhumatologie

M. Jacques WEBER HCN Physiologie

MAITRES DE CONFERENCES

Mme Noëlle BARBIER-FREBOURG HCN Bactériologie – Virologie

M. Jeremy BELLIEN HCN Pharmacologie

Mme Carole BRASSE LAGNEL HCN Biochimie

Mme Mireille CASTANET HCN Pédiatrie

M. Gérard BUCHONNET HCN Hématologie

Mme Nathalie CHASTAN HCN Physiologie

Mme Sophie CLAEYSSENS UFR Biochimie et biologie moléculaire

M. Moïse COEFFIER HCN Nutrition

M. Manuel ETIENNE HCN Maladies infectieuses et tropicales

M. Guillaume GOURCEROL HCN Physiologie

Mme Catherine HAAS-HUBSCHER HCN Anesthésie - Réanimation chirurgicale

M. Serge JACQUOT UFR Immunologie

M. Joël LADNER HCN Epidémiologie, économie de la santé

M. Jean-Baptiste LATOUCHE UFR Biologie Cellulaire

Mme Lucie MARECHAL-GUYANT HCN Neurologie

M. Thomas MOUREZ HCN Bactériologie

M. Jean-François MENARD HCN Biophysique

Mme Muriel QUILLARD HCN Biochimie et Biologie moléculaire

M. Vincent RICHARD UFR Pharmacologie

M. Francis ROUSSEL HCN Histologie, embryologie, cytogénétique

Mme Pascale SAUGIER-VEBER HCN Génétique

Mme Anne-Claire TOBENAS-DUJARDIN HCN Anatomie

PROFESSEUR AGREGE OU CERTIFIE

Mme Dominique LANIEZ UFR Anglais

Mme Cristina BADULESCU UFR Communication

II - PHARMACIE

PROFESSEURS

M. Thierry BESSON Chimie Thérapeutique

M. Jean-Jacques BONNET Pharmacologie

M. Roland CAPRON (PU-PH) Biophysique

M. Jean COSTENTIN (Professeur émérite) Pharmacologie

Mme Isabelle DUBUS Biochimie

M. Loïc FAVENNEC (PU-PH) Parasitologie

M. Jean Pierre GOULLE Toxicologie

M. Michel GUERBET Toxicologie

M. Olivier LAFONT Chimie organique

Mme Isabelle LEROUX Neurophysiologie

M. Paul MULDER Science du médicament

Mme Martine PESTEL CARON (PU-PH) Microbiologie

Mme Elisabeth SEGUIN Pharmacognosie

M. Jean Marie VAUGEOIS Pharmacologie

M. Philippe VERITE Chimie analytique

Mle Cécile BARBOT Chimie Générale et Minérale

Mme Dominique BOUCHER Pharmacologie

M. Frédéric BOUNOURE Pharmacie Galénique

M. Abdeslam CHAGRAOUI Physiologie

M. Jean CHASTANG Biomathématiques

Mme Marie Catherine CONCE-CHEMTOB Législation pharmaceutique et économie de la santé

Mme Elizabeth CHOSSON Botanique

Mle Cécile CORBIERE Biochimie

M. Eric DITTMAR Biophysique

Mme Nathalie DOURMAP Pharmacologie

Mle Isabelle DUBUC Pharmacologie

Mme Roseline DUCLOS Pharmacie Galénique

M. Abdelhakim ELOMRI Pharmacognosie

M. François ESTOUR Chimie Organique

M. Gilles GARGALA (MCU-PH) Parasitologie

Mme Najla GHARBI Chimie analytique

Mle Marie-Laure GROULT Botanique

M. Hervé HUE Biophysique et Mathématiques

Mme Hong LU Biologie

Mme Sabine MENAGER Chimie organique

Mme Christelle MONTEIL Toxicologie

M. Paul MULDER Sciences du médicament

M. Mohamed SKIBA Pharmacie Galénique

Mme Malika SKIBA Pharmacie Galénique

Mme Christine THARASSE Chimie thérapeutique

M. Rémi VARIN (MCU-PH) Pharmacie Hospitalière

M. Frédéric ZIEGLER Biochimie

PROFESSEUR ASSOCIE

Mme. Sandrine PANCHOU Pharmacologie Officinale

PROFESSEUR CONTRACTUEL

Mme Elizabeth DE PAOLIS Anglais

ATTACHES TEMPORAIRES D’ENSEIGNEMENT ET DE RECHERCHE

M. Mazim MEKAOUI Chimie Analytique

Melle Virginie OXARAN Microbiologie

III – MEDECINE GENERALE

PROFESSEURS

M. Jean-Loup HERMIL UFR Médecine générale

PROFESSEURS ASSOCIES A MI-TEMPS :

M. Pierre FAINSILBER UFR Médecine générale

M. Alain MERCIER UFR Médecine générale

M. Philippe NGUYEN THANH UFR Médecine générale

MAITRE DE CONFERENCES ASSOCIE A MI-TEMPS :

M. Emmanuel LEFEBVRE UFR Médecine générale

Mme Elisabeth MAUVIARD UFR Médecine Générale

Mme Marie Thérèse THUEUX UFR Médecine générale

CHEF DES SERVICES ADMINISTRATIFS : Mme Véronique DELAFONTAINE

HCN - Hôpital Charles Nicolle HB - Hôpital de BOIS GUILLAUME

CB - Centre HENRI BECQUEREL CHS - Centre Hospitalier Spécialisé du Rouvray

CRMPR - Centre Régional de Médecine Physique et de Réadaptation

LISTE DES RESPONSABLES DE DISCIPLINE

Melle Cécile BARBOT Chimie Générale et Minérale

M. Thierry BESSON Chimie thérapeutique

M. Roland CAPRON Biophysique

M Jean CHASTANG Mathématiques

Mme Marie-Catherine CONCE-CHEMTOB Législation, Economie de la Santé

Mle Elisabeth CHOSSON Botanique

M. Jean Jacques BONNET Pharmacodynamie

Mme Isabelle BUBUS Biochimie

M. Loïc FAVENNEC Parasitologie

M. Michel GUERBET Toxicologie

M. Olivier LAFONT Chimie organique

Mme Isabelle LEROUX Physiologie

Mme Martine PESTEL-CARON Microbiologie

Mme Elisabeth SEGUIN Pharmacognosie

M. Mohamed SKIBA Pharmacie Galénique

M. Philippe VERITE Chimie analytique

ENSEIGNANTS MONO APPARTENANTS

M. Sahil ADRIOUCH Biochimie et biologie moléculaire (Unité INSERM 905)

Mme Gaëlle BOUGEARD DENOYELLE Biochimie et biologie moléculaire (UMR 1079)

Mme Carine CLEREN Neurosciences (Néovasc)

Mme Pascaline GAILDRAT Génétique moléculaire humaine (UMR 1079)

M. Antoine OUVRARD PASCAUD Physiologie (Unité INSERM 1076)

Mme Isabelle TOURNIER Biochimie (UMR 1079)

PROFESSEURS DES UNIVERSITES

M. Serguei FETISSOV Physiologie (Groupe ADEN)

Mme Su RUAN Génie Informatique

Par délibération en date du 3 mars 1967, la faculté a arrêté que les

opinions émises dans les dissertations qui lui seront présentées doivent être

considérées comme propres à leurs auteurs et qu’elle n’entend leur donner

aucune approbation ni improbation.

REMERCIEMENTS

Au Professeur Priscille Gerardin :

Merci d!avoir accept", en toute simplicit", de pr"sider cette th#se. Vos qualit"s

de psychiatre vous rendent $ m%me de juger cette th#se. Veuillez accepter mes remerciements les plus sinc#res pour votre pr"cieux temps accord".

Au Professeur Veber :

Pour votre disponibilit" $ mon "gard durant mon internat et pour l!honneur que vous me faites en acceptant de juger ce travail. Veuillez trouver ici

l!expression de ma sinc#re reconnaissance et de mon profond respect.

Au Professeur Emmanuel Gerardin :

Pour la spontan"it" avec laquelle vous avez accept" d!%tre juge de cette th#se.

Merci pour votre ouverture d!esprit sur ce travail de m"decine g"n"rale. Je vous exprime toute ma gratitude et ma consid"ration la plus sinc#re.

Au Docteur Armangau-Turck :

Vous me faites l!honneur et le plaisir de diriger cette th#se. Merci de m!avoir aid" $ d"finir les fondamentaux de ce travail. J!ai appr"ci" votre disponibilit"

tout au long de ce travail de th#se. J!esp#re que ce travail vous apportera

satisfaction et qu!il pourra vous %tre utile dans votre exercice de m"decin g"n"raliste. Veuillez trouver ici l!expression de ma profonde estime et de ma

reconnaissance la plus sinc#re.

Au Docteur Ladner :

Merci d!avoir pris le temps, au cours d!un voyage en Tunisie, de parfaire les r"sultats de mon travail de th#se. Sans votre aide, l!analyse statistique de ce travail aurait "t" moins rigoureuse. Veuillez trouver dans ces mots l!expression de ma gratitude et de mes sinc#res remerciements.

A Guil laume , mon futur mari, merci de ton soutien si précieux tout au long de ce travail. Merci d’avoir cru en moi quand moi-même je n’y croyais plus. Merci pour ta patience, ton optimisme et ta rigueur dans ce travail. Ces quatre années passées à tes côtés ont fait de moi une femme épanouie. Merci pour tous les bons moments partagés et toutes les belles aventures à venir. Je t’aime…

A ma famil l e . A mes parents , merci de m’avoir toujours soutenu dans mes projets et pour l’éducation que j’ai reçu. Vous êtes un modèle comme quoi, malgré les épreuves, l’amour est plus fort que tout. A ma maman, merci pour ton amour indéfectible. Notre complicité est, et restera toujours, essentielle à mes yeux. A mon papa, merci pour ta présence. Les années ont permis de nous rapprocher davantage. Celles qui suivront n’en seront que meilleures. A mon frère Pierre , merci d’avoir toujours été là pour moi. Merci pour ta bonne humeur. Que tes projets se concrétisent aussi bien que les miens et te fassent voler de tes propres ailes. Je te souhaite le meilleur. A ma cous ine Sonia , son mari Manu et mes pet i t s cous ins Anthony e t Gregory , merci d’être présents à mes côtés aujourd’hui. A Françoise , ma grand-mère d’adoption, pour ta générosité, ta simplicité et ton écoute. Une pensée pour Robert, ton mari, qui nous a quitté trop tôt. Il restera à jamais dans nos cœurs. A Chatou, en souvenir de tous ces déjeuners en sortie de garde. Merci pour tes encouragements tout au long de ces années.

A mes amis . A Agnès , pour tes étourderies qui me feront toujours sourire, Vincent pour ton humour indémodable surtout quand tu nous parle de « partage », à Ismaël e t Nathal i e , pour les soirées barbeuc et les parties de « fou rire », à Beber e t Laure , qui décrochent trop peu leur téléphone, à Nanou e t Mousse t t e , les inséparables, toujours avec le sourire, en souvenir d’une virée en Espagne mémorable, à Emil i e e t Edouard, les jeunes mariés, collègues et amis dans la vie, pour avoir pu partager avec vous cette belle journée du 13 juillet, je vous souhaite plein de bonheur. A Cathia , la niçoise, revenue de loin. Merci d’avoir traversé la France pour cet instant. Merci pour tous les bons moments partagés et les coupes de champagne rosé !!!

A Mathi lde , tu ne pouvais pas être là aujourd’hui, partie vers de nouveaux horizons. En souvenir de nos longues soirées arrosées au Saint Mac.

A mes maîtres de s tage Merci pour votre enseignement, votre disponibilité et pour tous les bons conseils prodigués.

A mes co l l ègues . A toute l ’ équipe des urgences adul tes e t pédiatr iques de l ’hôpi ta l Charles Nico l l e e t à l ’ équipe du SAMU de Rouen. Merci pour votre bonne humeur en toutes circonstances, votre professionnalisme et votre bienveillance durant ces longues nuits de garde. Cela a été un réel plaisir d’apprendre à vos côtés. Au Dr Brousse , à Serge , Arnaud e t toute l ’ équipe des urgences d ’Elbeuf . Pour la confiance qui m’est donnée de venir travailler à vos côtés et votre accueil déjà si chaleureux. Je suis impatiente de vous rejoindre. A bientôt ! A toutes celles et ceux que j’ai malencontreusement oubliés mille excuses mais c’est avec le corps et l’esprit saturés que je termine ce travail !

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Nombre FMC

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Echelle d'Incapacité Fonctionnelle pour l'Evaluation des

Lombalgies: EIFEL

Questions Oui = 1 Non = 0

1-Je reste pratiquement tout le temps à la maison à cause de mon dos

2-Je change souvent de position pour soulager mon dos

3-Je marche plus lentement que d'habitude à cause de mon dos

4-A cause de mon dos, je n'effectue aucune tâche que j'ai l'habitude de

faire à la maison

5-A cause de mon dos, je m'aide de la rampe pour monter les escaliers

6-A cause de mon dos, je m'allonge plus souvent pour me reposer

7-A cause de mon dos, je suis obligé(e) de prendre un appui pour sortir

d'un fauteuil

8-A cause de mon dos, j'essaie d'obtenir que d'autres fassent des choses

à ma place

9-A cause de mon dos, je m'habille plus lentement que d'habitude

10-Je ne reste debout que de courts moments à cause de mon dos

11-A cause de mon dos, j'essaie de ne pas me baisser ni de

m'agenouiller

12-A cause de mon dos, j'ai du mal à me lever d'une chaise

13-J'ai mal au dos la plupart du temps

14-A cause de mon dos, j'ai des difficultés à me retourner dans mon lit

15-J'ai moins d'appétit à cause de mon mal de dos

16-A cause de mon mal de dos, j'ai du mal à mettre mes chaussettes

(bas, collants)

17-Je ne peux marcher que sur de courtes distances à cause de mon mal

de dos

18-Je dors moins à cause de mon mal de dos

19-A cause de mon dos, quelqu'un m'aide pour m'habiller

20-A cause de mon dos, je reste assis(e) la plus grande partie de la

journée

21-A cause de mon dos, j'évite de faire de gros travaux à la maison

22-A cause de mon dos, je suis plus irritable que d'habitude et de

mauvaise humeur avec les gens

23-A cause de mon dos, je monte les escaliers plus lentement les

escaliers

24-A cause de mon dos, je reste au lit la plupart du temps

Plus le score est élevé, plus le retentissement du mal de dos est important

+##/7/!fP!1A9D>;GHH=;89!TJ;HM=C=M;>K!TJ&DR9D>8b!

Questionnaire d'évaluation de la capacité fonctionnelle

(Version française de l’Oswestry Disability Index) 1

Nom, prénom : …………………………………………… Date : . . / . . / 200 .

"Merci de bien vouloir compléter ce questionnaire.

Il est conçu pour nous donner des informations sur la façon dont votre mal au dos (ou votre douleur

dans la jambe) a influencé votre capacité à vous débrouiller dans la vie de tous les jours.

Veuillez répondre à toutes les sections du questionnaire. Pour chaque section, cochez une seule

case, celle qui vous décrit le mieux actuellement."

1 Intensité de la douleur

0 Je n'ai pas mal actuellement.

1 La douleur est très légère actuellement.

2 La douleur est modérée actuellement.

3 La douleur est plutôt intense actuellement.

4 La douleur est très intense actuellement.

5 La douleur est la pire que l’on puisse imaginer actuellement.

2 Soins personnels ( se laver, s'habiller, ...etc )

0 Je peux prendre soin de moi normalement, sans augmenter la douleur.

1 Je peux prendre soin de moi normalement, mais c’est très douloureux.

2 Cela me fait mal de prendre soin de moi, et je le fait lentement et en faisant attention.

3 J’ai besoin d’aide, mais dans l'ensemble je parviens à me débrouiller seul.

4 J’ai besoin d’aide tous les jours pour la plupart de ces gestes quotidiens.

5 Je ne m'habille pas, me lave avec difficulté et reste au lit.

3 Manutention de charges

0 Je peux soulever des charges lourdes sans augmenter mon mal de dos

1 Je peux soulever des charges lourdes mais cela augmente ma douleur

2 La douleur m'empêche de soulever des charges lourdes à partir du sol mais j'y parviens si la

charge est bien placée ( par exemple sur une table )

3 La douleur m'empêche de soulever des charges lourdes mais je peux déplacer des charges

légères ou de poids moyen si elles sont correctement placées

4 Je peux seulement soulever des objets très légers

5 Je ne peux soulever ni transporter quoi que ce soit

1 Oswestry Disability Index, version 2.0, Baker D, Pynsent P, Fairbank J 1989

4 Marche à pied

0 La douleur ne limite absolument pas mes déplacements

1 La douleur m'empêche de marcher plus de 2 km

2 La douleur m'empêche de marcher plus de 1 km

3 La douleur m'empêche de marcher plus de 500 m

4 Je me déplace seulement avec une canne ou des béquilles

5 Je reste au lit la plupart du temps et je me traîne seulement jusqu'au WC

5 Position assise

0 Je peux rester assis sur un siège aussi longtemps que je veux.

1 Je peux rester assis aussi longtemps que je veux mais seulement sur mon siège favori.

2 La douleur m'empêche de rester assis plus d'une heure.

3 La douleur m'empêche de rester assis plus d'1/2 heure.

4 La douleur m'empêche de rester assis plus de 10 minutes.

5 La douleur m'empêche de rester assis.

6 Position debout

0 Je peux rester debout aussi longtemps que je veux sans augmenter la douleur.

1 Je peux rester debout aussi longtemps que je veux mais cela augmente la douleur.

2 La douleur m'empêche de rester debout plus d'une heure.

3 La douleur m'empêche de rester debout plus d'1/2 heure.

4 La douleur m'empêche de rester debout plus de 10 minutes.

5 La douleur m'empêche de rester debout.

7 Sommeil

0 Mon sommeil n’est jamais perturbé par la douleur.

1 Mon sommeil est parfois perturbé par la douleur

2 A cause de la douleur, je dors moins de 6 heures

5 La douleur m'empêche complètement de dormir

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V_5h_\!4!;HM=C=M;>K!:GTK8K9!

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8 Vie sexuelle

0 Ma vie sexuelle n'est pas modifiée et n'augmente pas mon mal de dos

1 Ma vie sexuelle n'est pas modifiée, mais elle augmente la douleur

2 Ma vie sexuelle est pratiquement normale, mais elle est très douloureuse

3 Ma vie sexuelle est fortement limitée par la douleur

4 Ma vie sexuelle est presque inexistante à cause de la douleur

5 La douleur m'interdit toute vie sexuelle

9 Vie sociale (sport, cinéma, danse, souper entre amis)

0 Ma vie sociale est normale et n’a pas d’effet sur la douleur

1 Ma vie sociale est normale, mais elle augmente la douleur

2 La douleur n'a pas d'effet sur ma vie sociale, sauf pour des activités demandant plus d'énergie

(sport par exemple)

3 La douleur a réduit ma vie sociale et je ne sors plus autant qu'auparavant

4 La douleur a limité ma vie sociale à ce qui se passe chez moi, à la maison

5 Je n'ai plus de vie sociale à cause du mal de dos

10 Déplacements (en voiture ou par les transports en commun)

0 Je peux me déplacer n'importe où sans effet sur mon mal de dos

1 Je peux me déplacer n'importe où, mais cela augmente la douleur

2 La douleur est pénible mais je supporte des trajets de plus de 2 heures

3 La douleur me limite à des trajets de moins d'une heure

4 La douleur me limite aux courts trajets indispensables, de moins de 30 minutes

5 La douleur m'empêche de me déplacer, sauf pour aller voir le docteur ou me rendre à l'hôpital

Score global d'handicap fonctionnel

Total des scores partiels : ..../…... (sur 50 au maximum)

Résultat en pourcentage (score ODI) : ........%

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QUESTIONNAIRE DE QUAQUESTIONNAIRE DE QUAQUESTIONNAIRE DE QUA LITE DE VIELITE DE VIE : SF: SF: SF -- 12 12

1. Dans l’ensemble, pensez-vous que votre santé est :

! 1 Excellente ! 2 Très bonne ! 3 Bonne ! 4 Médiocre ! 5 Mauvaise

2. En raison de votre état de santé actuel, êtes-vous limité pour :

• des efforts physiques modérés (déplacer une table, passer l’aspirateur, jouer aux boules…) ?

! 1 Oui, beaucoup limité ! 2 Oui, un peu limité ! 3 Non, pas du tout limité

• monter plusieurs étages par l’escalier ? ! 1 Oui, beaucoup limité ! 2 Oui, un peu limité ! 3 Non, pas du tout limité

3. Au cours de ces 4 dernières semaines, et en raison de votre état physique :

• avez-vous accompli moins de choses que vous auriez souhaité ?

! 1 Toujours ! 2 La plupart du temps ! 3 Souvent ! 4 Parfois ! 5 Jamais

• avez-vous été limité pour faire certaines choses ? ! 1 Toujours ! 2 La plupart du temps ! 3 Souvent ! 4 Parfois ! 5 Jamais

4. Au cours de ces 4 dernières semaines, et en raison de votre état émotionnel (comme vous sentir triste, nerveux ou déprimé) :

• avez-vous accompli moins de choses que vous auriez souhaité ?

• avez-vous eu des difficultés à faire ce que vous aviez à faire avec autant de soin et d’attention que d’habitude ? ! 1 Toujours ! 2 La plupart du temps ! 3 Souvent ! 4 Parfois ! 5 Jamais

5. Au cours de ces 4 dernières semaines, dans quelle mesure vos douleurs physiques vous ont -elles limité dans votre travail ou

vos activités domestiques ?

! 1 Pas du tout ! 2 Un petit peu ! 3 Moyennement ! 4 Beaucoup ! 5 Enormément

6. Les questions qui suivent portent sur comment vous vous êtes senti au cours de ces 4 dernières semaines. Pour chaque question, indiquez la réponse qui vous semble la plus appropriée.

• y a t-il eu des moments où vous vous êtes senti calme et détendu ? ! 1 Toujours ! 2 La plupart du temps ! 3 Souvent ! 4 Parfois ! 5 Jamais

• y a t-il eu des moments où vous vous êtes senti débordant d’énergie ?

• y a t-il eu des moments où vous vous êtes senti triste et abattu ? ! 1 Toujours ! 2 La plupart du temps ! 3 Souvent ! 4 Parfois ! 5 Jamais

7. Au cours de ces 4 dernières semaines, y a t-il eu des moments où votre état de santé physique ou émotionnel vous a gêné

dans votre vie sociale et vos relations avec les autres, votre famille, vos amis, vos connaissances ? ! 1 Toujours ! 2 La plupart du temps ! 3 Souvent ! 4 Parfois ! 5 Jamais

! "CC!

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