Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial

Introduction: Non-specific chronic low back pain (NSCLBP) is a very common and costly musculoskeletal disorder associated with a complex interplay of biopsychosocial factors. Cognitive functional therapy (CFT) represents a novel, patientcentred intervention which directly challenges painrelated beha...

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Main Authors: O'Keeffe, M., Purtill, H., Kennedy, N., O'Sullivan, Peter, Dankaerts, W., Tighe, A., Allworthy, L., Dolan, L., Bargary, N., O'Sullivan, K.
Format: Journal Article
Published: BMJ Publishing Group 2015
Online Access:http://hdl.handle.net/20.500.11937/44372
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author O'Keeffe, M.
Purtill, H.
Kennedy, N.
O'Sullivan, Peter
Dankaerts, W.
Tighe, A.
Allworthy, L.
Dolan, L.
Bargary, N.
O'Sullivan, K.
author_facet O'Keeffe, M.
Purtill, H.
Kennedy, N.
O'Sullivan, Peter
Dankaerts, W.
Tighe, A.
Allworthy, L.
Dolan, L.
Bargary, N.
O'Sullivan, K.
author_sort O'Keeffe, M.
building Curtin Institutional Repository
collection Online Access
description Introduction: Non-specific chronic low back pain (NSCLBP) is a very common and costly musculoskeletal disorder associated with a complex interplay of biopsychosocial factors. Cognitive functional therapy (CFT) represents a novel, patientcentred intervention which directly challenges painrelated behaviours in a cognitively integrated, functionally specific and graduated manner. CFT aims to target all biopsychosocial factors that are deemed to be barriers to recovery for an individual patient with NSCLBP. A recent randomised controlled trial (RCT) demonstrated the superiority of individualised CFT for NSCLBP compared to manual therapy combined with exercise. However, several previous RCTs have suggested that class-based interventions are as effective as individualised interventions. Therefore, it is important to examine whether an individualised intervention, such as CFT, demonstrates clinical effectiveness compared to a relatively cheaper exercise and education class. The current study will compare the clinical effectiveness of individualised CFT with a combined exercise and pain education class in people with NSCLBP. Methods and analysis: This study is a multicentre RCT. 214 participants, aged 18-75 years, with NSCLBP for at least 6 months will be randomised to one of two interventions across three sites. The experimental group will receive individualised CFT and the length of the intervention will be varied in a pragmatic manner based on the clinical progression of participants. The control group will attend six classes which will be provided over a period of 6-8 weeks. Participants will be assessed preintervention, postintervention and after 6 and12 months. The primary outcomes will be functional disability and pain intensity. Non-specific predictors, moderators and mediators of outcome will also be analysed. Ethics and dissemination: Ethical approval has been obtained from the Mayo General Hospital Research Ethics Committee (MGH-14-UL). Outcomes will be disseminated through publication according to the SPIRIT statement and will be presented at scientific conferences.
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spelling curtin-20.500.11937-443722017-09-13T14:12:17Z Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial O'Keeffe, M. Purtill, H. Kennedy, N. O'Sullivan, Peter Dankaerts, W. Tighe, A. Allworthy, L. Dolan, L. Bargary, N. O'Sullivan, K. Introduction: Non-specific chronic low back pain (NSCLBP) is a very common and costly musculoskeletal disorder associated with a complex interplay of biopsychosocial factors. Cognitive functional therapy (CFT) represents a novel, patientcentred intervention which directly challenges painrelated behaviours in a cognitively integrated, functionally specific and graduated manner. CFT aims to target all biopsychosocial factors that are deemed to be barriers to recovery for an individual patient with NSCLBP. A recent randomised controlled trial (RCT) demonstrated the superiority of individualised CFT for NSCLBP compared to manual therapy combined with exercise. However, several previous RCTs have suggested that class-based interventions are as effective as individualised interventions. Therefore, it is important to examine whether an individualised intervention, such as CFT, demonstrates clinical effectiveness compared to a relatively cheaper exercise and education class. The current study will compare the clinical effectiveness of individualised CFT with a combined exercise and pain education class in people with NSCLBP. Methods and analysis: This study is a multicentre RCT. 214 participants, aged 18-75 years, with NSCLBP for at least 6 months will be randomised to one of two interventions across three sites. The experimental group will receive individualised CFT and the length of the intervention will be varied in a pragmatic manner based on the clinical progression of participants. The control group will attend six classes which will be provided over a period of 6-8 weeks. Participants will be assessed preintervention, postintervention and after 6 and12 months. The primary outcomes will be functional disability and pain intensity. Non-specific predictors, moderators and mediators of outcome will also be analysed. Ethics and dissemination: Ethical approval has been obtained from the Mayo General Hospital Research Ethics Committee (MGH-14-UL). Outcomes will be disseminated through publication according to the SPIRIT statement and will be presented at scientific conferences. 2015 Journal Article http://hdl.handle.net/20.500.11937/44372 10.1136/bmjopen-2014-007156 BMJ Publishing Group fulltext
spellingShingle O'Keeffe, M.
Purtill, H.
Kennedy, N.
O'Sullivan, Peter
Dankaerts, W.
Tighe, A.
Allworthy, L.
Dolan, L.
Bargary, N.
O'Sullivan, K.
Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial
title Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial
title_full Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial
title_fullStr Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial
title_full_unstemmed Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial
title_short Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: Study protocol for a multicentre randomised controlled trial
title_sort individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: study protocol for a multicentre randomised controlled trial
url http://hdl.handle.net/20.500.11937/44372