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

Abstract

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. 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). 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. 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.