[Aims] "Iki-iki" in Japanese means "active". The purpose of this study was to analyze the effectiveness of a exercise facilitation method in combination with cognitive behavioral therapy (CBT) using the "Iki-iki Rehabilitation Notebook" in patients with intractable chronic pain. [Methods] The subjects were 5 males and 11 females (48 +/- 20, mean +/- SD, years of age) with chronic low back (n=10), or lower extremity (n=5), or neck (n=1) pain without specific lesions over 3 months. Indications for using the notebook were as follows: 1) Numeric Rating Scale (NRS) for pain >3, and 2) Patient felt disabilities of ADL or social work due to the pain. Patients were asked to write in their notebooks daily or once a week regarding their emotion, mood, anxiety, and exercise routine (muscle exertion, gait distance). Once every 2 weeks, the patients returned to the clinic to go over the notebook/journal. The evaluation contents were NRS (Numerical Rating Scale), PDAS (Pain Disability Assessment Scale), HADS (Hospital Anxiety and Depression Scale), PCS (Pain Catastrophizing Scale), EQ-5D (EuroQol 5 Dimension), PSEQ (Pain Self Efficacy Questionnaire). [Results] The NRS, PDAS, PCS, HADS (anxiety), PSEQ and EQ-5D, but not HADS (depression), improved significantly 10 months after starting to use this notebook. Conclusion: The Iki-iki Rehabilitation Notebook is a valuable tool to educate patients about the cause and treatment of pain and to actively facilitate CBT-based exercise.

Exercise facilitation method in combination with cognitive behavioral therapy using the "Iki-iki Rehabilitation Notebook" in patients with intractable chronic pain