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Exercise combined with Acceptance and Commitment Therapy compared with a standalone supervised exercise programme for
Máire-Bríd Casey1, Keith M Smart1, Ricardo Segurado1
1School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland.
Pain
|December 16, 2021
Summary
Adding Acceptance and Commitment Therapy (ACT) to supervised exercise did not improve pain interference in adults with chronic pain. However, the combined approach enhanced pain self-efficacy and reduced pain catastrophizing compared to exercise alone.
Area of Science:
- Behavioral Medicine
- Clinical Psychology
- Rehabilitation Science
Background:
- Chronic pain affects millions globally, significantly impacting quality of life.
- Supervised exercise programs are a common intervention, but often augmented to improve outcomes.
- Acceptance and Commitment Therapy (ACT) shows promise in managing chronic pain through psychological flexibility.
Purpose of the Study:
- To compare the effectiveness of a combined Exercise and ACT (ExACT) intervention versus supervised exercise alone for adults with chronic pain.
- To evaluate the impact on primary outcome of pain interference and secondary outcomes including pain self-efficacy and catastrophizing.
- To assess treatment satisfaction and global impression of change.
Main Methods:
- A prospective, 2-armed, parallel group randomized controlled trial (RCT) involving 175 adults with chronic pain.
- Participants were randomized to either the ExACT intervention (8 weekly ACT sessions + supervised exercise) or supervised exercise alone.
- The primary outcome was pain interference at 12-week follow-up, analyzed using intention-to-treat principles with linear mixed-effects models.
Main Results:
- No significant difference was found in pain interference between the ExACT group and the supervised exercise alone group at 12-week follow-up (mean difference -0.18, P = 0.59).
- Participants in the ExACT group reported significantly greater improvements in pain self-efficacy, pain catastrophizing, and committed action.
- Higher treatment satisfaction and global impression of change were reported by participants in the ExACT group.
Conclusions:
- Combining ACT with supervised exercise did not demonstrate superiority over supervised exercise alone in reducing pain interference for adults with chronic pain.
- The ExACT intervention may offer benefits for psychological aspects of pain management, such as self-efficacy and catastrophizing.
- Further research could explore optimal integration of ACT within exercise programs for chronic pain populations.
