Classification-based cognitive functional group therapy (CB-CFT) in patients with non-specific chronic low back pain (NSCLBP)

Sheeran, L., Hemming, R. and Sparkes, V. (2014) Classification-based cognitive functional group therapy (CB-CFT) in patients with non-specific chronic low back pain (NSCLBP). Orthopaedic Proceedings, 96-B, 35. (doi:10.1302/1358-992X.96BSUPP_4.SBPR2013-035).

Abstract

Background
CB-CFT targeting specific pain provoking posture/movements in NSCLBP patients was shown more beneficial than current best practice. Resources for such interventions are substantial and so modifications for today's NHS are warranted. This study investigated feasibility and effect of CB-CFT delivered in a group setting (CB-CFT/G).

Methods
Twenty three patients referred to Physiotherapy with NSCLBP undertook (i) 6 week CB-CFT/G(n=13) or (ii) current best practice (C)(n=10). Outcomes: Oswestry Disability Questionnaire (ODQ), pain (VAS), fear avoidance (Tampa Scale of Kinaesiophobia;TSK), physical activity (International Physical Activity Questionnaire;IPAQ), distress&risk assessment (DRAM), StarTBack and satisfaction. Unpaired t-tests assessed between-group difference in mean change of each outcome (p<0.05).

Results
With no between-group baseline differences, there was a statistically significant difference between the groups mean change (SD) in ODQ [CB-CFT/G=14.9(8.0), C=5.2(12.4) p=.034], VAS [CB-CFT/G = 2.1(1.5), C=0.7(1.8) p=.045], TSK [CB-CFT/G=12.4(7.2), C=4.1(2.6) p=.002], IPAQ [CB-CFT/G =1855min(1085), C=19min(1672) p=.000] and StarTBack [CB-CFT/G =2.5(1.6), C=0.2(2.2) p=.009]. DRAM also showed greater improvements in CB-CFT/G [8.3(4.7) compared to C [-0.3(15.3) but this was not significant. CB-CFT/G group element was perceived as highly beneficial allowing patients to learn from each other, enhancing awareness and coping.

Conclusion
CB-CFT/G is feasible, brings benefits to NSCLBP patients and meets with high levels of satisfaction. Long term effects are currently being evaluated.

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Contributors

Author: L. Sheeran

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