How Movement Is Assessed Matters. Changes in Forward Bending During Cognitive Functional Therapy Treatment for People...

Area of Science:

• Biomechanics of the spine
• Rehabilitation science
• Musculoskeletal physiotherapy

Background:

• Low back pain (LBP) is a prevalent condition affecting mobility.
• Cognitive Functional Therapy (CFT) is a treatment approach for LBP.
• Understanding changes in trunk and pelvic motion during therapeutic interventions is crucial.

Purpose of the Study:

• To investigate changes in forward bending range of motion (ROM) and velocity in LBP patients undergoing CFT.
• To determine the timing and magnitude of these changes in the trunk, pelvis, and lumbar spine.
• To compare changes between participants with and without sensor biofeedback and baseline movement limitations.

Main Methods:

• Observational study involving 261 LBP patients receiving CFT.
• Motion sensors (T12 and S2 levels) measured ROM and velocity during forward bending.
• Regression models and time-group interactions analyzed changes over 90 days, subgrouped by biofeedback and baseline movement.

Main Results:

• Most changes in ROM and velocity occurred within the first 21 days of CFT.
• Significant increases in ROM at T12 and S2, and velocity at T12, S2, and intersensor angle were observed.
• Sensor biofeedback did not significantly augment changes; participants with baseline movement limitations showed larger improvements.

Conclusions:

• CFT leads to rapid improvements in forward bending ROM and velocity, particularly within the initial 21 days.
• Improvements are more pronounced in individuals with baseline movement restrictions.
• Clinicians should monitor velocity and global ROM changes when targeting forward bending in LBP patients, as biofeedback offers minimal added benefit.