The effect of classification-based cognitive functional therapy on spinal kinematics and function in subgroups of chronic low back pain

Sheeran, Liba ORCID: https://orcid.org/0000-0002-1502-764X, Jones, Sarah, Hemming, Rebecca ORCID: https://orcid.org/0000-0002-8708-5638, Van Deursen, Robert ORCID: https://orcid.org/0000-0002-9461-0111 and Sparkes, Valerie ORCID: https://orcid.org/0000-0003-4500-9327 2016. The effect of classification-based cognitive functional therapy on spinal kinematics and function in subgroups of chronic low back pain. The Spine Journal 16 (4) , S45-S46. 10.1016/j.spinee.2016.01.027

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Abstract

BACKGROUND CONTEXT: Chronic low back pain (CLBP) is a global problem with effective treatments unknown. Heterogeneity is thought responsible for lack of success. Classification-based cognitive functional therapy (CB-CFT) targeting person's pain mechanisms demonstrated efficacy. CB-CFT effect on spinal movement and function has not been studied. PURPOSE: To investigate CB-CFT effect on 3D spinal kinematics and function. STUDY DESIGN/SETTING: Pragmatic randomised clinical pilot study in Primary Care Outpatients Physiotherapy. PATIENT SAMPLE: 23 CLBP patients sub-classified with flexion and extension control impairment. OUTCOME MEASURES:Physiologic: Spinal movement range (ROM) during flexion-extension, reaching, lifting. Self-reported: Oswestry Disability Questionnaire (ODQ), pain (visual analogue scale [VAS]), Tampa Scale of Kinesiophobia (TSK), Distress and Risk Assessment Method (DRAM). Functional: International Physical Activity Questionnaire (IPAQ). METHODS: Participants were randomised into CB-CFT (N=13), current best practice (C) (N=10). Unpaired t test assessed mean change between-group difference (p>.05). Funding: National Institute of Social Care and Health Research, Wales. No conflicts of interest. RESULTS: No between-group differences at baseline, CB-CFT showed significant increase in lumbar ROM during flexion-extension and thoracic ROM during lifting compared to reduction in C. No between-group differences shown in thoracic ROM during flexion-extension, thoracic and lumbar ROM during reaching. Statistically significant improvements demonstrated in disability (ODQ)[CB-CFT=14.9(8.0),C=5.2(12.4)], pain (VAS)[CB-CFT=2.1(1.5),C=0.7(1.8)], TSK[CB-CFT=12.4(7.2),C=4.1(2.6)], IPAQ[CB-CFT=1,855.6 min(1,085),C=19 min(1,672)]. DRAM between-group change wasn't significant. CONCLUSIONS: Preliminary evidence for positive effect on spinal kinematics and function were demonstrated to inform full scale randomised controlled trial. CONFLICTS OF INTEREST: None. FUNDING SOURCES: National Institute of Social Care and Health Research, Wales.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RZ Other systems of medicine
Publisher:	Elsevier
ISSN:	1529-9430
Funders:	Health and Care Research Wales (formerly known as National Institute of Social Care and Health Research, Wales), Arthritis Research UK Biomechanics and Bioengineering Centre
Last Modified:	03 Nov 2022 09:29
URI:	https://orca.cardiff.ac.uk/id/eprint/105092

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