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

Sheeran, Liba, Jones, Sarah, Hemming, Rebecca, Van Deursen, Robert and Sparkes, Valerie 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 Oct 2017 08:55
URI: http://orca-mwe.cf.ac.uk/id/eprint/105092

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