Comparison of cognitive functional therapy and neurofeedback training on kinetic gait in patients with chronic non-specific low back pain: a randomised controlled trial

Disabil Rehabil. 2025 Aug;47(17):4443-4452. doi: 10.1080/09638288.2025.2451219. Epub 2025 Jan 22.

Abstract

Purpose of the article: Walking disorders are a significant issue for patients with low back pain. The aim of clinical trials is to compare the effects of cognitive functional therapy (CFT) and neurofeedback training (NFBT) on gait kinetics in chronic non-specific low back pain (CNSLBP) patients.

Materials and methods: Sixty females with chronic non-specific low back pain were recruitment for clinical trials. They were randomly divided into experimental and one control groups (Each group 20 patients). The experimental group received the relevant interventions for eight weeks. The primary outcome was pain, kinesiophobia and disability. The secondary outcome was vertical ground reaction force (VGRF) parameters. Two-Way Repeated Measures ANOVA statistical method was used for data analysis.

Results: Within-group comparisons showed that neurofeedback training and cognitive functional therapy groups experienced significant improvement in pain intensity, disability and kinesiophobia after eight-week (p < 0.05). However, the cognitive functional therapy group improved the vertical ground reaction force parameters better than the neurofeedback training group (p < 0.05).

Conclusions: cognitive functional therapy intervention had a greater effect on the vertical ground reaction force parameters. The reason for the greater effect of cognitive functional therapy intervention on vertical ground reaction force parameters can be partially explained due to the multimodal therapy used through cognitive exercises and motor control.

Keywords: Low back pain; cognitive functional therapy; gait kinetics; neuro-rehabilitation; psychological.

Plain language summary

Cognitive functional therapy and neurofeedback training was shown to reduce pain intensity, disability, and kinesiophobia, Consequently improving vertical ground reaction force parameters in patients with Chronic non-specific low back pain.Among the psychological interventions used, the cognitive functional therapy significantly showed more effectiveness in improving the vertical ground reaction force parameters of patients with chronic non-specific low back pain.Our research may inform clinical decision-making and guide the development of therapeutic interventions for patients with chronic non-specific low back pain.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Chronic Pain* / rehabilitation
  • Cognitive Behavioral Therapy* / methods
  • Disability Evaluation
  • Female
  • Gait* / physiology
  • Humans
  • Low Back Pain* / physiopathology
  • Low Back Pain* / rehabilitation
  • Low Back Pain* / therapy
  • Middle Aged
  • Neurofeedback* / methods
  • Pain Measurement
  • Treatment Outcome