Effects of Commitment and Acceptance Therapy and Training on the Chronic Pain Clinical Pain Advisor

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The results of a randomized controlled study showed it was not effective. Acceptance and Commitment Therapy (ACT) when combined with exercise supervision was ineffective for reducing discomfort among people suffering from chronic pain. The findings are published in the journal Pain..

The combination training as well as ACT study was a single-center, two-arm parallel group, controlled by a randomized superiority study conducted by Mater Misericordiae University Hospital in Ireland between 2017 and the year 2018. Adults (N=175) suffering from non-cancer-related chronic pain and with a Brief Pain Inventory (BPI) interference subscale score of minimum 2 were randomly assigned to receive either a mix with exercise ACT (n=87) and exercise by itself (n=88). The main outcome was the changes in pain interference over 12 weeks.

These activity trackers were worn by the participants throughout the day for a week prior to the start of the intervention and for the entire duration of the intervention (9 weeks total).

The program consisted of 8 sessions every week, which included two hours of psychotherapy group therapy which was focused on the improvement of mindfulness and psychologic flexibility which was and then 1.5 hours of gym supervisedor hydrotherapy-based exercises. The exercise-only intervention comprised just 1.5 hours of gymnasium supervisionor hydrotherapy-based exercises.

In the case of participants who received an exercise-based combination with ACT and those who were given exercise on its own, the mean age range was 48.41+-10.39 as well as 47.69+-11.67 years. Sixty-nine percent and 72.7 percent were females and the median length of the suffering measured 8.83+-7.52 respectively. 10.07+-8.29 years and 10.07+-8.29 years, respectively. Furthermore, those who participated of the combined intervention as well as exercise-only groups suffered the same amount of pain in a variety of locations (mean, 4.14+-2.39 vs 4.44+-2.34) as well as 78.2 percent and 70.1 percent were not employed and 70.1% were employed.

In comparison to patients in the group that received intervention, the percentage of patients who were absent during each treatment (17 percent against 11.5 percent) and withdrawal from study (17 percent against 13.8%)) were significantly higher in the group who exercised alone. Out of the eight total sessions, those in the intervention group took part in an average of 4.94+-2.73 sessions while those in the exercise-only group attended a median 4.42+-2.71 sessions. 4.42+-2.71 sessions.

Comparatively to the baseline data, participants in the intervention group saw significant decreases in BPI subscale scores of interference at the end of the treatment (mean, 6.86 vs 6.4; P =.03) and scores remained steady until the week twelve (mean, 6.36; P =.03). There was no significant reduction in BPI scores on the interference subscale was reported by participants in the exercise-only group at the conclusion of treatment (mean, 6.92 vs 6.62; P =.185) as well as scores measured in Week twelve (mean, 6.59; P =.17).

Despite the significant longitudinal patterns that were observed between the groups, no significant differences between groups in BPI scores on the interference subscale were found after the sessions were all finished (mean difference [MDof -0.17 (95 percent 95% CI, -0.78 to 0.44; P =.58) and in week 12 (MD, -0.18; 95 percent C.I, -0.84 to 0.48; P =.59).

The study was hindered by the inability of blinding participants to their specific group assignment, as well as the amount of participants missing follow-up.

The researchers concluded that “further research on participants with different levels of pain severity at baseline are required.”


Disclosure: The author has disclosed affiliations with the industry. Check the original reference for a complete list disclosures.

References:

Casey M-B, Smart KM, Segurado R, et al. Exercise in conjunction with Acceptance and Commitment Therapy as compared to a stand-alone program of exercise that is supervised for people suffering from chronic pain in a randomised controlled trial. Pain. 2022;163(6):1158-1171. doi:10.1097/j.pain.0000000000002487