Table 2.

Clinical results of the included studies.

Study	Intervention (s)	Control	Follow-Up	Outcomes (Tool)	Conclusion
Cherkin et al., 2016	Mindfulness: body scan, yoga, meditation, for 8 weeks. CBT: education about chronic pain, relationships between thoughts and emotional and physical reactions, sleep hygiene, setting and working toward behavioral goals, relaxation skills, activity pacing, and pain-coping strategies, for 8 weeks	Usual care (whatever care participants received)	12 months	Disability (RMDQ) QoL (SF-12) Depression (PHQ-8) Anxiety (GAD-2)	Among adults with CLBP, treatment with MBSR or CBT, compared with usual care, resulted in greater improvement in back pain and functional limitations at 26 weeks, with no significant differences in outcomes between MBSR and CBT
Monticone et al., 2013	CBT: intervention to modify fear of movement beliefs, catastrophizing thinking, and negative feelings, and ensuring gradual reactions to illness behaviors, for 5 weeks	Active and passive mobilizations of the spine, and exercises aimed at stretching and strengthening muscles, and improving postural control, for 5 weeks	12 months	Disability (RMDQ) Pain (NRS) QOL (SF-36) Fear advoidance behaviours (TSK)	The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear- avoidance beliefs and pain, and enhancing the quality of life of patients with chronic low back pain. The effects were clinically tangible and lasted for at least 1 year after the intervention ended.
Johnson et al., 2007	CBT: educational pack containing a booklet and audio-cassette + problem solving, pacing and regulation of activity, challenging distorted cognitions about activity and harm, for 6 week	Educational pack containing a booklet and audio-cassette + usual care for 6 weeks	15 months	Pain (VAS) Disability (RMDQ) QoL (EQ-5D)	CBT intervention program produces only modest effects in reducing LBP and disability over a 1-year period.
Smeets et al., 2006	CBT: operant behavioral graded activity training and problem solving training Active Physical Treatment (APT): aerobic training, and three dynamic static strengthening exercises for 4 weeks Combined Treatment (CT): CBT + APT	Waiting List (WL) for 10 weeks	12 months	Disability (RMDQ) Pain (VAS) Depression (BDI)	CBT are as effective in reducing the subjective experienced level of functioning
Rutledge et al., 2018	CBT: to provide core educational information, guide patients’ learning and skills development, and structure self-monitoring exercises for the respective session, for 8 weeks	Supportive Care: - Education by distribution of a standard text - Active Listening by the therapist to participant’s concerns - Supportive care following Rogerian principles	12 months	Disability (RMDQ) Pain (NRS) Depression (BDI)	No evidence of meaningful effect size differences between the treatments.
Rutledgeet al., 2018	CBT: managing pain, managing stress, thinking differently, assertive communication, setting goals for 8 weeks	Supportive Care: - Education by distribution of a standard text - Active Listening by the therapist to participant’s concerns - Supportive care following Rogerian principles	12 months	Disability (RMDQ) Pain (NRS)	CBT versus SC therapy demonstrated statistically significant and comparable patterns of improved outcomes on measures of back pain disability, pain severity, and self- rated improvement.
Linden et al., 2014	general orthopedic inpatient treatment + therapy in reference to the GRIP and the pain and illness management program from Geissner at al. with additional cognitive behavior therapy interventions which aim at stress reduction and problem solving, self monitoring, pain management, change in dysfunctional cognitions, reduction of avoidance behavior, and wellbeing therapy for 3 weeks	General orthopedic inpatient treatment	3 weeks	Fear advoidance behaviours (FABQ) Pain (VAS) Pain related disability (PDI)	CBT can reduce back pain and increase functional coping, and that this is not mediated by an improvement in mental health and a reduction of depression, anxiety or somatization in general or by induc- tion of some general optimistic views. Pain is not identical with mental problems.
Khan et al., 2016	general exercise + CBT aimed to guide patients to achieve their daily life goals. CBT consisted of operant behavioural graded activity and problem solving training, for 12 weeks	General exercise at home 2 times per day and at least 5 times a week (for 12 weeks)	12 weeks	Disability (RMDQ) Pain (VAS)	This study found that both CBT with General exercises and General exercises alone significantly reduced pain intensity and disability in patients with chronic low back pain. Furthermore, subjects treated with CBT & Exercises showed an additional clinical benefit as compared to General Exercises only. Hence, CBT & Exercises could be a better option in clinical practice.
Pincus et al., 2015	Session content was not structured, and at the discretion of therapists, included any features of Contextual Cognitive-Behavioural Therapy (CCBT) they thought were appropriate at the point with that patient.	Physiotherapy, comprised back to fitness group exercises with at least 60% of content exercise-based.	3 months	Fear advoidance behaviours (TSK) pain (Brief Pain Inventory) disability (RMDQ) anxiety and depression (HADS) QoL (EQ-5D and SF-36)	CCBT is a credible and acceptable intervention for LBP patients who exhibit psychological obstacles to recovery.
Basler et al., 1997	medical treatment such as pain medication, nerve blocks, TENS, and physical therapy + CBT therapy: education, relaxation, Modifying thoughts and feelings, Pleasant activity scheduling, Training of posture	Medical treatment such as pain medication, nerve blocks, TENS, and physical therapy	6 months	Pain (NRS) Disability (Dusseldorf disability scale)	Experimental subjects reported less pain, more pleasurable activities and feelings, less avoidance and less catastrophizing, and disability was reduced. The results were maintained at follow-up. Patients who only received medical treatment showed little improvement. Data indicate that the program meets the needs of the patients and should be continued.
Linton et al., 2007	Sessions were organized to activate participants and promote coping. Each session began with a short review, in which homework was covered. The treatment lasts 6 weeks	1. pamphlet: straightforward advice about the best way to cope with back pain by remaining active and thinking positively. 2. Information package: advice and illustrations showing how the patient might cope with spinal pain or prevent it by such methods as lifting properly and main- taining good posture.	12 months	Pain (VAS) Depression and anxiety (HAD) Fear Advoidance (FABQ)	This study demonstrates that CBT group intervention can lower the risk of a long-term disability developing.
Zgierska et al., 2016	Usual care and opioid therapy management + manualized training in the meditation-CBT intervention 2 h per week for 8 weeks	Pharmacotherapy, opioid therapy management and physical therapy	26 weeks	Pain (Brief Pain Inventory) Disability (ODI)	Mindfulness meditation and CBT-based interventions have the potential to safely reduce pain severity and sensitivity in patients with opioid-treated CLBP
Morone et al., 2008	Mindfulness: body scan, sitting practice, walking meditation	Waiting List	3 months	Pain (McGill pain Questionnaire- Short Form and SF-36 pain scale) Disability (RMDQ) QoL (SF-36)	The mindfulness intervention sustained improvement in physical function and pain acceptance.
Morone et al., 2009	Mindfulness: body scan, sitting practice, walking meditation	Educational program (8 weeks), including lectures, group discussion, and homework assignments based on the health topics discussed	4 months	Disability (RMDQ) Pain (McGill pain Questionnaire- Short Form and SF-36 pain scale) QoL (SF-36)	A mindfulness meditation program and an education control group both showed improvement at program completion on measures of pain, and physical and psychological function.
Morone et al., 2016	Mindfulness: body scan, sitting practice, walking meditation for 8 weeks	Educational program on a successful aging curriculum known as the 10 Keys to Healthy Aging	6 months	Disability (RMDQ) Pain (NRS) QoL (SF-36)	A mind-body program for chronic LBP improved short-term function and long-term current and most severe pain. The functional improvement was not sustained.
Day et al., 2019	MBCT for pain protocol integrates cognitive and be- havioral techniques with mindfulness-based strategies	CT techniques delivered: treatment involved traditional Beckian style column technique restructuring exercises Mindufulness: cognitive-behavioral and mindful movement components removed	6 months	Pain (NRS) Physical function (PROMIS) Depression (PROMIS)	The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sus- tained benefits that exceed MM on some important CLBP outcomes.