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Cognitive functional therapy for persistent low back pain

What we are doing:

A single site, mixed methods, feasibility, parallel, randomised controlled trial will compare cognitive functional therapy (CFT) with usual physiotherapy care for 60 people with persistent low back pain in a NHS secondary care physiotherapy service.

Nested qualitative studies will explore the barriers and facilitators to CFT and the acceptability of the intervention and research process from the perspectives of physiotherapists and people with persistent low back pain. 

Why we are doing it:

Low back pain (LBP) is the primary cause of years lived with disability in the United Kingdom and globally, contributing to a significant economic burden. For a number of decades LBP has been recognised as a complex biopsychosocial disorder, requiring assessment and management across multiple interacting domains.

A multi-dimensional biopsychosocial assessment and treatment intervention called CFT has been developed, showing promise in one randomised controlled trial. To date, the clinical and cost effectiveness of CFT has not been evaluated in the NHS. 

This study aims to determine the feasibility of completing a future definitive, randomised controlled trial that will evaluate the clinical and cost-effectiveness of CFT in comparison to usual physiotherapy care for people with persistent LBP attending an NHS physiotherapy service.

What the benefits will be:

By targeting the multi-dimensional nature of LBP, CFT offers a new model of care with the potential to improve the quality of life for individuals and reduce the burgeoning economic and societal impact of LBP in the UK and globally. Should CFT show clinical and cost-effectiveness in a future definitive randomised controlled trial then significant economic impacts will be realised via reductions in disability, work absenteeism, welfare benefit payments and direct healthcare costs. 

Who we are working with:

The PhD is supervised by Professor Pip Logan, Professor of Rehabilitation Research, University of Nottingham; Dr Claire Diver Associate Professor, University of Nottingham; Dr Vicky Booth, Research Associate, University of Nottingham and Dr Seth O’Neill, Senior Lecturer in Physiotherapy, University of Leicester.

Professor Peter O’Sullivan, Professor of Physiotherapy, Curtin University, Perth, Australia and Dr Kieran O’Sullivan, Lead Physiotherapist and Senior Lecturer, Sports Spine Centre, Aspetar, Qatar and University of Limerick, Ireland, make up an international advisory group.  


Chris Newton, 

Photo by Afif Kusuma on Unsplash