A total of 49 women with CPP for >6 months and kinesiophobia were recruited from a gynaecological service in Spain and were randomly allocated into one of three groups:
- Patient-centered graded exposure therapy (GET) added to manual therapy (6 sessions of GET + 12 sessions of manual therapy);
- Manual therapy (12 sessions);
- Control (received booklet about CPP).
Graded exposure therapy involved the participant identifying their five most fearful movements and re-introducing them to such movements in a graded manner over a six-week period. The manual therapy component included soft tissue mobilizations and myofascial release (20 mins), deep-pressure massage (10 mins) and muscle energy techniques (10 mins).
Prior to and after the intervention period, all participants were assessed with a variety of outcome measures focusing on:
- Fear avoidance beliefs;
- Pain interference with activities of daily living;
- Severity of pain;
- Level of disability.
The results indicate a significant improvement in all outcomes in the manual therapy with added GET group (within group difference) and compared to the other groups (between group difference) immediately following the intervention period and at three months follow-up. The manual therapy group demonstrated significant improvements in all outcomes except pain interference compared to the control group at three months follow-up.