{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:39:31Z","timestamp":1794004771690,"version":"4.8.0"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The purpose of this systematic review was to investigate the effect of adding the cognitive behavioral treatment (CBT) component to routine physical therapy (PT) on pain and depression reduction, improvement in quality of life, and enhanced function in patients with chronic low back pain (CLBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Type<\/jats:title>\n                    <jats:p>Systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Literature Survey<\/jats:title>\n                    <jats:p>Google Scholar, PubMed, Ovid, ScienceDirect, ProQuest, Scopus, Cochrane Library, and Embase electronic databases were explored for the key terms of \u201cbehavioral (or behavioural) treatment\u201d OR \u201cbehavior (behaviour) treatment\u201d OR \u201cbehavior (behaviour) therapy\u201d OR \u201ccognitive behavior (or behaviour) treatment\u201d OR \u201ccognitive treatment\u201d OR \u201ccognitive therapy\u201d OR \u201coperant behavior (or behaviour) treatment\u201d OR \u201crespondent behavior (or behaviour) treatment\u201d AND \u201cphysical therapy\u201d OR \u201cphysiotherapy\u201d OR \u201cexercise therapy\u201d OR \u201celectrotherapy\u201d OR \u201celectrical therapy\u201d OR \u201cmanual therapy\u201d OR \u201cmyofascial therapy\u201d OR \u201crehabilitation\u201d AND \u201clow back pain\u201d OR \u201clower back pain\u201d OR \u201cback pain\u201d OR \u201cchronic back pain\u201d OR \u201cchronic lower back pain\u201d, with no limitation on language, through January 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>All randomized controlled trials that statistically compared the effectiveness of CBT\u2009+\u2009PT and PT were included for quality analysis. Studies were rated by high to poor quality, using Hailey's classification, based on their design and performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Synthesis<\/jats:title>\n                    <jats:p>Of the 10 included studies, 7 were rated as high quality and 3 as good quality. Although CBT\u2009+\u2009PT was found to be superior to PT for pain, disability, quality of life, and functional capacity variables in some of the included studies, no extra benefit from CBT was documented in other investigations. The included studies also failed to show any advantage of CBT\u2009+\u2009PT over PT in reducing depression, and PT was even found to be superior to CBT\u2009+\u2009PT in one high\u2010quality study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although appearing to be advantageous by reducing pain and disability and enhancing functional capacity and quality of life, CBT effects on depression cannot be teased out from the effects of PT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>I<\/jats:p>\n                  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