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Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain: A Randomized Controlled Trial

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Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain : A Randomized Controlled Trial. / Godfrey, Emma; Wileman, Vari; Galea Holmes, Melissa; McCracken, Lance M.; Norton, Sam; Moss-Morris, Rona; Noonan, Sandra; Barcellona, Massimo; Critchley, Duncan.

In: JOURNAL OF PAIN, 05.06.2019.

Research output: Contribution to journalArticle

Harvard

Godfrey, E, Wileman, V, Galea Holmes, M, McCracken, LM, Norton, S, Moss-Morris, R, Noonan, S, Barcellona, M & Critchley, D 2019, 'Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain: A Randomized Controlled Trial', JOURNAL OF PAIN. https://doi.org/10.1016/j.jpain.2019.05.012

APA

Godfrey, E., Wileman, V., Galea Holmes, M., McCracken, L. M., Norton, S., Moss-Morris, R., ... Critchley, D. (2019). Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain: A Randomized Controlled Trial. JOURNAL OF PAIN. https://doi.org/10.1016/j.jpain.2019.05.012

Vancouver

Godfrey E, Wileman V, Galea Holmes M, McCracken LM, Norton S, Moss-Morris R et al. Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain: A Randomized Controlled Trial. JOURNAL OF PAIN. 2019 Jun 5. https://doi.org/10.1016/j.jpain.2019.05.012

Author

Godfrey, Emma ; Wileman, Vari ; Galea Holmes, Melissa ; McCracken, Lance M. ; Norton, Sam ; Moss-Morris, Rona ; Noonan, Sandra ; Barcellona, Massimo ; Critchley, Duncan. / Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain : A Randomized Controlled Trial. In: JOURNAL OF PAIN. 2019.

Bibtex Download

@article{379d5912399447c4aaaca10d45caf12f,
title = "Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain: A Randomized Controlled Trial",
abstract = "Chronic low back pain (CLBP) is a major cause of global disability and improving management is essential. Acceptance and commitment therapy (ACT) is a promising treatment for chronic pain but has not been modified for physical therapy. This randomized controlled trial (RCT) compared physical therapy informed by ACT (PACT) against standard care physical therapy for patients with CLBP. Patients with CLBP (duration ≥12 weeks, mean 3 years) were recruited from physical therapy clinics in 4 UK public hospitals. The Roland-Morris Disability Questionnaire (RMDQ) at 3 months’ post-randomization was the primary outcome. Two hundred forty-eight participants (59{\%} female, mean age = 48) were recruited and 219 (88.3{\%}) completed measures at 3 and/or 12 months’ follow-up. At 3 months, PACT participants reported better outcomes for disability (RMDQ mean difference = 1.07, p =.037, 95{\%} CI = −2.08 to −.07, d =.2), Patient Specific Functioning (p =.008), SF12 physical health (p =.032), and treatment credibility (p <.001). At 12 months’ follow-up, there were no significant differences between groups. PACT was acceptable to patients and clinicians and feasible to deliver. Physical therapists incorporated psychological principles successfully and treatment was delivered with high (≥80{\%}) fidelity. Our results may inform the management of CLBP, with potential benefits for patients, health care providers, and society. Perspective: Psychologically informed physical therapy has great potential but there are challenges in implementation. The training and support included in the PACT trial enabled the intervention to be delivered as planned. This successfully reduced disability in the short but not long term. Findings could inform physical therapists’ treatment of CLBP.",
keywords = "acceptance and commitment therapy, Chronic low back pain, physical therapy, randomized controlled trial",
author = "Emma Godfrey and Vari Wileman and {Galea Holmes}, Melissa and McCracken, {Lance M.} and Sam Norton and Rona Moss-Morris and Sandra Noonan and Massimo Barcellona and Duncan Critchley",
year = "2019",
month = "6",
day = "5",
doi = "10.1016/j.jpain.2019.05.012",
language = "English",
journal = "JOURNAL OF PAIN",
issn = "1526-5900",
publisher = "Churchill Livingstone",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Physical Therapy Informed by Acceptance and Commitment Therapy (PACT) Versus Usual Care Physical Therapy for Adults With Chronic Low Back Pain

T2 - A Randomized Controlled Trial

AU - Godfrey, Emma

AU - Wileman, Vari

AU - Galea Holmes, Melissa

AU - McCracken, Lance M.

AU - Norton, Sam

AU - Moss-Morris, Rona

AU - Noonan, Sandra

AU - Barcellona, Massimo

AU - Critchley, Duncan

PY - 2019/6/5

Y1 - 2019/6/5

N2 - Chronic low back pain (CLBP) is a major cause of global disability and improving management is essential. Acceptance and commitment therapy (ACT) is a promising treatment for chronic pain but has not been modified for physical therapy. This randomized controlled trial (RCT) compared physical therapy informed by ACT (PACT) against standard care physical therapy for patients with CLBP. Patients with CLBP (duration ≥12 weeks, mean 3 years) were recruited from physical therapy clinics in 4 UK public hospitals. The Roland-Morris Disability Questionnaire (RMDQ) at 3 months’ post-randomization was the primary outcome. Two hundred forty-eight participants (59% female, mean age = 48) were recruited and 219 (88.3%) completed measures at 3 and/or 12 months’ follow-up. At 3 months, PACT participants reported better outcomes for disability (RMDQ mean difference = 1.07, p =.037, 95% CI = −2.08 to −.07, d =.2), Patient Specific Functioning (p =.008), SF12 physical health (p =.032), and treatment credibility (p <.001). At 12 months’ follow-up, there were no significant differences between groups. PACT was acceptable to patients and clinicians and feasible to deliver. Physical therapists incorporated psychological principles successfully and treatment was delivered with high (≥80%) fidelity. Our results may inform the management of CLBP, with potential benefits for patients, health care providers, and society. Perspective: Psychologically informed physical therapy has great potential but there are challenges in implementation. The training and support included in the PACT trial enabled the intervention to be delivered as planned. This successfully reduced disability in the short but not long term. Findings could inform physical therapists’ treatment of CLBP.

AB - Chronic low back pain (CLBP) is a major cause of global disability and improving management is essential. Acceptance and commitment therapy (ACT) is a promising treatment for chronic pain but has not been modified for physical therapy. This randomized controlled trial (RCT) compared physical therapy informed by ACT (PACT) against standard care physical therapy for patients with CLBP. Patients with CLBP (duration ≥12 weeks, mean 3 years) were recruited from physical therapy clinics in 4 UK public hospitals. The Roland-Morris Disability Questionnaire (RMDQ) at 3 months’ post-randomization was the primary outcome. Two hundred forty-eight participants (59% female, mean age = 48) were recruited and 219 (88.3%) completed measures at 3 and/or 12 months’ follow-up. At 3 months, PACT participants reported better outcomes for disability (RMDQ mean difference = 1.07, p =.037, 95% CI = −2.08 to −.07, d =.2), Patient Specific Functioning (p =.008), SF12 physical health (p =.032), and treatment credibility (p <.001). At 12 months’ follow-up, there were no significant differences between groups. PACT was acceptable to patients and clinicians and feasible to deliver. Physical therapists incorporated psychological principles successfully and treatment was delivered with high (≥80%) fidelity. Our results may inform the management of CLBP, with potential benefits for patients, health care providers, and society. Perspective: Psychologically informed physical therapy has great potential but there are challenges in implementation. The training and support included in the PACT trial enabled the intervention to be delivered as planned. This successfully reduced disability in the short but not long term. Findings could inform physical therapists’ treatment of CLBP.

KW - acceptance and commitment therapy

KW - Chronic low back pain

KW - physical therapy

KW - randomized controlled trial

UR - http://www.scopus.com/inward/record.url?scp=85068956844&partnerID=8YFLogxK

U2 - 10.1016/j.jpain.2019.05.012

DO - 10.1016/j.jpain.2019.05.012

M3 - Article

C2 - 31173921

AN - SCOPUS:85068956844

JO - JOURNAL OF PAIN

JF - JOURNAL OF PAIN

SN - 1526-5900

ER -

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