Science & Technology, Australia (Commonwealth Union) – Cognitive Functional Therapy (CFT) is an approach to treating chronic pain that aims to change the way people think, move and behave in connection to their pain. It is based on the understanding that pain is not just a physical sensation but impacted by psychological, social and environmental factors. CFT involves a comprehensive assessment of the patient’s pain, including physical and psychological factors, lifestyle and work habits, and their beliefs about pain. The therapy is designed to help patients understand the complex interplay between these factors and how they contribute to their pain.
A methodical review of CFT has discovered that it’s not better than traditional therapies, which was based on evidence gathered from prior studies.
The review lead Mr Jack Devonshire, a PhD candidate with the University of New South Wales (UNSW) and Neuroscience Research Australia (NeuRA), who explored studies of CFT as a therapy for chronic back pain described it in his research as pain felt continuously for 3 months or higher in locations such as the 12th rib and the crease of the buttocks.
CFT has received widespread attention with practitioners since the 1st clinical trial in 2013 based on a theory formed back in 2005. Mr Devonshire notes that many trials worldwide have been conducted since then, and also indicated that CFT integrates treatments that could be useful in handling chronic lower back pain, like pain education, exercise, along with lifestyle coaching, into a model of care informed by present knowledge of an individual’s entire pain experience.
“The therapy aims to build upon the biopsychosocial model to provide health professionals with what we call a clear ‘clinical reasoning framework’ to tailor strategies to manage this chronic condition,” said Mr. Devonshire.
Despite the therapy being merged into healthcare systems across the UK and Finland, together with many training courses online for clinicians, there was no comprehensive analysis of research exploring this therapy, according to researchers.
“So we decided to perform a systematic review and meta-analysis, the highest level of evidence, to look at past studies to find out how effective the treatment is on pain, disability and safety,” he said.
Following the evaluation of all the studies belonging to the research criteria, Mr Devonshire and his fellow authors discovered that ultimately the effectiveness of CFT was still unknown at the current stage, and they called for future trials with blinded participants, which is when participants do not know if the therapy given is actual or fake and studies including bigger sample sizes.
“The results of our study found that CFT may not reduce pain intensity and disability in people with chronic low back pain, compared to manual therapy and core exercises, either at the end of treatment or at the 12-month follow-up,” Mr Devonshire says.
“This is important as we want our exercise physiologists, physios and other health professionals who manage people with low back pain to be armed with the best available information on the available effective treatments – especially since learning to deliver CFT as a therapist is quite intensive, taking an average 106 hours of training to properly deliver the treatment.”
The review had otherwise seen no adverse events indicated among patients following the CFT treatment.
Mr Devonshire observed that the certainty in the researchers’ systematic review was restricted by variations between the study controls, minute sample sizes and an increased risk of bias across all included studies, that effects the trustworthiness of the results from these studies. The group looks forward to more studies that enhance the present evidence through clinical trials on CFT.
The review which appeared recently in the Journal of Orthopaedic & Sports Physical Therapy, is likely draw attention among therapists on the possible benefits and drawbacks of future CFT studies.
