{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:16:21Z","timestamp":1788444981652,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,5,14]],"date-time":"2019-05-14T00:00:00Z","timestamp":1557792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This randomized controlled trial investigated the efficacy of cognitive functional therapy (CFT) compared with manual therapy and exercise (MT\u2010EX) for people with non\u2010specific chronic low back pain (NSCLBP) at 3\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Hundred and twenty\u2010one patients were randomized to CFT (<jats:italic>n<\/jats:italic>\u00a0=\u00a062) or MT\u2010EX (<jats:italic>n<\/jats:italic>\u00a0=\u00a059). Three\u2010year data were available for 30 (48.4%) participants in the CFT group, and 33 (55.9%) participants in the MT\u2010EX 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\u2010related fear (Fear\u2010Avoidance Belief Questionnaire). A full intention to treat analysis was conducted using linear mixed models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2010EX group (95%CI:\u201010.1 to \u22123.1, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001, standardized effect size\u00a0=\u00a00.70). There was no significant difference in pain intensity between the groups at 3\u00a0years (0.6 points 95%CI:\u20101.4\u20130.3, <jats:italic>p\u00a0<\/jats:italic>=\u00a00.195). Significantly greater reductions were also observed for the CFT group for Hopkins Symptoms Checklist and Fear\u2010Avoidance Belief Questionnaire (Work).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CFT is more effective at reducing disability, depression\/anxiety and pain\u2010related fear, but not pain, at 3\u2010year follow\u2010up than MT\u2010EX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Cognitive functional therapy (CFT) was more effective than manual therapy and exercise (MT\u2010EX) in reducing disability at 3\u2010year follow\u2010up, in people with non\u2010specific chronic low back pain. The sustained reduction in disability without concomitant reductions in pain intensity in the CFT group suggests a de\u2010coupling of the pain\u2014disability relationship.<\/jats:p><jats:p>CFT resulted in long\u2010lasting reductions in anxiety and depression, and pain\u2010related fear regarding work compared to MT\u2010EX. The findings support the long\u2010term benefits of a individualized behaviourally orientated intervention that targets pain beliefs, functional restoration and lifestyle factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1399","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T06:48:29Z","timestamp":1555051709000},"page":"1416-1424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":105,"title":["Cognitive functional therapy in patients with non\u2010specific chronic low back pain\u2014a randomized controlled trial 3\u2010year follow\u2010up"],"prefix":"10.1002","volume":"23","author":[{"given":"Kjartan","family":"Vibe Fersum","sequence":"first","affiliation":[{"name":"Physiotherapy Research Group, Department of Public Health and Primary Health Care University of Bergen 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