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Preventing the Transition From Acute to Persistent Disabling Low Back Pain Through Cognitive Functional Therapy
Sponsor: University of Oulu
Summary
Acute low back pain often resolves spontaneously, but some patients develop persistent pain and disability. The goal of this clinical trial is to determine whether Cognitive Functional Therapy (CFT), compared with usual care, can help prevent recent low back pain from becoming persistent in adults receiving direct-access physiotherapy in primary care. The main questions it aims to answer are: * Does CFT reduce low back pain-related disability over 12 months compared with usual care? * Is CFT cost-effective compared with usual care? * What are the long-term effects of CFT compared with usual care over a 3-year follow-up period? Researchers will compare CFT to usual care to see if CFT prevents the transition from acute to persistent low back pain. Participants will: * Receive either Cognitive Functional Therapy or usual care. * Complete questionnaires at baseline and follow-up assessments throughout the study.
Official title: FIN-BACK: Preventing the Transition From Acute to Persistent Disabling Low Back Pain Through Cognitive Functional Therapy
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
461
Start Date
2027-09
Completion Date
2031-09
Last Updated
2026-10-16
Healthy Volunteers
No
Interventions
Cognitive Functional Therapy (CFT)
Participants receive Cognitive Functional Therapy delivered by CFT-trained physiotherapists. CFT is a patient-centred, behaviourally oriented physiotherapy approach targeting individual physical, lifestyle related and psychosocial barriers to recovery. Through structured interviewing and functional movement assessment, individualized biopsychosocial factors contributing to the condition are identified. A personalized management plan is then developed collaboratively with the patient. The intervention includes three components: (1) Making sense of pain; (2) Exposure with control; and (3) Lifestyle change. Treatment is delivered over 3 months in primary care physiotherapy settings, in person or via telehealth. Sessions last \~60 minutes initially and 30-45 minutes thereafter, with \~2-5 sessions based on clinical judgement. Where clinically appropriate, the treating physiotherapist may arrange a 6-month follow-up call, with a follow-up visit if needed.
Usual Care
Patients receive care according to the physiotherapist's usual practice. The number and content of visits are not restricted or pre-specified, and sessions may be delivered in person or remotely and typically last 30-60 minutes. As this is a pragmatic trial conducted in direct-access physiotherapy settings, the care pathway may vary according to clinical presentation and local practice. Additional treatments are not restricted. Care received during follow-up will be characterized using patient-reported questionnaires, electronic medical records, national healthcare registry data, and video recordings of a sample of consultations.
Locations (1)
University of Oulu
Oulu, North Ostrobothnia, Finland