This study aimed to evaluate the potential of CFT within an interdisciplinary care program for patients with generalized, high-impact PMP. Further objectives included documenting the clinical processes and exploring changes and associations in pain, disability, movement behavior, subjective overall improvement, health-related quality of life (HRQoL), and work status. The goal was to contribute evidence supporting the integration of CFT into interdisciplinary care and advance the translation of biopsychosocial principles into clinical practice.
A single-case experimental design was conducted with three patients suffering from long-term, high-impact PMP affecting the lumbar spine, shoulder, and knee. CFT was integrated into a holistic interdisciplinary approach with a physiotherapist, job coach, and mental coach, after referral by a case manager and physician. The 12-month intervention was structured into six modules targeting illness cognition, functional capacity, and work-related capacity. Outcome measures included pain (NRS), functional limitations (Patient-Specific Functional Scale), video analysis for movement behavior quantification, disability (Oswestry Disability Index, DASH-G, VISA-P-G), HRQoL (SF-12), subjective overall improvement and work status. Visual and statistical analyses, including Nonoverlap of All Pairs (NAP), were used to evaluate the intervention’s impact. A cross-lagged correlation analysis, using Simulation Modeling Analysis, was conducted to examine temporal associations.
All three patients completed the intervention. After introducing the intervention systematic changes were seen, with medium to large changes (Nonoverlap of All Pairs 0.67–1) for all outcome measures. Associations between outcome changes were strong (r ≥ 0.50), with concurrent improvements noted. Minimally clinically important difference thresholds were surpassed for all outcomes, and two patients achieved relevant improvements in work reintegration.
This study provides evidence that CFT, integrated into an interdisciplinary care framework, significantly improves pain, disability, movement behaviors, HRQoL, and work status in patients with PMP. The 12-month intervention enabled sustained progress, with gains maintained at follow-up. These findings align with existing CFT literature and extend its application to a heterogeneous PMP population within interdisciplinary care. Notably, the 12-month duration, longer than in many CFT interventions, allowed for continuous improvements, suggesting that extended interventions may offer greater sustained benefits within this patient group. Further research is required to replicate these results across a broader population and clinical settings.
This study explores the applicability of CFT in a heterogeneous population within an interdisciplinary setting, addressing the complex needs of PMP. The detailed descriptions of the clinical processes aim to improve clinical care. The results underscore CFT’s potential to improve clinical, functional, and occupational goals, critical for improving patient quality of life and reducing societal burden.
Behavioral change
Biopsychosocial
