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PHYSIOTHERAPY INFORMED BY ACCEPTANCE AND COMMITMENT THERAPY FOR PERSISTENT LOW BACK PAIN: THE PACT STUDY

Research output: Chapter in Book/Report/Conference proceedingConference paper

Duncan John Critchley, Lance McCracken, Ranbir Talewar, Walker Nicholas, Duncan Sanders, Emma Louise Godfrey

Original languageEnglish
Title of host publicationPhysiotherapy
Pagese277
Volume101
EditionS1
DOIs
Publication statusPublished - May 2015

King's Authors

Abstract

Background: Many persistent low back pain (LBP) interventions have small-moderate effects on pain and disability with none clearly superior. Cognitive behavioural therapy approaches are popular but often incorporates many methods without attention to key therapeutic processes leading to less focused and effective treatment. Acceptance and Commitment Therapy (ACT) is a promising theory-based form of cognitive behavioural therapy effective in persistent pain. It is particularly appropriate for physiotherapist-led delivery since it emphasises goal setting, behavioural activation, and improving function despite pain, mirroring many physiotherapy management strategies. Physiotherapist-delivered management based on ACT has not been evaluated. Purpose: To examine the feasibility and acceptability of a physiotherapist-delivered intervention informed by Acceptance and Commitment Therapy for people with persistent low back pain. Methods: We developed a brief physiotherapist-delivered ACT-based intervention 'PACT' consisting of two one hour sessions plus a follow-up phone call. PACT aims to enhance psychological flexibility and reduce struggle with pain. This involves helping people to accept their pain and related feelings, become more aware of the present and less dominated by thoughts and beliefs about pain, and values-based goal-setting. PACT was delivered by an experienced physiotherapist following two days training from a professor in behavioral medicine highly experienced in ACT. Participants with non-specific low back pain referred for physiotherapy were recruited from a London UK, public hospital. Outcomes immediately post-intervention were evaluated both qualitatively and quantitatively. All quantitative data are presented as means (standard deviations).

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