{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T07:17:56Z","timestamp":1788247076077,"version":"build-2803163510"},"reference-count":34,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"9","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>OBJECTIVES: We aimed to determine whether, for patients with severely disabling chronic low back pain (cLBP), initiating care with cognitive functional therapy combined with psychologist support (CFT+) improved disability and pain, and was cost-effective compared with an interdisciplinary pain management program (IPMP) at 12 months.<\/jats:p>\n                  <jats:p>METHODS: We conducted a randomized controlled trial (NCT04399772) with concealed allocation, blinded patients, and intention-to-treat analysis. One hundred thirty-three adults with severely disabling cLBP, who were referred to an interdisciplinary pain center, were randomized to CFT+ for 3 months, with optional access to IPMP thereafter, or to IPMP alone. The primary outcome was the proportion of patients who achieved a \u22658-point improvement on the Oswestry Disability Index (ODI) at 12 months. Secondary outcomes were pain intensity, pain catastrophizing, patient enablement, global impression of change, and cost-effectiveness assessed using quality-adjusted life years (QALYs) derived from the EQ-5D-3L (EuroQol 5-Dimension 3-Level Questionnaire) and health care contacts.<\/jats:p>\n                  <jats:p>RESULTS: At 12 months, ODI data were available for 46 (70%) patients in the CFT+ group and 45 (67%) in the IPMP group. A \u22658-point ODI improvement was achieved by 22% of patients who received CFT+ and 18% who received IPMP (difference, 3.9%; 95% CI: \u221212.4%, 20.3%; P = .64). Mean ODI change did not differ between groups (difference, 0.2; 95% CI: \u22123.8, 4.2; P = .92). There were no significant between-group differences for the secondary outcomes. Economic analysis estimated an incremental cost-effectiveness ratio of \u20ac53 075 per QALY for CFT+ versus IPMP.<\/jats:p>\n                  <jats:p>CONCLUSION: CFT+ was not superior to IPMP for people with severely disabling cLBP. J Orthop Sports Phys Ther 2026;56(9):596-610. 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