accompanying editorial<\/a>, Dimitrios Lytras, PhD, Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece, applauded how the study was conducted.<\/p>\n\u201cMethodologically, RESTORE is exemplary: a pragmatic, multicenter trial embedded in routine care [and] supported by thorough therapist training,\u201d Lytras wrote.<\/p>\n
He added that the results \u201coffer cautious optimism\u201d and a shift from passive care models to ones that are more patient-centered.<\/p>\n
The addition of biofeedback not leading to added benefit could be explained by the fact that CFT \u201calready incorporates rich feedback mechanisms, making supplementary sensor input redundant,\u201d he noted.<\/p>\n
Lytras wrote that the intervention is also low risk and high value.<\/p>\n
Durable Functional Gains<\/p>\n
Commenting for Medscape Medical News,\u00a0Sean Mackey, MD, PhD, Redlich professor and chief of the Division of Pain Medicine at Stanford Medicine, Palo Alto, California, said the study showed durable functional gains and modest pain changes.<\/p>\n
The dose of seven visits over 12 weeks plus a 26-week booster was \u201clean,\u201d but the effects held, which was \u201cpleasantly surprising,\u201d said Mackey, who was not involved with the research.<\/p>\n
However, he did note a few caveats, including that only 63% of the randomized cohort contributed to the 3-year data. In addition, \u201cthose followed were less severe at baseline and did better at 1 year, though loss to follow-up was nondifferential by arm,\u201d he said.<\/p>\n
In reflecting on the study design, Mackey noted that an \u201cattention-matched active comparator to blunt performance and expectancy bias\u201d would have been helpful. He pointed out that the researchers themselves acknowledged that usual care was not contact-matched.<\/p>\n
He added that it would also have been valuable to include data on 3-year adverse events, healthcare utilization, and costs.<\/p>\n
If future research confirms its generalizability to other countries, Mackey said he would recommend clinicians \u201cadopt the CFT package\u201d of graded exposure with a control and lifestyle coaching, schedule 6-8 visits plus a 6-month booster, measure function as the primary outcome, and set expectations for about a one-point reduction in pain. He recommended against adding sensor biofeedback because \u201cit didn\u2019t help.\u201d<\/p>\n
Hancock reported being a member of the Australian Physiotherapy Association and holding research grants from the Australian National Health and Medical Research Council and Medical Research Future Fund, the Physiotherapy Research Foundation, the Australian Chiropractors Education and Research Foundation, and the Canadian Institutes of Health Research. The other investigators reported having a wide list of financial relationships, which are fully provided in the original article. Lytras and Mackey reported having no relevant financial relationships.<\/p>\n","protected":false},"excerpt":{"rendered":"A personalized protocol involving self-managed cognitive functional therapy (CFT) was associated with sustained symptom improvement at 3 years…\n","protected":false},"author":2,"featured_media":64427,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[64,63,51586,51585,51587,51588,137,11742,29561,46466,51589,51590],"class_list":["post-64426","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-au","tag-australia","tag-back-pain","tag-chronic-back-pain-chronic-pain-of-the-back","tag-chronic-low-back-pain","tag-chronic-pain-of-the-low-back","tag-health","tag-pain","tag-pain-management","tag-physical-medicine-and-rehabilitation-physiatry-pmampr-physical-medicine-and-rehabilitation-pmr","tag-physical-therapy","tag-physiotherapy"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/64426","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=64426"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/64426\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/64427"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=64426"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=64426"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=64426"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}