Chronic Pain
Conditions
Keywords
pain, rehabilitation, exercise, psychological, intervention
Brief summary
Only to a limited extent has been compared the effectiveness of physical exercise and psychological interventions in subjects with chronic pain. Knowledge about this is necessary in order to compose optimal multimodal rehabilitation programs at different health care levels. Moreover, assuming that both types of interventions have effects, these effects may necessarily not concern the same outcome variables. Therefore it may be important to understand to what extent the effects overlap and the extent to which the effects are isolated to an intervention. The overall strategic purpose of the present study is to develop effective multimodal rehabilitation programs. In this study the effectiveness of following three interventions are compared. * Group-based rehabilitation according to a concept based on an Acceptance and Commitment Training -Stress Management Intervention (ACT-SMI) * Group-based rehabilitation compromised of physical exercise (Exercise). * Group-based discussion concerning pain and its consequences (i.e., the control group, CON) The effectiveness is investigated with respect to long-term effects on pain and its consequences, including perceived health and return to work / sick leave. The overall hypothesis is that the former intervention means better long-term results because it clearly helps the individual to process the psychological aspects of itself likely to have long lasting effects.
Interventions
BEHAVIORALACT
ACT is a type of Cognitive behavioral Therapy (CBT) that focuses on acceptance and mindfulness. The aim is to prevent avoidance and control of negative private events such as anxiety or pain. The treatment consists of 7 weekly group sessions, 2 hours a week. The participants are given homework between sessions.
OTHERPhysical activity
Participants are going to perform a training programme including aerobic exercise as well as endurance and strength training for the neck, shoulders, low back, core and leg muscles. The training is group-based and supervised by a physiotherapist two times a week, one hour a time for eight weeks. Home exercises twice a week are also a part of the intervention. It is possible to individually adjust movements and intensity to the participants' capacity if needed.
Sponsors
Linkoeping University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* chronic pain in the neck and/or back with or without pain in one or more quadrants of the body
Exclusion criteria
* Inflammatory and neurological diseases, severe social and/or psychological problems, patients that already have taken part in multidisciplinary rehabilitation programs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain intensity | Change from baseline pain intensity at 12 months | Pain intensity recent 7 days using a numeric rating scale |
| Change in Depression | Change from baseline depression at 12 months | Depression scale of Hospital Anxiety and Depression Scale (HADS) |
| Change in Catastrophizing | Change from baseline catastrophizing at 12 months | The Pain Catastrophizing Scale (PCS) |
| Change in Acceptance | Change from baseline acceptance at 12 months | The Chronic Pain Acceptance Questionnaire (CPAQ) |
| Change in Disability | Change from baseline disability at 12 months | Pain Disability Index (PDI) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Health | Change from baseline health at 12 months | The EuroQol instrument |
| Change in Disability2 | Change from baseline disability2 at 12 months | Oswestry Disability Index (ODI) |
| Change in Life satisfaction | Change from baseline life satisfaction at 12 months | The Life Satisfaction Questionnaire. |
| Change in Flexibility | Change from baseline flexibility at 12 months | The Psychological Inflexibility in Pain Scale (PIPS) |
| Change in Insomnia | Change from baseline insomnia at 12 months | The Insomnia Severity Index (ISI) |
| Change in Fear-avoidance beliefs | Change from baseline fear-avoidance at 12 months | Fear-Avoidance Beliefs Questionnaire (FABQ) |
Countries
Sweden
Outcome results
None listed