Only to a limited extent has been compared the effectiveness of physical exercise and psychological interventions in subjects with chronic pain. Knowledge about this is necessary in order to compose optimal multimodal rehabilitation programs at different health care levels. Moreover, assuming that both types of interventions have effects, these effects may necessarily not concern the same outcome variables. Therefore it may be important to understand to what extent the effects overlap and the extent to which the effects are isolated to an intervention. The overall strategic purpose of the present study is to develop effective multimodal rehabilitation programs. In this study the effectiveness of following three interventions are compared. * Group-based rehabilitation according to a concept based on an Acceptance and Commitment Training -Stress Management Intervention (ACT-SMI) * Group-based rehabilitation compromised of physical exercise (Exercise). * Group-based discussion concerning pain and its consequences (i.e., the control group, CON) The effectiveness is investigated with respect to long-term effects on pain and its consequences, including perceived health and return to work / sick leave. The overall hypothesis is that the former intervention means better long-term results because it clearly helps the individual to process the psychological aspects of itself likely to have long lasting effects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
180
ACT is a type of Cognitive behavioral Therapy (CBT) that focuses on acceptance and mindfulness. The aim is to prevent avoidance and control of negative private events such as anxiety or pain. The treatment consists of 7 weekly group sessions, 2 hours a week. The participants are given homework between sessions.
Participants are going to perform a training programme including aerobic exercise as well as endurance and strength training for the neck, shoulders, low back, core and leg muscles. The training is group-based and supervised by a physiotherapist two times a week, one hour a time for eight weeks. Home exercises twice a week are also a part of the intervention. It is possible to individually adjust movements and intensity to the participants' capacity if needed.
Rehabilitation medicine, IMH, Linköping University
Linköping, Östergötland County, Sweden
Change in Pain intensity
Pain intensity recent 7 days using a numeric rating scale
Time frame: Change from baseline pain intensity at 12 months
Change in Depression
Depression scale of Hospital Anxiety and Depression Scale (HADS)
Time frame: Change from baseline depression at 12 months
Change in Catastrophizing
The Pain Catastrophizing Scale (PCS)
Time frame: Change from baseline catastrophizing at 12 months
Change in Acceptance
The Chronic Pain Acceptance Questionnaire (CPAQ)
Time frame: Change from baseline acceptance at 12 months
Change in Disability
Pain Disability Index (PDI)
Time frame: Change from baseline disability at 12 months
Change in Flexibility
The Psychological Inflexibility in Pain Scale (PIPS)
Time frame: Change from baseline flexibility at 12 months
Change in Insomnia
The Insomnia Severity Index (ISI)
Time frame: Change from baseline insomnia at 12 months
Change in Fear-avoidance beliefs
Fear-Avoidance Beliefs Questionnaire (FABQ)
Time frame: Change from baseline fear-avoidance at 12 months
Change in Disability2
Oswestry Disability Index (ODI)
Time frame: Change from baseline disability2 at 12 months
Change in Health
The EuroQol instrument
Time frame: Change from baseline health at 12 months
Change in Life satisfaction
The Life Satisfaction Questionnaire.
Time frame: Change from baseline life satisfaction at 12 months
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