Comparative Effects of Cognitive Functional Therapy With Kinetic Control Training on Non-specific Low Back Pain

NCT ID: NCT07282925

Last Updated: 2025-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-15

Study Completion Date

2026-07-20

Brief Summary

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The goal of this clinical trial is to compare Cognitive Functional Therapy (CFT) with Kinetic Control Training (KCT) in participants with non-specific low back pain. The study wants to see which approach helps lower pain, reduce disability and improve movement control. The main questions it aims to answer is

* Is there difference between Cognitive Functional Therapy and Kinetic control training on pain intensity, disability and movement control in participants with Non Specific Low Back Pain?
* Is there difference between Cognitive Functional Therapy and Kinetic control training on pain catastrophizing and self-efficacy in participants with Non Specific Low Back Pain? Researcher will compare the both CFT and KCT group to see if one treatment is superior to other in treating participants with non-specific back pain.

Participants will

* Attend treatment sessions based on the group they are placed in.
* Take session three times each week for eight weeks.
* They will be asked short questions about their pain, daily activity, and movement throughout the study.

Detailed Description

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Low back pain (LBP) has the highest prevalence globally among musculoskeletal disorders, affecting around 619 million people in 2020 and it is expected that the number of cases will increase to 843 million by 2050. LBP is defined as the localized pain below the costal margin and above the inferior gluteal folds which may or may not include leg pain. It is commonly categorized as specific and non-specific low back pain. Non-Specific Low Back Pain (NSLBP) accounts for nearly 90% of all cases.

NSLBP is multifactorial and mostly new cases recover within a short time but the condition frequently recurs and may become persistent. An extensive review regarding the management of LBP has stated that exercise plays a fundamental role in treating patients with NSLBP. However, the results regarding the appropriate type of exercise are the subject of controversy. Over the past decades, researchers have advised a variety of exercises. However, despite applying various treatment approaches, conservative treatment for NSLBP yields small effect sizes.

Cognitive Functional Therapy (CFT) is a contemporary exercise intervention developed by Peter O'Sullivan, to address the multidimensional nature of non-specific low back pain. The CFT is structured into three phases: (1) making sense of pain, (2) exposure with control, and (3) lifestyle changes. Rather than adopting a one size fits all approach, CFT provides clinicians with the opportunity to explore the multidimensional nature of NSLBP.

Kinetic Control Training (KCT) developed by Comerford, is a clinical framework focused on the assessment and correction of uncontrolled movement. KCT emphasizes identifying direction-specific movement faults (e.g., flexion, extension, rotation control deficits) that contribute to symptom provocation. KCT utilizes a three-stage retraining process: (1) cognitive facilitation of correct muscle activation; (2) integration into low-load, non-provocative tasks; and (3) progression to complex, functional movements under load and fatigue.

Despite the promising evidence supporting both CFT and KCT, a clear comparative study of their effectiveness in addressing NSLBP is lacking. Most existing studies have focused on one technique or compared it with general exercise. This study seeks to address this gap by evaluating and comparing the effects of Cognitive Functional Therapy and Kinetic Control Training in individuals with NSLBP.

Conditions

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Low Back Pain Non Specific Chronic Low Back Pain

Keywords

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Low Back Pain Non Specific Low Back Pain Chronic Low Back Pain Cognitive Functional Therapy Kinetic Control Training Pain Disability Movement Control

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Cognitive Functional Therapy

Group Type EXPERIMENTAL

Cognitive Functional Therapy

Intervention Type BEHAVIORAL

Patients will receive 3 sessions per week for 8 weeks for a total of 24 sessions. Each session will be of 1 hour 15 minutes.

Standard Physical Therapy will be provided in which patient will receive Hot pack with TENS and perform a set of exercises including Curl up, Bird dog and side bridge back exercises for 5 repetitions.

Then Cognitive Functional Therapy (CFT) will be applied from day one. CFT is structured into three phases: (1) making sense of pain, (2) exposure with control, and (3) lifestyle changes. Making Sense of Pain : This component reflects the cognitive aspect of Cognitive Functional Therapy. It involves hearing patient's personal narrative about their chronic pain. Exposure with Control: It involves graded exposure to feared movements and functional tasks. Lifestyle Changes: This component focuses on lifestyle factors that contribute to pain and disability. It involves modifying sedentary lifestyle behaviors and encouraging healthy routine.

Kinetic Control Training

Group Type ACTIVE_COMPARATOR

Kinetic Control Training

Intervention Type OTHER

Patients will receive 3 sessions per week for 8 weeks. In each session, Standard Physical Therapy will be applied which will be the same in both groups.

In Kinetic Control Training (KCT), patients will first undergo direction specific movement control tests. These tests will identify direction-specific movement faults (e.g., flexion, extension, rotation control deficits) that contribute to symptoms. Based on these tests, individualized retraining will be provided to the patients. This retraining will improve control of specific muscles which will help reduce pain and improve disability.

Interventions

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Cognitive Functional Therapy

Patients will receive 3 sessions per week for 8 weeks for a total of 24 sessions. Each session will be of 1 hour 15 minutes.

Standard Physical Therapy will be provided in which patient will receive Hot pack with TENS and perform a set of exercises including Curl up, Bird dog and side bridge back exercises for 5 repetitions.

Then Cognitive Functional Therapy (CFT) will be applied from day one. CFT is structured into three phases: (1) making sense of pain, (2) exposure with control, and (3) lifestyle changes. Making Sense of Pain : This component reflects the cognitive aspect of Cognitive Functional Therapy. It involves hearing patient's personal narrative about their chronic pain. Exposure with Control: It involves graded exposure to feared movements and functional tasks. Lifestyle Changes: This component focuses on lifestyle factors that contribute to pain and disability. It involves modifying sedentary lifestyle behaviors and encouraging healthy routine.

Intervention Type BEHAVIORAL

Kinetic Control Training

Patients will receive 3 sessions per week for 8 weeks. In each session, Standard Physical Therapy will be applied which will be the same in both groups.

In Kinetic Control Training (KCT), patients will first undergo direction specific movement control tests. These tests will identify direction-specific movement faults (e.g., flexion, extension, rotation control deficits) that contribute to symptoms. Based on these tests, individualized retraining will be provided to the patients. This retraining will improve control of specific muscles which will help reduce pain and improve disability.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients of both sexes
* Aged between 19 to 39
* Patients who score 6 points or higher on the Roland-Morris Disability Questionnaire (RMDQ) at the time of screening
* Patients who will have Non-Specific Chronic Low Back pain for at least 3 months duration

Exclusion Criteria

* If the primary pain area is not the lumbar spine.
* If leg pain is the primary problem.
* If patient have inflammatory disease.
* If patient have progressive neurological disease.
* If patient have red flag disorders (malignancy/cancer, traumas such as fracture).
* Pregnant females.
Minimum Eligible Age

19 Years

Maximum Eligible Age

39 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lahore University of Biological and Applied Sciences

OTHER

Sponsor Role lead

Responsible Party

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Umber Nawaz

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nayab Naseem

Role: PRINCIPAL_INVESTIGATOR

Lahore University of Biological and Applied Sciences

Locations

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Ghurki Trust Teaching Hospital

Lahore, Punjab Province, Pakistan

Site Status

Private Physical Therapy Clinic

Lahore, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

Central Contacts

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Nayab Naseem

Role: CONTACT

Phone: +92 334 4769616

Email: [email protected]

Umber Nawaz

Role: CONTACT

Phone: +92 333 4888279

Email: [email protected]

Other Identifiers

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U1111-1331-9059

Identifier Type: REGISTRY

Identifier Source: secondary_id

UBAS/ERB/FoRS/25/021

Identifier Type: -

Identifier Source: org_study_id