Identifying chronic low back pain patients who respond better to cognitive functional therapy: secondary analysis of a randomized clinical trial

Abstract

Introduction: Chronic chronic pain (CLD) is a public health problem responsible for high rates of disability, absenteeism and financial burdens worldwide. Research has been carried out with the objective of identifying subgroups of patients who improve a certain type of intervention. Cognitive-functional therapy (CBT) is a model-based patient-centered behavioral intervention. There are still no studies that have identified subgroups of patients that respond better to TCF. Objective: To identify potential psychosocial and neurophysiological modifiers of the effect of TCF treatment on reducing pain intensity and disability 3 months after randomization compared to manual therapy combined with motor control exercises in patients with CLBP. Methods: Potential psychosocial and neurophysiological modifiers of effect of TCF treatment in reducing pain intensity and disability 3 months after randomization compared with manual therapy and motor control exercises in identification combined with DLC. It is a random therapy (1) secondary to a clinical trial that investigated1 a method of analyzing the TCF compared to a manual therapy combined with an exercise in pain and disability in DLC. Potential TCF modifiers versus manual therapy and motor control exercises were investigated for potential effects. As 7 predictor variables were investigated in univariate models alone, all dichonomic variables. Results: Variable anxiety modified the effect of TCF in reducing disability (BC [beta coefficient] = -19.25; 95% CI = -31.88 to -6.61; P = 0.003). A number of areas of depression, social isolation, catastrophizing, movement, stress and high risk of chronicity were not modified from the effect of TCF treatment without prejudice. of the TCF changes was altered in relation to the reduction in the importance of pain. Conclusion: Anxiety was a modifier of the effect of TCF in reducing disability in patients with chronic pain compared to manual therapy combined with motor control exercises. Clinical trials with stratification of subgroups of patients with and without high levels of anxiety randomized to receive TCF or manual therapy and motor control exercises will be needed.