Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-22T12:25:30.308Z Has data issue: false hasContentIssue false
  • English
  • Français

Physical Activity of Patients With Chronic Pain Receiving Acceptance and Commitment Therapy or Cognitive Behavioural Therapy

Published online by Cambridge University Press:  21 May 2014

Katherine VanBuskirk ,
Scott Roesch ,
Niloofar Afari  and
Julie Loebach Wetherell
Katherine VanBuskirk*
Affiliation:
VA San Diego Healthcare System, San Diego, California, USA SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, California, USA
Scott Roesch
Affiliation:
Department of Psychology, San Diego State University, San Diego, California, USA
Niloofar Afari
Affiliation:
VA San Diego Healthcare System, San Diego, California, USA VA Center of Excellence for Stress and Mental Health, San Diego, California, USA Department of Psychiatry, University of California, San Diego, California, USA
Julie Loebach Wetherell
Affiliation:
VA San Diego Healthcare System, San Diego, California, USA Department of Psychiatry, University of California, San Diego, California, USA
*
Address for correspondence: Katherine VanBuskirk, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA. Email: [email protected]
Get access

Abstract

Physical activity is positively related to various indices of quality of life and is found to reduce symptoms in individuals with chronic pain. This manuscript presents findings from a post hoc analysis investigating whether treatment-related improvements from psychological treatment for chronic pain are mediated by changes in physical activity (PA). Secondary analyses sought to determine predictor variables of PA in patients with chronic pain and to determine the relationship between objective and self-report measurements of PA. The effect of psychological treatment on physical activity was assessed using accelerometers in a sample of participants with chronic pain in a randomised controlled trial comparing 8 weeks of acceptance and commitment therapy (ACT) to cognitive behavioural therapy (CBT). Participants wore actigraph accelerometers for 7 consecutive days at baseline, post-treatment, and at 6-month follow-up. Hierarchical linear modelling analyses found that the variance in physical activity was not significantly predicted by time (b = 104.67, p = .92) or treatment modality (b = −1659.34, p = .57). Women had greater increases in physical activity than did men (b = 6804.08, p = .02). Current ‘gold standard’ psychological treatments for chronic pain were not found to significantly increase physical activity, an important outcome to target in the treatment of physical and mental health. These results suggest that tailored interventions with greater emphasis on exercise may complement psychological treatment for chronic pain. In particular, gender-tailored interventions may capitalise on physical activity differences found between men and women.

Keywords

chronic painbehaviour changeexerciseclinical health psychologygender differences
Type
Standard Papers
Information
Behaviour Change , Volume 31 , Issue 2 , June 2014 , pp. 131 - 143
Creative Commons
This is a work of the U.S. Government and is not subject to copyright protection in the United States.
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Actigraph. (2012, 2/8/2012). What are counts? Retrieved from support.theactigraph.com/faq/countsGoogle Scholar
Alschuler, K.N., Hoodin, F., Murphy, S.L., & Geisser, M.E. (2011). Ambulatory monitoring as a measure of disability in chronic low back pain populations. The Clinical Journal of Pain, 27, 707–715. doi:10.1097/AJP.0b013e318217b7d0CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., Ball, R., & Ranieri, W.F. (1996). Comparison of the Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67, 588–597. doi:10.1207/s15327752jpa6703_13CrossRefGoogle Scholar
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
Bouten, C.V.C., Verboeket-van de Venne, W.P. H.G., Westerterp, K.R., Verduin, M., & Janssen, J.D. (1996). Daily physical activity assessment: Comparison between movement registration and doubly labeled water. Journal of Applied Physiology, 81, 1019–1026.CrossRefGoogle ScholarPubMed
Byrne, A., & Byrne, D.G. (1993). The effect of exercise on depression, anxiety, and other mood states: A review. Journal of Psychosomatic Research, 37, 565–574.CrossRefGoogle ScholarPubMed
Catellier, D.J., Hannan, P.J., Murray, D.M., Addy, C.L., Conway, T.L., Yang, S., & Rice, J.C. (2005). Imputation of missing data when measuring physical activity by accelerometry. Medicine & Science in Sports & Exercise, 37 (Suppl. 11), S555–S562. doi:10.1249/01.mss.0000185651.59486.4eCrossRefGoogle ScholarPubMed
Cleeland, C.S., & Ryan, K.M. (1994). Pain assessment: Global use of the Brief Pain Inventory. Annals of the Academy of Medicine Singapore, 23, 129–138.Google ScholarPubMed
Colley, R.C., Garriguet, D., Janssen, I., Craig, C.L., Clarke, J., & Tremblay, M.S. (2011). Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Reports, 22, 1–8.Google ScholarPubMed
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1995). Structured clinical interview for DSM-IV. New York: New York State Psychiatric Institute.Google Scholar
Forman, E.M., Herbert, J.D., Moitra, E., Yeomans, P.D., & Geller, P.A. (2007). A randomized controlled effectiveness trial of Acceptance and Commitment Therapy and Cognitive Therapy for anxiety and depression. Behavior Modification, 31, 772–799. doi:10.1177/0145445507302202CrossRefGoogle ScholarPubMed
Goedendorp, M.M., Peterse, M.E., Gielissen, M.F., Witjes, J.A., Leer, J.W., Verhagan, C.A., & Bleijenberg, G. (2010). Is increasing physical activity necessary to diminish fatigue during cancer treatment? Comparing cognitive behavior therapy with a brief nursing intervention with usual care in a multicenter randomized controlled trial. The Oncologist, 15, 1122–1132.CrossRefGoogle Scholar
Hayes, S.C., & Duckworth, M.P. (2006). Acceptance and commitment therapy and cognitive behavior therapy approaches to pain. Cognitive and Behavioral Practice, 13, 185–187.CrossRefGoogle Scholar
Kerns, R.D., Turk, D.C., & Rudy, T.E. (1985). The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain, 23, 345–356. doi:10.1016/0304-3959(85)90004-1CrossRefGoogle ScholarPubMed
Korszun, A., Young, E.A., Engleberg, N.C., Brucksch, C.B., Greden, J.F., & Crofford, L.A. (2002). Use of actigraphy for monitoring sleep and activity levels in patients with fibromyalgia and depression. Journal of Psychosomatic Research, 52, 439–443. doi:10.1016/S0022-3999(01)00237-9CrossRefGoogle ScholarPubMed
Littner, M., Kushida, C.A., Anderson, W.M., Bailey, D., Berry, R.B., Davila, D.G., . . .Standards of Practice Committee of the American Academy of Sleep Medicine. (2003). Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: An update for 2002. Sleep, 26 (3), 337–341.CrossRefGoogle Scholar
McCracken, L.M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): Preliminary development and validity. Pain Research & Management, 7, 45–50.CrossRefGoogle Scholar
McCracken, L.M., & Turk, D.C. (2002). Behavioral and cognitive-behavioral treatment for chronic pain. Spine, 27, 2564–2573.CrossRefGoogle ScholarPubMed
Mannion, A.F., Muntener, M., Taimela, S., & Dvorak, J. (2001). Comparison of three active therapies for chronic low back pain: Results of a randomized clinical trial with one-year follow-up. Rheumatology, 40(772–778). doi:10.1093/rheumatology/40.7.772CrossRefGoogle ScholarPubMed
Morley, S. (2011). Efficacy and effectiveness of cognitive behaviour therapy for chronic pain: Progress and some challenges. Pain, 152 (Suppl. 3), S99–106. doi:10.1016/j.pain.2010.10.042CrossRefGoogle ScholarPubMed
Morley, S., Eccleston, C., & Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 1–13. doi:10.1016/S0304-3959(98)00255-3CrossRefGoogle ScholarPubMed
Murphy, S.L. (2009). Review of physical activity measurement using accelerometers in older adults: Considerations for research design and conduct. Preventative Medicine, 48, 108–114. doi:10.1016/j.ypmed.2008.12.001CrossRefGoogle ScholarPubMed
Nielens, H., & Plaghki, L. (2001). Cardiorespiratory fitness, physical activity level, and chronic pain: Are men more affected than women? Clinical Journal of Pain, 17, 129–137.CrossRefGoogle ScholarPubMed
Prince, S.A., Adamo, K.B., Hamel, M.E., Hardt, J., Gorber, S.C., & Tremblay, M. (2008). A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 5, 56. doi:10.1186/1479-5868-5-56CrossRefGoogle ScholarPubMed
Pull, C.B. (2009). Current empirical status of acceptance and commitment therapy. Current Opinion in Psychiatry, 22, 55–60. doi: 10.1097/YCO.0b013e32831a6e9dCrossRefGoogle ScholarPubMed
Raudenbush, S.W., & Bryk, A.S. (2002). Hierarchical linear models: Applications and data analysis methods. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Raudenbush, S.W., Bryk, A.S., Cheong, Y.F., Congdon, R., & du Toit, M. (2011). HLM 7: Hierarchical linear and nonlinear modeling. Lincolnwood, IL: Scientific Software International, Inc.Google Scholar
Saffer, H., Dave, D.M., & Grossman, M. (2011). Racial, ethnic and gender differences in physical activity (National Bureau of Economic Research Working Paper 17413). Cambridge, MA: National Bureau of Economic Research.CrossRefGoogle Scholar
Stewart, A.L., Hays, R.D., Wells, K.B., Rogers, W.H., Spritzer, K.L., & Greenfield, S. (1994). Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the medical outcomes study. Journal of Clinical Epidemiology, 47, 719–730.CrossRefGoogle ScholarPubMed
Tan, G., Jensen, M.P., Thornby, J.I., & Shanti, B.F. (2004). Validation of the Brief Pain Inventory for Chronic Nonmalignant Pain. The Journal of Pain, 5, 133–137. doi:10.1016/j.jpain.2003.12.005CrossRefGoogle ScholarPubMed
Turk, D.C., & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. Journal of Consulting and Clinical Psychology, 70, 678–690. doi:10.1037/0022-006X.70.3.678CrossRefGoogle ScholarPubMed
Turner, J.A., Holtzman, S., & Mancl, L. (2007). Mediators, moderators, and predictors of therapeutic change in cognitive-behavioral therapy for chronic pain. Pain, 127, 276–286. doi:10.1016/j.pain.2006.09.005CrossRefGoogle ScholarPubMed
van Weering, M., Vollenbroek-Hutten, M.M.R., Kotte, E.M., & Hermens, H.J. (2007). Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls: A systematic review. Clinical Rehabilitation, 21, 1007–1023. doi:10.1177/0269215507078331CrossRefGoogle ScholarPubMed
Verhaak, P.F.M., Kerssens, J.J., Dekker, J., Sorbi, M.J., & Bensing, J.M. (1998). Prevalence of chronic benign pain disorder among adults: A review of the literature. Pain, 77, 231–239. doi:10.1016/S0304-3959(98)00117-1CrossRefGoogle ScholarPubMed
Warburton, D.E.R., Nicol, C.W., & Bredin, S.S.D. (2006). Health benefits of physical activity: The evidence. Canadian Medical Association Journal, 174, 801–809.CrossRefGoogle ScholarPubMed
Ward, D.S., Evenson, K.R., Vaughn, A., Rodgers, A.B., & Troiano, R.P. (2005). Accelerometer use in physical activity: Best practices and research recommendations. Medicine & Science in Sports & Exercise, 37 (Suppl. 11), S582–S588. doi:10.1249/01.mss.0000185292.71933.91CrossRefGoogle ScholarPubMed
Ware, J.E., Kosinski, M.A., & Keller, S.D. (1994). A 12-item short form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.CrossRefGoogle Scholar
Westerterp, K.R. (2008). Physical activity as determinant of daily energy expenditure. Physiology & Behavior, 93, 1039–1043.CrossRefGoogle ScholarPubMed
Wetherell, J.L., Afari, N., Rutledge, T., Sorrell, J.T., Stoddard, J.A., Petkus, A.J., . . . Atkinson, J.H. (2011). A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain, 152, 2098–2107. doi:10.1016/j.pain.2011.05.016CrossRefGoogle ScholarPubMed
Wiborg, J.F., Knoop, H., Stulemeijer, M., Prins, J.B., & Bleijenberg, G. (2010). How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity. Psychological Medicine, 40, 1281–1287. doi:10.1017/S0033291709992212CrossRefGoogle ScholarPubMed
Wilson, A.C., & Palermo, T.M. (2012). Physical activity and function in adolescents with chronic pain: A controlled study using actigraphy. The Journal of Pain, 13, 121–130. doi:10.1016/j.jpain.2011.08.008CrossRefGoogle ScholarPubMed