Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review

Purpose: To determine if physiotherapist-led cognitive-behavioural (CB) interventions are effective for low back pain (LBP) and described sufficiently for replication. <br/>Method: RCTs of patients with LBP treated by physiotherapists using a CB intervention were included. Outcomes of disabil...

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Main Authors: Hall, A, Richmond, H, Copsey, B, Hansen, Z, Williamson, E, Jones, G, Cooper, Z, Lamb, S
Outros autores: Muller, D
Formato: Journal article
Publicado: Taylor and Francis 2016
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author Hall, A
Richmond, H
Copsey, B
Hansen, Z
Williamson, E
Jones, G
Cooper, Z
Lamb, S
author2 Muller, D
author_facet Muller, D
Hall, A
Richmond, H
Copsey, B
Hansen, Z
Williamson, E
Jones, G
Cooper, Z
Lamb, S
author_sort Hall, A
collection OXFORD
description Purpose: To determine if physiotherapist-led cognitive-behavioural (CB) interventions are effective for low back pain (LBP) and described sufficiently for replication. <br/>Method: RCTs of patients with LBP treated by physiotherapists using a CB intervention were included. Outcomes of disability, pain and quality of life were assessed using the GRADE approach. Intervention reporting was assessed using the Template for Intervention Description and Replication. <br/>Results: Of 1898 titles, 5 RCTs (n=1,390) were identified. Compared to education and/or exercise interventions, we found high quality evidence that CB had a greater effect (SMD; 95% CI) on reducing disability (-0.19; -0.32, -0.07), pain (- 0.21; -0.33, -0.09); and moderate quality evidence of little difference in quality of life (-0.06; -0.18 to 0.07). Sufficient information was provided on dose, setting and provider; but not content and procedural information. Studies tended to report the type of CB component used (e.g. challenging unhelpful thoughts) with little detail on how it was operationalised. Moreover, access to treatment manuals, patient materials and provider training was lacking. <br/>Conclusions: With additional training, physiotherapists can deliver effective CB interventions. However, without training or resources, successful translation and implementation remains unlikely. Researchers should improve reporting of procedural information, provide relevant materials and offer accessible provider training.
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spelling oxford-uuid:4e2f47fd-db99-47c9-a16e-329add1b0c282022-03-26T15:59:43ZPhysiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic reviewJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4e2f47fd-db99-47c9-a16e-329add1b0c28Symplectic Elements at OxfordTaylor and Francis2016Hall, ARichmond, HCopsey, BHansen, ZWilliamson, EJones, GCooper, ZLamb, SMuller, DPurpose: To determine if physiotherapist-led cognitive-behavioural (CB) interventions are effective for low back pain (LBP) and described sufficiently for replication. <br/>Method: RCTs of patients with LBP treated by physiotherapists using a CB intervention were included. Outcomes of disability, pain and quality of life were assessed using the GRADE approach. Intervention reporting was assessed using the Template for Intervention Description and Replication. <br/>Results: Of 1898 titles, 5 RCTs (n=1,390) were identified. Compared to education and/or exercise interventions, we found high quality evidence that CB had a greater effect (SMD; 95% CI) on reducing disability (-0.19; -0.32, -0.07), pain (- 0.21; -0.33, -0.09); and moderate quality evidence of little difference in quality of life (-0.06; -0.18 to 0.07). Sufficient information was provided on dose, setting and provider; but not content and procedural information. Studies tended to report the type of CB component used (e.g. challenging unhelpful thoughts) with little detail on how it was operationalised. Moreover, access to treatment manuals, patient materials and provider training was lacking. <br/>Conclusions: With additional training, physiotherapists can deliver effective CB interventions. However, without training or resources, successful translation and implementation remains unlikely. Researchers should improve reporting of procedural information, provide relevant materials and offer accessible provider training.
spellingShingle Hall, A
Richmond, H
Copsey, B
Hansen, Z
Williamson, E
Jones, G
Cooper, Z
Lamb, S
Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review
title Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review
title_full Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review
title_fullStr Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review
title_full_unstemmed Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review
title_short Physiotherapist-delivered cognitive behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review
title_sort physiotherapist delivered cognitive behavioural interventions are effective for low back pain but can they be replicated in clinical practice a systematic review
work_keys_str_mv AT halla physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT richmondh physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT copseyb physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT hansenz physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT williamsone physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT jonesg physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT cooperz physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview
AT lambs physiotherapistdeliveredcognitivebehaviouralinterventionsareeffectiveforlowbackpainbutcantheybereplicatedinclinicalpracticeasystematicreview