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Exercise combined with Acceptance and Commitment Therapy for chronic pain: One-year follow-up from a randomized controlled trial.
Casey, M B; Takemasa, S; O'Reilly, T; Leamy, M; Mc Kearney, E; Buckley, M; Smart, K M; Segurado, R; Lowry, D; Flanagan, D; Gopal, H; Hearty, C; Doody, C.
Afiliación
  • Casey MB; Department of Public Health & Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
  • Takemasa S; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • O'Reilly T; Clinical Development, Clinical Development Centre, Asahi Kasei Pharma Corporation, Tokyo, Japan.
  • Leamy M; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • Mc Kearney E; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • Buckley M; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • Smart KM; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • Segurado R; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • Lowry D; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.
  • Flanagan D; Department of Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Gopal H; Department of Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Hearty C; Department of Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Doody C; Department of Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
Eur J Pain ; 28(6): 913-928, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38348557
ABSTRACT

BACKGROUND:

Acceptance and Commitment Therapy (ACT) is a type of Cognitive Behavioural Therapy, which has demonstrated positive outcomes in individuals with chronic pain. The purpose of this study was to compare the effect of an 8-week programme combining Exercise with Acceptance and Commitment Therapy (ExACT) with a standalone supervised exercise programme at 1-year follow-up.

METHODS:

One hundred and seventy-five people with chronic pain were randomly assigned to ExACT or supervised exercise only. The primary outcome was pain interference measured with the Brief Pain Inventory-Interference Scale. Secondary and treatment process outcomes included pain severity, depression, anxiety, pain catastrophizing, pain self-efficacy, fear avoidance, pain acceptance, committed action, healthcare utilization, patient satisfaction, and global impression of change. Estimates of treatment effects at 1-year follow-up were based on intention-to-treat analyses, implemented using a linear mixed-effects model.

RESULTS:

Eighty-three participants (47.4%) returned the outcome measures at 1-year follow-up. No significant difference was observed between the groups for the primary outcome, pain interference. There was a statistically significant difference between the groups, in favour of ExACT for pain catastrophizing. Within group improvements that were observed within both groups at earlier timepoints were maintained at 1-year follow-up for many of the secondary and treatment process outcomes. ExACT group participants reported higher levels of satisfaction with treatment and global perceived change.

CONCLUSIONS:

The study results showed no significant difference between the two groups for the primary outcome pain interference at 1-year follow-up. Future research could investigate factors that may predict and optimize outcomes from these types of intervention for people living with chronic pain.

SIGNIFICANCE:

Few previous randomized controlled trials investigating ACT for chronic pain have included long-term follow-up. This study found that Exercise combined with ACT was not superior to supervised exercise alone for reducing pain interference at 1-year follow-up. Further research is necessary to identify key processes of therapeutic change and to explore how interventions may be modified to enhance clinical outcomes for people with chronic pain.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia por Ejercicio / Dolor Crónico / Terapia de Aceptación y Compromiso Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Pain Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia por Ejercicio / Dolor Crónico / Terapia de Aceptación y Compromiso Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Pain Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Reino Unido