Efficacy of cognitive functional therapy for pain intensity and disability in patients with non-specific chronic low back pain: a randomised sham-controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(17):20 Br J Sports Med . 2025 Jun 18;59(13):912-920.What this means for my practice?
CFT, delivered in six individualized sessions, yields clinically important, sustained reductions in pain and disability versus a credible sham in non-specific CLBP. In practice, physiotherapists can consider CFT to improve pain, function, and self-efficacy over weeks to months. Limitations include inability to blind the therapist, delivery by a single clinician ≤60-year population, a sham that did not mirror active components, and potential allegiance bias.
Study Summary
One hundred fifty-two patients with non-specific chronic low back pain (CLBP) were randomized to receive individualized cognitive functional therapy (CFT)(n=76) or a sham intervention (neutral talking plus detuned low-level laser; n=76). The primary outcomes were pain intensity (0–10) and Oswestry Disability Index (0–100) at 6 weeks. Secondary outcomes included pain and disability at 3 and 6 months, functioning, pain self-efficacy, global perceived effect, and analgesic use. Outcomes were assessed pre-treatment, post-treatment (6 weeks), and at 3 and 6 months. Overall, the results revealed clinically meaningful, statistically significant advantages for CFT over sham at 6 weeks that persisted through 6 months. In short, CFT produced durable improvements in pain, disability, functioning, and self-efficacy beyond contextual effects.
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