Category: Pain Rehabilitation; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective(s) : This review aimed to evaluate the effectiveness of cognitive functional therapy (CFT) in patients with chronic non-specific low back pain (CNSLBP).
Data Sources : A systematic search of the following online databases was conducted including Medline, EMBASE, CINAHL, Cochrane and PEDro (inception to end July 2018).
Study Selection : Only randomised controlled trials (RCTs) and observational studies (e.g. cohort studies and case-control studies) that evaluate the effectiveness of CFT on CNSLBP were included. This review measured pain severity and functional disability as primary outcomes and anxiety and depression, and fear-avoidance beliefs of physical activity as secondary outcomes.
Data Extraction : PRISMA guidelines was followed to conduct this review. PEDro scale and Modified Downs and Black assessment checklist were used to assess the quality of studies. Two authors independently extracted data and assessed the quality of included studies.
Data Synthesis : One RCT and one multiple case-cohort study met the eligibility criteria. The RCT study scored 5/10 (low quality) on the PEDro scale, and the multiple case-cohort study scored 20/28 (good quality) on the Modified Downs and Black assessment checklist. Overall, both trials reported significant improvement for pain and disability in the short-term and long-term. Moreover, depression and anxiety, and fear-avoidance beliefs of physical activity were significantly improved.
Conclusions : The current evidence suggests that CFT shows early promise as an effective intervention. However, the results must be taken with caution as the evidence comes from a limited amount of high-quality evidence in this topic. Further research, with high-quality studies, well-designed RCTs, larger sample size, is required.
Omar Khoja– Physiotherapist, Medical Rehabilitation Hospital, Jeddah, Makkah
Esra Koculu– Physiotherapist, University of Nottingham, Nottingham, England
Alan Taylor– Assistant Professor, University of Nottingham, Nottingham, England
Mansour Alshehri– Lecturer, Umm Al-Qura University, Mecca, Makkah