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Integrating Mind-Body Skills With Physical Activity to Improve Physical and Emotional Outcomes in Patients With Chronic Pain

Not Applicable
Conditions
Pain
Chronic Pain
Physical Activity
Interventions
Behavioral: GetActive
Behavioral: Get Active with Fitbit
Registration Number
NCT03412916
Lead Sponsor
Massachusetts General Hospital
Brief Summary

The aims of this study are to adapt, pilot, and examine the credibility, acceptability, and feasibility of an evidence-based mind-body program, the Relaxation Response Resiliency Program for Chronic Pain (p3RP), and the p3RP-Digital Monitoring Device (p3RP-DMD), which is the p3RP integrated with a commercial DMD, the Fitbit.

Detailed Description

The study has three phases. In phase I, the investigators are adapting the 3RP as a multidisciplinary team, and then conducting two focus groups. In phase two, the investigators are piloting the p3RP and p3RP-DMD. In phase three, the investigators are conducting a small randomized-controlled trial of the p3RP versus p3RP-DMD.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Male and female patients, age 18 years or older
  • Have nonmalignant chronic pain for more than 3 months
  • Able to perform a 6-minute walk test
  • Owns a smartphone with Bluetooth 4.0
  • Willingness and ability to participate in the 3RP intervention and to comply with the requirements of the study protocol (including weekly sessions and DMD use)
  • Free of concurrent psychotropic or pain medication for at least 2 weeks prior to initiation of treatment, OR stable on current psychotropic or pain medication for a minimum of 6 weeks and willing to maintain a stable dose
  • Cleared by a medical doctor for study participation
  • Leads a sedentary lifestyle
Exclusion Criteria
  • Diagnosed with medical illness expected to worsen in the next 6 months
  • Serious mental illness or instability for which hospitalization may be likely in the next 6 months
  • Current suicidal ideation reported on self-report
  • Lifetime history of schizophrenia, bipolar disorder, or other psychotic disorder, or substance dependence
  • Current substance use disorder, within the past 6 months
  • Practice of yoga/meditation, or other mind-body techniques that elicit the relaxation response, once per week for 45 minutes or more within the last 3 months or less
  • Regular use of DMD in the last 3 months
  • Engagement in regular intensive physical exercise for >30 minute daily
  • Unable to walk without use of assistance (e.g., wheelchair, walker)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GetActiveGetActiveThe GetActive program uses a multimodal approach to introduce and reinforce new skills, including didactics, in-session activities, discussions, and weekly practice assignments (homework). The GetActive sessions reflect a purposeful integration of the three treatment approaches (relaxation methods, stress appraisal \& coping, and growth enhancement). The format is a 10-week program with weekly meetings and a focus on relaxation response strategies, cognitive behavioral training, positive psychology and mind-body interactions.
GetActive with FitbitGet Active with FitbitThe GetActive with Fitbit is identical to that of the p3RP with the addition of a digital monitoring device (i.e., Fitbit) for recording of physical activity.
Primary Outcome Measures
NameTimeMethod
Change in Client Satisfaction Questionnaire 3-Item (CSQ-3)Post-Test (10 Weeks)

Items are summed to generate a total score; scores range from 3 to 12, with higher values indicating higher satisfaction.

Secondary Outcome Measures
NameTimeMethod
Adherence to DMDBaseline (0 Weeks), Post-Test (10 Weeks)

Rate of participant's use of DMD throughout the study

Adherence to HomeworkBaseline (0 Weeks), Post-Test (10 Weeks)

Rate of participant's completion of homework assigned throughout the study

Therapist Adherence to SessionsBaseline (0 Weeks), Post-Test (10 Weeks)

Rate of interventionist's delivering the programs by following the established session topics and skills

Feasibility of Quantitative MeasuresBaseline (0 Weeks), Post-Test (10 Weeks)

Rate of participant's completion of self-report measures

Rescue (Non-Narcotic) Analgesic UseBaseline (0 Weeks), Post-Test (10 Weeks)

Single-item question on demographics form

Narcotic Analgesic UseBaseline (0 Weeks), Post-Test (10 Weeks)

Single-item question on demographics form

Adverse EventsBaseline (0 Weeks), Post-Test (10 Weeks)

any self reported or observed negative events related to participation

Credibility and Expectancy Questionnaire (CEQ)Baseline (0 Weeks)

Measures how much one thinks the intervention will work

Pittsburgh Sleep Quality Index (PSQI)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

Measures one's sleep quality

PROMIS Physical Function v.8bBaseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The 8-item scale assesses for how difficult it is for one to perform daily living activities

Physical Activity Scale for Persons with Physical Disabilities (PASIPD)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The PASIPD measures one's level of physical activity and exercise in the past 7 days

Numerical Rating ScaleBaseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

Measures pain at rest and pain with activity on a Likert scale with 0 being no pain and 10 being the worst pain ever

WHO Disability Assessment Schedule 2.0 (WHODAS)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The WHODAS measures level of functioning in six domains: cognition, mobility, self-care, getting along, life activities, and participation

Pain Resilience Scale (PRS)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The PRS, a 14-item scale, measures pain resilience and how one would respond emotionally when faced with prolonged pain

PROMIS Emotional Support v.4aBaseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The 4-item scale measures how often one feels valued and confidant has relationships

Cognitive and Affective Mindfulness Scale (CAMS)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The CAMS, a 12-item scale, measures how much one experiences their thoughts and feelings

PROMIS Depression v.8bBaseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The 8-item scale measures depressive symptoms over the past week

PROMIS Anxiety v.8aBaseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The 8-item scale measures fear and worry over the past week

PROMIS Social Isolation v.4aBaseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The 4-item scale measures how often one perceives feeling apart from others and excluded.

Pain Catastrophizing Scale (PCS)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The PCS, a 13-item scale, measures how individuals experience pain, in terms of catastrophizing. A higher score indicates more catastrophizing

Tampa Kinesiophobia Scale (TKS)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The TKS is a 17-item scale that measures one's fear of movement, with a greater score indicating greater fear

Measure of Current Status (MOCS-A)Baseline (0 Weeks), Post-Test (10 Weeks), 3-Month Follow-Up (23 Weeks)

The MOCS-A, a 13-item scale, measures one's perceived ability to perform various skills that the intervention aims to target

Patient Global Impression of Change (PGIC)Post-Test (10 Weeks)

The PGIC assesses clinically important change from baseline to post-test

Post-Test Feasibility QuestionsPost-Test (10 Weeks)

Assesses how helpful components of the intervention were

3-Month Follow Up Questions3-Month Follow-Up (23 Weeks)

Assesses for physical activity in the DMD group

Trial Locations

Locations (1)

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

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