Cognitive Functional Therapy Compared With Pilates in Elderly Patients With Chronic Low Back Pain
Cognitive Functional Therapy Compared With Pilates in Elderly Patients With Chronic Low Back Pain Treated Via Telerehabilitation: A Randomized Controlled Trial
Centro Universitário Augusto Motta
200 participants
Sep 2, 2022
INTERVENTIONAL
Conditions
Summary
There is evidence of three randomized controlled trials that face-to-face CFT reduces disability compared with active interventions for adults with chronic low back pain. The pandemic enabled the popularization of tele rehabilitation around the globe, but there are still no clinical trial testing the effectiveness of Cognitive Functional Therapy (CFT) via tele rehabilitation for elderly people with chronic low back pain. The aim of this study is to investigate the effectiveness of CFT compared with Pilates, both via tele rehabilitation in elderly patients with chronic low back pain.
Eligibility
Inclusion Criteria6
- A main complaint of pain in the area between the 12th rib and buttock crease with or without accompanying non-radicular leg pain;
- Episode of ongoing low back pain for at least 12 weeks' duration;
- Presenting to a primary care clinician at least 6 weeks ago for this episode of LBP;
- Being able to walk independently (with or without aids);
- Ability to understand Portuguese well enough to be able to fill in the questionnaires.
- Medium or high risk score on STartback screening tool.
Exclusion Criteria9
- Known or suspected red flag disorders like fracture, malignancy/cancer, cauda equina syndrome or progressive neurological disorder, inflammatory or infective diseases of the spine;
- Suspected radicular pain (dominant leg pain, positive neural tissue provocation tests and/or any two of altered strength, reflexes or sensation for the same nerve root, assessed clinically);
- Spinal surgery < 6 months previously;
- Invasive procedures for pain relief (ex: epidural injection, rhizotomy) in the last three months;
- Scoliosis (if considered the primary cause of pain);
- Unstable heart conditions;
- Chikungunya or Dengue virus disease transmitted by mosquitoes;
- Relevant cognition deficit measured by 10 point cognitive screener, with a cut-off point of less than 8 points, 18 for participants with elementary education, and 26 for participants with secondary and/or higher education;
- Post Covid-19 sequelae of pain.
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Interventions
Participants in the CFT group will be treated by a physiotherapist with seventeen years of clinical experience and that has attended six CFT workshops with three of the international tutors of the method. She has completed 212 hours of training including workshops, patient examinations and a pilot study under the supervision of a physiotherapist with more than seven years of clinical experience in CFT. Another two physiotherapists, one with more than fifteen years and the other with more than ten years of clinical experience, and both with more than 106 hours of CFT training including CFT via tele physiotherapy, will complete the staff.
Physiotherapist will have the freedom to judge about the exercises´ progression and the need of adaptation considering both the level of difficulty to perform each exercise according to the original proposal and the individual´s demands. The treating physiotherapists will have at least 2 years of clinical practice in Pilates and clinical experience in Pilates via teleconference.
Locations(1)
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NCT05480982