Cited by 41Musculoskeletal pain and rehabilitationHealth Policy Implementation ScienceMusculoskeletal Disorders and Rehabilitation

The perspectives of physiotherapists on managing nonspecific low back pain following a training programme in cognitive functional therapy: A qualitative study

Cowell, Ian, O'Sullivan, Peter, O'Sullivan, Kieran, Poyton, Ross, McGregor, Alison, Murtagh, Ged·2019·Musculoskeletal Care

Abstract

Background:It has long been acknowledged that nonspecific chronic low back pain (NSCLBP) is associated with a complex combination of biopsychosocial (BPS) factors, and recent guidelines advocate that the management of back pain should reflect this multidimensional complexity. Cognitive functional therapy (CFT) is a behaviourally oriented intervention that targets patients' individual BPS profiles. Although the efficacy of CFT has been demonstrated in primary care, little evidence exists about the training requirements of this approach. Methods:Qualitative semistructured interviews were conducted with 10 physiotherapists working in primary care, who had undergone a formal training programme in CFT. A purposive sampling method was employed to seek the broadest perspectives. Thematic analysis was used to analyse the interview transcripts and capture the emergent themes. Results:Five main themes emerged: (i) the learning challenge; (ii) self‐reported changes in confidence; (iii) self‐reported changes in communication practice; (iv) self‐reported changes in attitudes and understanding; (v) the physiotherapists felt that CFT was more effective than their usual approach for NSCLBP but identified barriers to successful implementation, which included a lack of time and difficulties in engaging patients with strong biomedical beliefs. Conclusions:The study suggested that training in CFT has the capacity to produce self‐reported changes in physiotherapists' attitudes, confidence and practice. The provision of such training has implications in terms of time and costs; however, this this may be warranted, given the physiotherapists' strong allegiance to the approach compared with their usual practice.

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Crossref · 10.1002/msc.1370

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Authors
Cowell, I., O'Sullivan, P., O'Sullivan, K., Poyton, R., McGregor, A., & Murtagh, G.
Affiliations
  • Imperial College London (GB)
  • School of Physiotherapy and Exercise Science Curtin University Perth WA Australia
  • School of Allied Health University of Limerick Limerick Ireland
Corresponding author
Cowell, Ian
Venue
Musculoskeletal Care
Publisher
Wiley
Published
2018-11-23
Volume
17
Issue
1
Pages
79-90
ISSN
  • 1478-2189 (ISSN-L)
  • 1557-0681
OpenAlex
W2900883344
Cited by
41
References
44
Citations by year
2026: 5 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 3 · 2021: 4 · 2020: 10
FWCI
2.26
Type
journal article
Language
en
Open access
closed
Locations
  • Musculoskeletal Care (publishedVersion)
  • PubMed (publishedVersion)
  • Spiral (Imperial College London) (submittedVersion)
Funders
  • Musculoskeletal Association of Chartered Physiotherapists (Doctoral award)
  • Private Physiotherapy Educational Foundation (164)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Rehabilitation › Musculoskeletal Disorders and Rehabilitation
Keywords
cognitive functional therapy, chronic non-specific low back pain, physiotherapists, training program, biopsychosocial model, primary care, clinician attitudes, clinician confidence, clinician-patient communication, implementation barriers
MeSH terms
Adult, Clinical Competence, Female, Humans, Health Knowledge, Attitudes, Practice, London, Male, Cognitive Behavioral Therapy, Low Back Pain, Qualitative Research, Physical Therapists

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