MedPath

Integrative Breathwork Intervention for Chronic Pain

Phase 1
Recruiting
Conditions
Chronic Low-back Pain
Interventions
Behavioral: Integrative Breathwork Intervention
Registration Number
NCT06546956
Lead Sponsor
University of Florida
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Men and women 18-70 years of age.
  • Chronic primary low back pain that has persisted for at least 3 months and on most days for the past 6 months.
  • Average pain intensity of ≥ 4/10 for the past month.
  • Fluent in English.
  • Access to internet with a valid email address.
  • Able to lay down and stay relatively still for one hour.
Exclusion Criteria
  • Leg pain, or any other chronic pain, that is greater than low back pain.
  • Back pain possibly due to specific conditions (e.g., cancer, infection).
  • Ongoing legal action or disability claim related to low back pain.
  • Neurological symptoms associated with low back pain, including loss of control or incontinence of bowel or bladder.
  • Systemic rheumatic disease/condition (e.g. rheumatoid arthritis, systemic lupus erythematosus, fibromyalgia).
  • Respiratory disorder (e.g., chronic obstructive pulmonary disease) or moderate to severe asthma within the past 12 months.
  • Activity limiting heart disease including cardiovascular or peripheral arterial disease.
  • Uncontrolled hypertension (i.e. SBP/DBP of > 160/95) or orthostatic hypotension (e.g., issues with fainting).
  • Neurological disease (e.g. Parkinson's, multiple sclerosis, epilepsy, history of seizures) or evidence of previous brain injury, including stroke and traumatic brain injury.
  • Serious acute physical injuries or any surgery within the past 6 months.
  • Serious psychiatric disorder (e.g., schizophrenia) or mental health issues requiring hospitalization within the past 12 months or currently on anti-psychotic medications.
  • History of hospitalization or treatment of substance use disorder within the past 12 months.
  • Currently undergoing curative or palliative chemotherapy or radiation. Pregnant or plan to become pregnant during the study period.
  • Glaucoma or detached retina.
  • Current participation or participation in the past 2 months of an interventional research study.
  • Cognitive impairment or factors that would preclude comprehension of material and/or full participation in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Integrative Breathwork InterventionIntegrative Breathwork InterventionThe integrative, multicomponent breathwork intervention that will be tested in this study is called Guided Respiration Mindfulness Therapy. Participants will receive a 60 minute breathwork session once a week for 8 weeks.
Primary Outcome Measures
NameTimeMethod
Treatment AcceptabilityPost-treatment (after the 8-week intervention)

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).

Participant RetentionPost-treatment (Week 8)

Percentage of randomized participants who complete post-treatment assessment.

Intervention AdherencePost-treatment (Week 8)

Percentage of intervention sessions attended by participants.

Change in Pain IntensityChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

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).

Change in Pain InterferenceChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

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).

Secondary Outcome Measures
NameTimeMethod
Change in Fear Avoidance BeliefsChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

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).

Change in FatigueChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the PROMIS Fatigue-8a scale. (1-5; higher scores represent higher levels of fatigue over the past week).

Change in StressChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the 4-item Perceived Stress Scale. (0-4; higher scores represent higher levels of subjective stress over the past month).

Change in InteroceptionChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the Multidimensional Assessment of Interoceptive Awareness-2. (0-5; higher scores represent higher levels of interoception).

Change in Mindful Reappraisal of Pain SensationsChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the Mindful Reappraisal of Pain Sensations Scale. (0-6; higher scores represent higher levels of mindful reappraisal).

Treatment CredibilityAfter Intervention session 3

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).

Change in AnxietyChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the Generalized Anxiety Disorder-2 Questionnaire. (0-3; higher scores represent higher levels of anxiety over the past 2 weeks).

Acute Treatment EffectsBefore and after each intervention sessions (Weeks 1-8)

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).

Change in Physical FunctionChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

The PROMIS Physical Function-6b will be used assess pain dysfunction. (1-5; higher scores represent higher levels of physical function).

Change in Sleep DisturbanceChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the PROMIS-Sleep Disturbance 8b scale. (1-5; higher scores represent higher levels of sleep disturbance).

Change in Multisensory SensitivityChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

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).

Change in Pain CatastrophizingChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the 13-item Pain Catastrophizing Scale. (Scores range from 0-52; higher scores represent higher levels of pain catastrophizing).

Change in DepressionChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the Patient Health Questionnaire-2.(0-3; higher scores represent higher levels of depression over the past 2 weeks).

Change in Pain Self-EfficacyChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the 10-item Pain Self-Efficacy Scale. (0-6; higher scores represent higher levels of pain self-efficacy).

Change in Sleep Related ImpairmentChange from Baseline (Week 0) to Post-treatment (Week 8), 1-month follow-up.

Assessed using the PROMIS-Sleep Related Impairment 8a scale. (1-5; higher scores represent higher levels of sleep related impairment).

Trial Locations

Locations (1)

University of Florida

🇺🇸

Gainesville, Florida, United States

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