Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT)
| dc.contributor.author | O'Keeffe, Mary | |
| dc.contributor.author | O'Sullivan, Peter | |
| dc.contributor.author | Purtill, Helen | |
| dc.contributor.author | Bargery, Norma | |
| dc.contributor.author | O'Sullivan, Kieran | |
| dc.contributor.funder | University of Limerick | en |
| dc.date.accessioned | 2021-02-22T16:13:13Z | |
| dc.date.available | 2021-02-22T16:13:13Z | |
| dc.date.issued | 2019-10-19 | |
| dc.description.abstract | Background One-size-fits-all interventions reduce chronic low back pain (CLBP) a small amount. An individualised intervention called cognitive functional therapy (CFT) was superior for CLBP compared with manual therapy and exercise in one randomised controlled trial (RCT). However, systematic reviews show group interventions are as effective as one-to-one interventions for musculoskeletal pain. This RCT investigated whether a physiotherapist-delivered individualised intervention (CFT) was more effective than physiotherapist-delivered group-based exercise and education for individuals with CLBP. Methods 206 adults with CLBP were randomised to either CFT (n=106) or group-based exercise and education (n=100). The length of the CFT intervention varied according to the clinical progression of participants (mean=5 treatments). The group intervention consisted of up to 6 classes (mean=4 classes) over 6–8 weeks. Primary outcomes were disability and pain intensity in the past week at 6 months and 12months postrandomisation. Analysis was by intention-to-treat using linear mixed models. Results CFT reduced disability more than the group intervention at 6 months (mean difference, 8.65; 95% CI 3.66 to 13.64; p=0.001), and at 12 months (mean difference, 7.02; 95% CI 2.24 to 11.80; p=0.004). There were no between-group differences observed in pain intensity at 6 months (mean difference, 0.76; 95% CI -0.02 to 1.54; p=0.056) or 12 months (mean difference, 0.65; 95% CI -0.20 to 1.50; p=0.134). Conclusion CFT reduced disability, but not pain, at 6 and 12 months compared with the group-based exercise and education intervention. Future research should examine whether the greater reduction in disability achieved by CFT renders worthwhile differences for health systems and patients. Trial registration number ClinicalTrials.gov registry (NCT02145728). | en |
| dc.description.sponsorship | University of Limerick (Open access funding provided by the Health Research Institute, University of Limerick) | en |
| dc.description.status | Peer reviewed | en |
| dc.description.version | Published Version | en |
| dc.format.mimetype | application/pdf | en |
| dc.identifier.citation | O'Keeffe, M., O'Sullivan, P., Purtill, H., Bargary, N. and O'Sullivan, K. (2020) 'Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT)', British Journal of Sports Medicine, 54(13), pp. 782-789. doi: 10.1136/bjsports-2019-100780 | en |
| dc.identifier.doi | 10.1136/bjsports-2019-100780 | en |
| dc.identifier.eissn | 1473-0480 | |
| dc.identifier.endpage | 789 | en |
| dc.identifier.issn | 0306-3674 | |
| dc.identifier.issued | 13 | en |
| dc.identifier.journaltitle | British Journal of Sports Medicine | en |
| dc.identifier.startpage | 782 | en |
| dc.identifier.uri | https://hdl.handle.net/10468/11090 | |
| dc.identifier.volume | 54 | en |
| dc.language.iso | en | en |
| dc.publisher | BMJ Publishing Group | en |
| dc.rights | © Author(s) (or their employer(s)) 2020.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ | en |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | en |
| dc.subject | Low back pain (LBP) | en |
| dc.subject | Chronic low back pain (CLBP) | en |
| dc.subject | Cognitive functional therapy (CFT) | en |
| dc.title | Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT) | en |
| dc.type | Article (peer-reviewed) | en |
