Patient Perspectives on Participation in Cognitive Functional Therapy for Chronic Low Back Pain

Bunzli, Samantha; McEvoy, Sarah; Dankaerts, Wim; O’Sullivan, Peter; O’Sullivan, Kieran

doi:10.2522/ptj.20140570

Cited by 59 publications

(38 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, Pietilä Holmner, Stålnacke, Enthoven, and Stenberg (2018) recognized that knowledge of chronic pain increased the individuals' ability to manage their pain in everyday life. Bunzli et al (2016) also described results in line with ours, where the participants' improvements after intervention were related to their ability to self-manage their condition as result of gaining new information and improved body awareness. We find it interesting and encouraging that our findings of behaviour change in the primary care setting are aligned with the findings from studies focused on multidisciplinary and cognitive treatment programs (Pietilä Holmner, Stålnacke, Enthoven, and Stenberg, 2018;Wilson, Chaloner, Osborn, and Gauntlett-Gilbert, 2017).…”

Section: Discussionsupporting

confidence: 86%

“…Exercises and training are common expectations (Bernhardsson, Larsson, Johansson, and Öberg, 2017;Calner, Isaksson, and Michaelson, 2017), which is in line with the recommendations of Semmons (2016). Earlier findings also elucidate how patients expect a trusting relationship and good communication with the physiotherapist (Bunzli et al, 2016;Slade, Patel, Underwood, and Keating, 2014;Stenberg, Fjellman-Wiklund, and Ahlgren, 2012); and to be actively engaged in the treatment (Bernhardsson, Larsson, Johansson, and Öberg, 2017;Stenberg, Fjellman-Wiklund, and Ahlgren, 2012). In addition to the treatment process, expectations of treatment outcomes are also described, encompassing several aspects.…”

Section: Introductionsupporting

confidence: 61%

“…They also expected the physiotherapist to acknowledge and focus on their specific problems (Calner, Isaksson, and Michaelson, 2017). The importance of communication and a trusting relationship is in line with the studies of Bunzli et al (2016) and Slade, Underwood, and Keating (Slade, Patel, Underwood, and Keating, 2014). The patient's need to be recognized and affirmed as an individual is another aspect of a therapeutic alliance (Stenberg, Fjellman-Wiklund, and Ahlgren, 2012).…”

Section: Discussionmentioning

confidence: 80%

See 2 more Smart Citations

Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study

Calner

Isaksson

Michaelson

2019

Physiotherapy Theory and Practice

View full text Add to dashboard Cite

The aim of this study was to explore and describe the physiotherapy treatment experiences of persons with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain in the back, neck, or shoulders were included in the study. Data was collected via semistructured interviews and were analysed with qualitative content analysis. The analysis resulted in the theme "Towards acceptance and management of pain", comprising four sub-themes: 1) Establishing and maintaining a therapeutic alliance; 2) Being active, taking initiative and facing challenges; 3) Appreciating guidance, incentive and having a sounding board; and 4) Acquired knowledge and new body awareness change behaviours. The theme and sub-themes describe how the participants used increased knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies for managing pain and the process of acceptance. A trusting relationship and continual dialogue with the physiotherapist was considered to be important. The participants were actively involved in the process as exercises, activities and other treatment modalities were individualized. This was rewarding but also challenging and required effort on their part. The physiotherapist's initiatives and actions were an important incentive and means of support.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 80%

See 1 more Smart Citation

Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study

Calner

Isaksson

Michaelson

2019

Physiotherapy Theory and Practice

View full text Add to dashboard Cite

show abstract

“…Three interviews were then coded independently by both the first and second author and reviewed together to check for interrater reliability. The codebook was discussed between them until agreement was reached 30. The a‐priori codebook was revised to add other themes that emerged in the first three interviews.…”

Section: Methodsmentioning

confidence: 99%

“…The codebook was discussed between them until agreement was reached. 30 The a-priori codebook was revised to add other themes that emerged in the first three interviews. The second author coded the remainder of interviews using Atlas.ti.…”

Section: Interviews Took Place Either At Kaiser Permanente Washingtonmentioning

confidence: 99%

Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study

Flaherty

Schoeppe

Kruse‐Jarres

et al. 2018

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

Essentials Exploring exercise beliefs in people with hemophilia may improve efforts at fall prevention.Semi‐structured interviews of adults with hemophilia.Subjects expressed concerns regarding balance, falling, pain, and risks and benefits of exercise.Individualized treatment based on patient beliefs may facilitate exercise and fall prevention. BackgroundPrior research has established that falls are commonplace in adults with hemophilia, and advises that physical therapy and exercise are successful in fall prevention. Recognizing obstacles and catalysts to physical therapy and exercise in people with hemophilia may augment the efficacy of efforts to prevent falls in this population.ObjectivesTo learn about the experiences and ideas of patients with hemophilia, especially associated with balance, falls, and exercise.MethodsSemi‐structured interviews with 14 adult patients with hemophilia were performed. The interviews were coded for themes founded on the study aims.ResultsMost subjects described difficulty with balance, often ascribed to joint problems. They believed that staying strong and fit could positively influence balance, but expressed concerns and fear related to falling. Those who exercised regularly did not view exercise as hazardous, while those who did not dependably exercise articulated worry that dangers of exercise may offset the benefits. The most common obstacle to exercise was pain and having someone to exercise with was often described as an enabler. Barriers to partaking in physical therapy included weak proof of its success and distrust in the therapist. Positive physical therapy experiences in the past and the connection with the therapist were reported as facilitators.ConclusionsPeople with hemophilia describe some attitudes and experiences that are unique to hemophilia while others are found in the general population. Attending to fear, pain, and support for interventions, while encouraging a robust therapeutic alliance and a plan for routine exercise may aid fall prevention behaviors.

show abstract

Cognitive functional therapy in patients with non‐specific chronic low back pain—a randomized controlled trial 3‐year follow‐up

Fersum

Smith

Kvåle

et al. 2019

European Journal of Pain

Self Cite

View full text Add to dashboard Cite

Objectives This randomized controlled trial investigated the efficacy of cognitive functional therapy (CFT) compared with manual therapy and exercise (MT‐EX) for people with non‐specific chronic low back pain (NSCLBP) at 3‐year follow‐up. Methods Hundred and twenty‐one patients were randomized to CFT (n = 62) or MT‐EX (n = 59). Three‐year data were available for 30 (48.4%) participants in the CFT group, and 33 (55.9%) participants in the MT‐EX group. The primary outcomes were disability (Oswestry disability Index [ODI]) and pain intensity (numerical rating scale) and secondary outcomes were anxiety/depression (Hopkins Symptoms Checklist) and pain‐related fear (Fear‐Avoidance Belief Questionnaire). A full intention to treat analysis was conducted using linear mixed models. Results Significantly greater reductions in disability were observed for the CFT group, with ODI scores at 3 years 6.6 points lower in the CFT than the MT‐EX group (95%CI:‐10.1 to −3.1, p < 0.001, standardized effect size = 0.70). There was no significant difference in pain intensity between the groups at 3 years (0.6 points 95%CI:‐1.4–0.3, p = 0.195). Significantly greater reductions were also observed for the CFT group for Hopkins Symptoms Checklist and Fear‐Avoidance Belief Questionnaire (Work). Conclusions CFT is more effective at reducing disability, depression/anxiety and pain‐related fear, but not pain, at 3‐year follow‐up than MT‐EX. Significance Cognitive functional therapy (CFT) was more effective than manual therapy and exercise (MT‐EX) in reducing disability at 3‐year follow‐up, in people with non‐specific chronic low back pain. The sustained reduction in disability without concomitant reductions in pain intensity in the CFT group suggests a de‐coupling of the pain—disability relationship. CFT resulted in long‐lasting reductions in anxiety and depression, and pain‐related fear regarding work compared to MT‐EX. The findings support the long‐term benefits of a individualized behaviourally orientated intervention that targets pain beliefs, functional restoration and lifestyle factors.

show abstract

Patient Perspectives on Participation in Cognitive Functional Therapy for Chronic Low Back Pain

Abstract: A successful outcome after CFT is dependent on instilling biopsychosocial pain beliefs and developing independence among participants. Small improvers may require ongoing support to maintain results. Further study is needed to elucidate the optimal approach for those who were unchanged.

Cited by 59 publications

References 46 publications

Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study

Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study

Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study

Cognitive functional therapy in patients with non‐specific chronic low back pain—a randomized controlled trial 3‐year follow‐up

Contact Info

Product

Resources

About