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    Efficacy of classification based "cognitive functional therapy" in patients with non-specific chronic low back pain - a randomized controlled trial.

    Access Status
    Open access via publisher
    Authors
    Vibe Fersum, K.
    O'Sullivan, Peter
    Skouen, J.
    Smith, Anne
    Kvale, A.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Vibe Fersum, K. and O'Sullivan, P. and Skouen, J. and Smith, A. and Kvale, A. 2013. Efficacy of classification based "cognitive functional therapy" in patients with non-specific chronic low back pain - a randomized controlled trial. European Journal of Pain. 17 (6): pp. 916-928.
    Source Title
    European Journal of Pain
    DOI
    10.1002/j.1532-2149.2012.00252.x
    ISSN
    1090-3801
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/49178
    Collection
    • Curtin Research Publications
    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.

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