Table 2 Components of each treatment protocol used in the trial

Patho-anatomical/physiological explanation including generally favourable prognosis

✔

✔

✔

✔

X

✔

Advice in accordance with Indahl et al. [35]

X

X

X

X

X

✔

Explanation of pain physiology and central sensitisation for ongoing pain with multiple biopsychosocial contributing factors

O

O

O

O

✔

X

Discussion of treatment options available

✔

✔

✔

✔

✔

X

Discussion of timeframes and expectations

✔

✔

✔

✔

✔

X

Posture education including lifting technique

✔

✔

✔

O

X

X

Teaching pacing and graded exposure strategies

✔

✔

✔

O

✔

X

Goal setting (establishment and regular reviews)

✔

✔

✔

✔

✔

X

Specific motor control training (transversus abdominis, lumbar multifidus and pelvic floor)

✔

✔

✔

✔

O

X

Teaching and supervision of functional restoration exercises in the clinic with additional sessions at home

✔

✔

X

X

✔

X

Demonstration of functional restoration exercises for implementation at home

X

X

✔

✔

X

X

Education regarding pain management strategies (pharmacological)

O

O

O

O

O

X

Education regarding pain management strategies (non-pharmacological)

O

O

O

O

O

X

Strategies to control inflammation

O

O

O

O

O

X

Application of strapping tape to lumbar spine

✔

✔

✔

O

X

X

Discussion of strategies to manage work issues

O

O

O

O

O

X

Directional preference management (McKenzie program)...includes mechanical loading strategies, repeated movements, walking program, taping, and postural advice

O

O

✔

X

X

X

Manual therapy

X

X

X

✔

X

X

Relaxation strategies

O

O

O

O

O

X

Sleep strategies

O

O

O

O

O

X

Management of increases in pain

O

O

O

O

X

X

Explanation of improvement in function V's improvement in pain

O

O

O

O

X

X

Cognitive restructuring of counterproductive beliefs (via use of information sheets relating to the above treatment components)

✔

✔

✔

✔

✔

X

Behavioural strategies to support and reinforce the education and information provided and to modify unproductive behaviours

✔

✔

✔

✔

✔

X

Transfer to MFP protocol if inadequate progress with pathoanatomical approach after five sessions

O

O

O

O

X

X

Targeted cognitive restructuring and behavioural modification based on review of the Orebro Musculoskeletal Pain Questionnaire subscales

X

X

X

X

✔

X

Specific discussion of psychosocial barriers as an explanation for failure to recover

O

O

O

O

✔

X

Discharge planning for long-term management

✔

✔

✔

✔

✔

X