Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial
Abstract Background This study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP). Methods In a single-bli...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06815-x |
| _version_ | 1797578660133208064 |
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| author | Sahar Nazary Soltan Ahmad Amir Letafatkar Britton W. Brewer Ali Sharifnezhad |
| author_facet | Sahar Nazary Soltan Ahmad Amir Letafatkar Britton W. Brewer Ali Sharifnezhad |
| author_sort | Sahar Nazary Soltan Ahmad |
| collection | DOAJ |
| description | Abstract Background This study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP). Methods In a single-blind randomized clinical trial, we randomly assigned 91 patients with CNSLBP into CFT (n = 45) and MSI-based treatment (n = 46) groups. An 8-week training intervention was given to both groups. The researchers measured the primary outcome, which was pain intensity (Numeric rating scale), and the secondary outcomes, including disability (Oswestry disability index), Kinesiophobia (Tampa Kinesiophobia Scale), and vertical ground reaction force (VGRF) parameters at self-selected and faster speed (Force distributor treadmill). We evaluated patients at baseline, at the end of the 8-week intervention (post-treatment), and six months after the first treatment. We used mixed-model ANOVA to evaluate the effects of the interaction between time (baseline vs. post-treatment vs. six-month follow-up) and group (CFT vs. MSI-based treatment) on each measure. Results CFT showed superiority over MSI-based treatment in reducing pain intensity (P < 0.001, Effect size (ES) = 2.41), ODI (P < 0.001, ES = 2.15), and Kinesiophobia (P < 0.001, ES = 2.47) at eight weeks. The CFT also produced greater improvement in VGRF parameters, at both self-selected (FPF[P < 0.001, ES = 3], SPF[P < 0.001, ES = 0.5], MSF[P < 0.001, ES = 0.67], WAR[P < 0.001, ES = 1.53], POR[P < 0.001, ES = 0.8]), and faster speed, FPF(P < 0.001, ES = 1.33, MSF(P < 0.001, ES = 0.57), WAR(P < 0.001, ES = 0.67), POR(P < 0.001, ES = 2.91)] than the MSI, except SPF(P < 0.001, ES = 0.0) at eight weeks. Conclusion This study suggests that the CFT is associated with better results in clinical and cognitive characteristics than the MSI-based treatment for CNSLBP, and the researchers maintained the treatment effects at six-month follow-up. Also, This study achieved better improvements in gait kinetics in CFT. CTF seems to be an appropriate and applicable treatment in clinical setting. Trial registration The researchers retrospectively registered the trial 10/11/2022, at https://www.umin.ac.jp/ with identifier number (UMIN000047455). |
| first_indexed | 2024-03-10T22:24:59Z |
| format | Article |
| id | doaj.art-3cb30231bf334b59ab0f02b2189dca86 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-10T22:24:59Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3cb30231bf334b59ab0f02b2189dca862023-11-19T12:08:12ZengBMCBMC Musculoskeletal Disorders1471-24742023-08-0124111310.1186/s12891-023-06815-xComparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trialSahar Nazary Soltan Ahmad0Amir Letafatkar1Britton W. Brewer2Ali Sharifnezhad3Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi UniversityFaculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi UniversityDepartment of Psychology, Springfield CollegeDepartment of Sport Biomechanics and Technology, Sport Science Research InstituteAbstract Background This study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP). Methods In a single-blind randomized clinical trial, we randomly assigned 91 patients with CNSLBP into CFT (n = 45) and MSI-based treatment (n = 46) groups. An 8-week training intervention was given to both groups. The researchers measured the primary outcome, which was pain intensity (Numeric rating scale), and the secondary outcomes, including disability (Oswestry disability index), Kinesiophobia (Tampa Kinesiophobia Scale), and vertical ground reaction force (VGRF) parameters at self-selected and faster speed (Force distributor treadmill). We evaluated patients at baseline, at the end of the 8-week intervention (post-treatment), and six months after the first treatment. We used mixed-model ANOVA to evaluate the effects of the interaction between time (baseline vs. post-treatment vs. six-month follow-up) and group (CFT vs. MSI-based treatment) on each measure. Results CFT showed superiority over MSI-based treatment in reducing pain intensity (P < 0.001, Effect size (ES) = 2.41), ODI (P < 0.001, ES = 2.15), and Kinesiophobia (P < 0.001, ES = 2.47) at eight weeks. The CFT also produced greater improvement in VGRF parameters, at both self-selected (FPF[P < 0.001, ES = 3], SPF[P < 0.001, ES = 0.5], MSF[P < 0.001, ES = 0.67], WAR[P < 0.001, ES = 1.53], POR[P < 0.001, ES = 0.8]), and faster speed, FPF(P < 0.001, ES = 1.33, MSF(P < 0.001, ES = 0.57), WAR(P < 0.001, ES = 0.67), POR(P < 0.001, ES = 2.91)] than the MSI, except SPF(P < 0.001, ES = 0.0) at eight weeks. Conclusion This study suggests that the CFT is associated with better results in clinical and cognitive characteristics than the MSI-based treatment for CNSLBP, and the researchers maintained the treatment effects at six-month follow-up. Also, This study achieved better improvements in gait kinetics in CFT. CTF seems to be an appropriate and applicable treatment in clinical setting. Trial registration The researchers retrospectively registered the trial 10/11/2022, at https://www.umin.ac.jp/ with identifier number (UMIN000047455).https://doi.org/10.1186/s12891-023-06815-xChronic low back painCognitionExercise therapyGait kineticsKinesiophobia |
| spellingShingle | Sahar Nazary Soltan Ahmad Amir Letafatkar Britton W. Brewer Ali Sharifnezhad Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial BMC Musculoskeletal Disorders Chronic low back pain Cognition Exercise therapy Gait kinetics Kinesiophobia |
| title | Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial |
| title_full | Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial |
| title_fullStr | Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial |
| title_full_unstemmed | Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial |
| title_short | Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial |
| title_sort | comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients a randomized controlled trial |
| topic | Chronic low back pain Cognition Exercise therapy Gait kinetics Kinesiophobia |
| url | https://doi.org/10.1186/s12891-023-06815-x |
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