{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:13:43Z","timestamp":1772118823868,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006380","name":"Rehabilitation Research and Development Service","doi-asserted-by":"publisher","award":["I21RX002891"],"award-info":[{"award-number":["I21RX002891"]}],"id":[{"id":"10.13039\/100006380","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30AR072572"],"award-info":[{"award-number":["P30AR072572"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individual treatments for chronic low back pain (CLBP) have small magnitude effects. Combining different types of treatments may produce larger effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To (1) assess feasibility of conducting a factorial randomized controlled trial of these treatments; and (2) estimate individual and combined treatment effects of (a) lumbar radiofrequency ablation (LRFA) of the dorsal ramus medial branch nerves (vs. a simulated LRFA control procedure) and (b) Activity Tracker\u2010Informed Video\u2010Enabled Cognitive Behavioral Therapy program for CLBP (AcTIVE\u2010CBT) (vs. an educational control treatment) on back\u2010related disability at 3\u2009months post\u2010randomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) were randomized in a 1:1:1:1 ratio in a 2\u2009\u00d7\u20092 factorial randomized controlled trial. Feasibility goals included an enrollment proportion\u2009\u2265\u200930%, a randomization proportion\u2009\u2265\u200980%, and a\u2009\u2265\u200980% proportion of randomized participants completing the 3\u2010month Roland\u2010Morris Disability Questionnaire (RMDQ) primary outcome end point. An intent\u2010to\u2010treat analysis was used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The enrollment proportion was 62%, the randomization proportion was 81%, and all randomized participants completed the primary outcome. Though not statistically significant, there was a beneficial, moderate\u2010magnitude effect of LRFA versus control on 3\u2010month RMDQ (\u22123.25 RMDQ points [95% confidence interval [CI], \u221210.18 to 3.67]). There was a significant, beneficial, large\u2010magnitude effect of AcTIVE\u2010CBT versus control (\u22126.29 [95% CI, \u221210.97 to \u22121.60]). Though not statistically significant, there was a beneficial, large effect of LRFA+AcTIVE\u2010CBT versus control (\u22128.37 [95% CI: \u221221.47, 4.74]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We conclude that it is feasible to conduct a randomized controlled trial combining procedural and behavioral treatments for CLBP.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      Registration:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03520387\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03520387<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  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