Exercise and Acceptance and Commitment Therapy for Chronic Pain: A Case Series with One‐Year Follow‐Up

Abstract

Introduction There is growing evidence to support Acceptance and Commitment Therapy (ACT) in the management of chronic pain. However, there is a need for further research evaluating ACT combined with physical exercise, and few studies have assessed the long‐term impact of this type of intervention. This case series reports on the acceptability and impact of an ACT‐based multidisciplinary pain management programme on a range of health outcomes in both the short and long‐term. Methods Seventy‐three participants completed an 8‐week group‐based, pain management programme. The programme combined weekly sessions of ACT with education and exercise classes. Self‐report outcome measures were completed at baseline, post‐intervention and at one‐year follow‐up. The measures assessed pain intensity and interference, psychological distress, self‐efficacy, pain acceptance, values‐based action, pain catastrophizing, fear avoidance and healthcare utilization. Pedometers were worn to objectively measure physical activity. Data were analyzed using linear mixed modelling. Ethical approval for this study was granted by the Mater Misericordiae University Hospital (MMUH) Institutional Review Board (Reference 1/378/1541). Results Eighty‐six percent of respondents reported being satisfied with the intervention. Improvements were observed in most of the self‐report outcomes post‐intervention and many changes were maintained at one‐year. There was also a significant increase in average daily step‐count. Conclusion A pain management programme combining ACT with exercise appears to be an acceptable treatment option for people with chronic pain. While improvements were observed in both the short and long‐term, further fully powered RCTs with long‐term follow‐up are required to test the effectiveness of this type of intervention.

The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review

“…ACT is known as one of the third wave treatments and originates from the cognitive behavioral therapy (CBT), which increases psychological flexibility. Existing research works have shown that the effect of ACT in a 3-year follow-up has also been stable [52]. The use of this behavior therapy method has been observed in a wide range of diseases, which indicates the flexibility of this method.…”

Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial

“…In line with these results, previous studies using PE alone or in combination with psychological/cognitive techniques, reported beneficial effects on pain catastrophizing in people with FM or chronic pain, as disclosed by a number of studies. This includes those conducted by Lazaridou et al [35], in which a combined physical and psychological therapy (i.e., Yoga) was used, and those completed by Casey et al [65] who applied PE combined with Acceptance and Commitment Therapy, or conducted by Seemts et al [66] who combined aerobic exercise, mainly in water, with cognitive-behavioral treatment. These results suggest that psychological or/and physical techniques, either alone or in combination, may be beneficial to improve catastrophism in patients with chronic pain.…”

Assessing Walking Programs in Fibromyalgia: A Concordance Study between Measures

“…In this line, researchers and healthcare professionals use steps as a clinically relevant objective for the classification of a “sedentary lifestyle” and for prescribing step-based PA recommendations in people with chronic pain [ 27 , 28 ]. Specifically, studies have included self-report measures as well as objective measures to assess PA, especially walking behavior [ 29 , 30 , 31 ]. Regarding subjective measures, self-reports are the most commonly used method because they are inexpensive and easy to administer.…”