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Table 1 Summary of the three studies included in the meta-analysis

From: The effect of cognitive functional therapy for chronic nonspecific low back pain: a systematic review and meta-analysis

Study, data collection country, and the source of funding Participants Interventions Comparisons Outcome measures
Fersum [19]
Norway, The Norwegian Fund
Total n = 94 (from private physiotherapy outpatient practices, general practitioners, and the outpatient spine clinic at the Haukeland University Hospital in Bergen). Participants were aged between 18 and 65 years old diagnosed with nonspecific chronic low back pain for > 3 months
CFT group: Age 41 ± 10.3 years. Gender 24 males, 27 females. Mean duration of symptoms 3–12 months = 6, 1–5 years = 14, > 5 years = 31
Control group: Age 42.9 ± 12.5 years. Gender 22 males, 21 females. Mean duration of symptoms 3–12 months = 6, 1–5 years = 13, > 5 years = 23
Individual Intervention. CFT for 12 weeks by three experienced physiotherapists who had undergone, on average, 106 h of CB-CFT training. The mean number of treatments was 7.7 ± 2.6. The initial session was 1 h, and follow-ups were 30–45 min Individual Intervention. Joint mobilisation or manipulation techniques for 12 weeks by therapists who were specialists in orthopaedic manual therapy with an average of 25.7 years of experience with no prior training in the use of the MDCS or CB-CFT. Most patients (82.5%) were also given exercises, which included general or motor control exercise as a home programme. The mean number of treatments was 8.0 ± 2.9. The initial session was 1 h, and follow-ups were 30 min Pain: Week average, NRS
Disability/functional status: ODI
Fear physical activity: FABQ
Other objective measures that were not included in this review
Anxiety and Depression: HSCL-25
Lumbar ROM: Inclinometer method
Patient satisfaction: PSQ
Sick-leave days: OMPQ
Follow-up: 3, 12 months
Ng [20]
Australia, Sports Physiotherapy Australia grant
Total n = 36 (from school and community rowing clubs in Perth, Western Australia). Participants were adolescent male rowers aged between 14 and 19 years old with between 1 and 4 years of school-level rowing experience, suffering from LBP related to rowing
CFT group: Age 16.3 ± 1.5 years. Gender 19 males
Control group Age 15.2 ± 1.5 years. Gender 17 males
Individual Intervention. CFT for 8 weeks by a physical therapist with 5 years’ experience in the Australian Rowing and training in CFT. The initial session was approximately 1 h in duration and follow-up appointments were 30 min. Rowers were seen a week after the initial session and then fortnightly after that The control group did not receive any elements of the CFT intervention from their coaches or the treating physiotherapist Disability/functional status: RMDQ
Other objective measures that were not included in this review
Pain: Mean maximum pain during a 15-min ergometer trial, NRS
Back and lower limb muscle endurance: Biering-Sorensen test and isometric squat test
Lumbar kinematics: upper and lower lumbar angle during 15-min ergometer
Follow-up: 8, 12 weeks
O’Keeffe [21]
Australia, No funding
Total: n = 206 (from Ballina Primary Care Centre, Claremorris Primary Care Centre and Mayo General Hospital)
The participants were between 18 and 75 years of age, CNSLBP for at least 6 months duration
CFT group: Age 47.0 ± 13.2 years. Gender 24 males, 82 females. Median duration of symptoms 56 (24–120) months
Control group: Age 50.6 ± 14.9 years. Gender 30 males, 70 females. Median duration of symptoms: 60 (24–156) months
Individual Intervention. CFT for 12 weeks by three experienced physiotherapists who had undergone of CB-CFT training. Treatment was given weekly and reduced in frequency over time. The initial session was 1 h, and follow-ups were 30–60 min Group-based exercise and education intervention consisting of up to six classes over 6–8 weeks, each lasting ~ 1 h and 15 min, with up to 10 participants in each class Pain: Week average, NRS
Disability/functional status: ODI
Fear physical activity: FABQ
Other objective measures that were not included in this review
Beliefs: BBQ
Self-efficacy: PSEQ
Coping: CSQ
Sleep, depression and anxiety: SHC
Stress: DASS
Patient satisfaction: PSQ
Follow-up: Post intervention, 6, 12 months
  1. CFT cognitive functional therapy, NRS Numerical Rating Scale, ODI Oswestry Disability Index, FABQ Fear-Avoidance Beliefs Questionnaire, MDCS Multidimensional Classification System, ROM Range of Motion, RDQ Roland-Morris Disability Questionnaire, HSCL-25 Hopkins Symptoms Checklist, PSQ Patient Satisfaction Questionnaire, OMPQ Orebro Musculoskeletal Pain Questionnaire, CNSLBP chronic non-specific low back pain, BBQ Back Beliefs Questionnaire, PSEQ Pain Self-Efficacy Questionnaire, CSQ Coping Strategies Questionnaire, SHC Subjective Health Complaints Inventory, DASS Depression, Anxiety and Stress Scale