The proposed research is to develop and refine a multicomponent breathwork intervention, Guided Respiration Mindfulness Therapy, and to iteratively evaluate its feasibility, acceptability, and plausibility for clinically significant effects in people with chronic low back pain. This integrative breathwork intervention involves a 60-minute breathing session where the focus is to maintain a conscious connected breathing pattern (no pause between inhale and exhale), apply mindful acceptance to somatic sensations, and relax any physical tension. Each breathwork session will be delivered 1-on-1 in person by a trained facilitator. The treatment consists of 8 breathwork sessions, once per week for 8 weeks.
Multiple single-arm iterations of an 8-week breathwork intervention will be conducted to refine and optimize the intervention and protocol. Upon completion of each iteration, quantitative and qualitative data will be gathered to identify possible modifications before proceeding with the next iteration. This work will provide initial evidence on the feasibility, acceptability, and plausibility of clinically significant effects of this type of multicomponent breathwork intervention for adults with chronic low back pain.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
19
GRMT has three core components: respiratory regulation (i.e., sustained conscious connected breathing pattern into the upper chest where there is no pause between inhale and exhale), mindfulness of somatic sensations while breathing (i.e., interoceptive awareness with acceptance), and relaxation of physical tension. These components are the primary focus in every breathwork session. The intervention is delivered 1-on-1 in-person with a trained facilitator. Participants lay supine throughout the 60 minute session. The facilitator observes the participant's breathing pattern and guides the participant to apply the three core components. Each session ends with spontaneous, relaxed breathing and an opportunity to briefly share what happened during the session.
University of Florida
Gainesville, Florida, United States
Treatment Acceptability
Treatment acceptability and participant satisfaction of the breathwork intervention will be measured using the Client Satisfaction Questionnaire and several face valid items. (0-10; higher values = greater treatment acceptability and satisfaction).
Time frame: Post-treatment (after the 8-week intervention)
Intervention Adherence
Percentage of intervention sessions attended by participants.
Time frame: Post-treatment (Week 8)
Participant Retention
Percentage of randomized participants who complete post-treatment assessment.
Time frame: Post-treatment (Week 8)
Change in Pain Intensity
The Pain, Enjoyment, and General Activities (PEG-3) scale will be used to assess pain intensity over the past week on average. (0-10; higher values = greater pain intensity).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Pain Interference
The Pain, Enjoyment, and General Activities (PEG-3) will be used assess pain interference over the past week. (0-10; higher values = greater pain interference).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Treatment Credibility
Assessed using the 8-item Credibility and Expectancy Questionnaire where higher scores represent higher levels of treatment credibility. (1-9; higher values = greater treatment expectancy and credibility).
Time frame: After Intervention session 3
Acute Treatment Effects
Assessed using face-valid items related to feelings and emotions immediately before and after each intervention session. Change scores will be calculated from post-intervention to pre-intervention. (0-4; higher scores = greater changes in acute subjective effects).
Time frame: Before and after each intervention sessions (Weeks 1-8)
Change in Pain Catastrophizing
Assessed using the 13-item Pain Catastrophizing Scale. (Scores range from 0-52; higher scores represent higher levels of pain catastrophizing).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Pain Self-Efficacy
Assessed using the 10-item Pain Self-Efficacy Scale. (0-6; higher scores represent higher levels of pain self-efficacy).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Fear Avoidance Beliefs
Assessed using the 5-item Fear-Avoidance Beliefs Questionnaire-physical activity subscale. (0-6; higher scores represent higher levels of physical activity-related fear-avoidance beliefs).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Physical Function
The PROMIS Physical Function-6b will be used assess pain dysfunction. (1-5; higher scores represent higher levels of physical function).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Sleep Disturbance
Assessed using the PROMIS-Sleep Disturbance 8b scale. (1-5; higher scores represent higher levels of sleep disturbance).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Sleep Related Impairment
Assessed using the PROMIS-Sleep Related Impairment 8a scale. (1-5; higher scores represent higher levels of sleep related impairment).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Fatigue
Assessed using the PROMIS Fatigue-8a scale. (1-5; higher scores represent higher levels of fatigue over the past week).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Stress
Assessed using the 4-item Perceived Stress Scale. (0-4; higher scores represent higher levels of subjective stress over the past month).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Anxiety
Assessed using the Generalized Anxiety Disorder-2 Questionnaire. (0-3; higher scores represent higher levels of anxiety over the past 2 weeks).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Depression
Assessed using the Patient Health Questionnaire-2.(0-3; higher scores represent higher levels of depression over the past 2 weeks).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Multisensory Sensitivity
Assessed using the Multisensory Amplification Scale will be used to assess symptoms of central nervous system hypersensitivity, or central sensitization. (1-5; higher scores represent higher levels of sensory sensitivity).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Interoception
Assessed using the Multidimensional Assessment of Interoceptive Awareness-2. (0-5; higher scores represent higher levels of interoception).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
Change in Mindful Reappraisal of Pain Sensations
Assessed using the Mindful Reappraisal of Pain Sensations Scale. (0-6; higher scores represent higher levels of mindful reappraisal).
Time frame: Change from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.
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