Article Appraisal Summary: Original Research

Article Title: Cognitive functional therapy for disabling nonspecific chronic low back pain: Multiple case-cohort study.

Author(s): O'Sullivan K, Dankaerts W, O'Sullivan L, O'Sullivan PB

Journal, Year, Volume/Issue, Pages: Physical Therapy. 2015;95(11):1478-1488.

PICO Question: In a 50 y/o male with chronic low back pain lasting the last 9 months, does Cognitive Functional Therapy
(CFT) reduce functional disability as measured by the Oswestry Disability Index?

Study Clinical Chronic LBP is a costly debilitating disease with effective treatments remaining hidden.
Problem/Background

Hypothesis/Purpose/Aims To provide information about the efficacy of CFT in a case cohort format in order to set a
basis for a RCT. .
Intervention/Indicator Intervention of Interest: CFT

Independent variables CFT

Levels None

Dependent variables Pain and Functional Disability

Levels VAS and Oswestry Disability Index

Study design Case Cohort

Subjects Adults with CLBP

Sample Size 26

Inclusion criteria Age 18-65, independently mobile, capable of performing exercise, LBP was exacerbated
by changes in motion,
Exclusion criteria Spinal pathology, pregnant, neurological issues, pain-relieving medical procedure in last 3
months.
Subject selection Medical Consultant Clinics in Ireland

Threats to Validity Maturation Effect

Lack of Blinding

Statistical Analysis Pre and Post Intervention using Paired T-Test and Wilcoxon Signed Rank
 Results Pain and Disability were significantly reduced at 12 month follow up. No difference was
found in activity or posture.

Study Author’s Conclusions: Do not copy-paste. Create a summary of the authors’ conclusions
Patients receiving CFT had significant reductions in both pain and functional disability at 12 months post intervention.
The efficacy for use in debilitating LBP should be assessed in a RCT.

Your interpretation: What conclusions did you draw from the results and conclusions?
CFT shows some good efficacy in the management of CLBP especially at 12 month follow up. It is an intervention to
consider in the management of CLBP. There was shown no side effects but CFT does require excess training in order to
perform.

Study Quality: Describe factors about the study that would increase or decrease its quality and how confident you are in
its findings.
Lack of blinding and a control limit the overall quality of the research. However, the study was well performed and the
information can be utilized clinically.

Applicability to PICO Question: How does the information in the study specifically apply to your PICO question? How can
you make a connection between the study results and the question you are trying to answer?
This study helps to answer the population, intervention and outcomes.