Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain.
Peter B O'Sullivan, J P Caneiro, Mary O'Keeffe and 4 others
PMID 29669082WHAT IT FOUND
For physical therapists, CFT is a behavioral approach for disabling low back pain after serious and specific pathology is excluded.
It targets beliefs, fear, guarding, and lifestyle; three illustrative cases do not show efficacy.
Key findings
01CFT is described as an integrated behavioral approach for individualizing management of disabling low back pain once serious and specific pathology has been excluded.
02Three illustrative cases are used to show how the framework can be applied to different people.
03Implementing CFT requires specific skills across several domains and a contextual understanding of behavioral psychology and neuroscience.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is not an original study; it reports no methods, no randomisation, no blinding, no dropout handling, and no primary outcome. The three cases are illustrative, so they cannot show that CFT works for other patients. The randomized trial mentioned in the efficacy section is not described here, so its results cannot be checked from this article. CFT is presented as requiring broad skills and a shift away from passive treatment, which may not be feasible without training and clinic time. It is framed for disabling low back pain after serious and specific pathology is excluded; urgent neurological signs require medical review.
Declared interests
The authors reported no conflicts of interest. P. O'Sullivan, JP Caneiro, W. Dankaerts, K. Fersum, and K. O'Sullivan reported payment for lectures or workshops on CFT.
The easy way to misread this
Do not read this article as proof that CFT works. It presents illustrative cases and cites another randomized trial, but it does not report that trial methods or outcomes.