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Randomized Controlled Trial
. 2013 Jul;17(6):916-28.
doi: 10.1002/j.1532-2149.2012.00252.x. Epub 2012 Dec 4.

Efficacy of Classification-Based Cognitive Functional Therapy in Patients With Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

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Free PMC article
Randomized Controlled Trial

Efficacy of Classification-Based Cognitive Functional Therapy in Patients With Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

K Vibe Fersum et al. Eur J Pain. .
Free PMC article

Abstract

Background: Non-specific chronic low back pain disorders have been proven resistant to change, and there is still a lack of clear evidence for one specific treatment intervention being superior to another.

Methods: This randomized controlled trial aimed to investigate the efficacy of a behavioural approach to management, classification-based cognitive functional therapy, compared with traditional manual therapy and exercise. Linear mixed models were used to estimate the group differences in treatment effects. Primary outcomes at 12-month follow-up were Oswestry Disability Index and pain intensity, measured with numeric rating scale. Inclusion criteria were as follows: age between 18 and 65 years, diagnosed with non-specific chronic low back pain for >3 months, localized pain from T12 to gluteal folds, provoked with postures, movement and activities. Oswestry Disability Index had to be >14% and pain intensity last 14 days >2/10. A total of 121 patients were randomized to either classification-based cognitive functional therapy group n = 62) or manual therapy and exercise group (n > = 59).

Results: The classification-based cognitive functional therapy group displayed significantly superior outcomes to the manual therapy and exercise group, both statistically (p < 0.001) and clinically. For Oswestry Disability Index, the classification-based cognitive functional therapy group improved by 13.7 points, and the manual therapy and exercise group by 5.5 points. For pain intensity, the classification-based cognitive functional therapy improved by 3.2 points, and the manual therapy and exercise group by 1.5 points.

Conclusions: The classification-based cognitive functional therapy produced superior outcomes for non-specific chronic low back pain compared with traditional manual therapy and exercise.

Figures

Figure 1
Figure 1
Flow chart depicting participant recruitment and finalenrolment for the two groups: manual therapy and exercise (MT-EX) and classification-based cognitive functionaltherapy (CB-CFT).

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References

    1. Adams M, Dolan P, Marx C, Hutton W. An electronic inclinometer technique for measuring lumbar curvature. Clin Biomech. 1986;1:130–134. - PubMed
    1. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–S300. - PMC - PubMed
    1. Asenlof P, Denison E, Lindberg P. Individually tailored treatment targeting activity, motor behavior, and cognition reduces pain-related disability: A randomized controlled trial in patients with musculoskeletal pain. J Pain. 2005;6:588–603. - PubMed
    1. Asenlof P, Denison E, Lindberg P. Long-term follow-up of tailored behavioural treatment and exercise based physical therapy in persistent musculoskeletal pain: A randomized controlled trial in primary care. Eur J Pain. 2009;13:1080–1088. - PubMed
    1. Assendelft WJJ, Morton SJ, Yu EI, Suttorp MJ, Shekelle PG. Spinal manipulative therapy for low back pain. Cochrane Database Syst Rev. 2004;(1) )CD000447. - PubMed

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