Cognitive functional therapy compared with core exercise and manual therapy in patients with chronic low back pain: randomised controlled trial

Review written by Ben Cormack info

Key Points

  1. Cognitive functional therapy did not outperform specific core training and manual therapy for low back pain or disability.
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Low back pain (LBP) is a very common problem and is the leading cause of pain and disability globally. It is now starting to be recognized as a biopsychosocial issue (1) that is influenced by many factors. Cognitive functional therapy (CFT) is directed at the multidimensional nature of LBP and is a targeted approach that is individualized to the patient’s profile and follows three main components: 1) making sense of pain; 2) exposure with control; and 3) lifestyle changes.

Previous research has focused on the ‘CFT’ approach for treating LBP with some success, although there have been some flaws highlighted (such as inappropriate intention to treat analysis and high risk of attrition bias) (2).

The aim of this study was to overcome some of these methodological problems and determine whether CFT is better than a program looking at specific core training and manual therapy (CORE-MT) for LBP. The authors did not give a hypothesis on a specific outcome.

Low back pain is the leading cause of pain and disability globally.
Taking the results at face value, both approaches (CFT and specific core training + manual therapy) may be equally successful.


  • This was a parallel group, randomized controlled trial that was pre-registered and reported using the CONSORT statement.
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