Efficacy of Classification Based 'Cognitive Functional Therapy' in Patients With Non Specific Chronic Low Back Pain

University of Bergen

Status

Completed

Conditions

Chronic Low Back Pain

Treatments

Other: Manual therapy and exercise

Other: Cognitive Functional Therapy

Study type

Interventional

Funder types

Other

Identifiers

NCT01129817

250.05.

Details and patient eligibility

About

A randomized controlled trial of the efficacy of classification based cognitive functional physiotherapy according to the system proposed by Peter O'Sullivan as compared to manual therapy and exercise in patients with non specific chronic low back pain.

The investigators hypothesis was that treatment targeted at the mechanism behind the problem from a multidimensional perspective would be superior to traditional treatment.

Full description

NSCLBP is widely viewed as a multifactorial biopsychosocial pain syndrome. It has been proposed by several authors that NSCLBP represents a vicious cycle associated with different combinations of maladaptive; cognitive (negative beliefs, fear avoidance behaviours, catastrophising, depression, stress, lack of pacing and coping), physical (pain provocative postures, movement patterns and pain behaviours) and lifestyle (inactivity, rest) behaviours that act to promote pain and disability. However a recent systematic review suggests that this change in paradigm and our new understanding of NSCLBP has not resulted in clinical trials utilizing multidimensional classification systems or targeted interventions based on the underlying mechanisms. line with this shift in paradigm a novel multidimensional classification system has been developed incorporating the biopsychosocial model, which subgroups patients based on their presentation of. with matched interventions directed at the maladaptive cognitive, physical and lifestyle behaviours associated with the disorder.

Enrollment

121 patients

Sex

All

Ages

18 to 65 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

all patients with non-specific LBP for more that 8 weeks duration
mechanical provocation of pain with postures, movement and activities
localised pain in the area from T12 to gluteal folds
moderate ongoing LBP with a VAS > 2/10
disability had to be higher than 14% on Oswestry Disability Index

Exclusion criteria

sick listed for more than 4 months continuous duration
acute exacerbation of LBP
radicular pain with positive neural tissue provocation test
any low limb surgery on the last 3 months
surgery involving the lumbar spine (fusion)
pregnancy
psychiatric disorders - somatisation
dominant psycho-social problems
widespread non-specific pain disorder (no primary LBP focus)
specific diagnoses: active rheumatologic disease, progressive neurological disease, serious cardiac or other internal medical condition, malignant basic diseases, acute traumas, infections, or acute vascular catastrophies