Effectiveness of Acceptance and Commitment Therapy (ACT) for the Management of Postsurgical Pain: Study Protocol of a Randomized Controlled Trial (SPINE-ACT Study)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants and Sample Size
2.3. Procedure
Forecast Execution Dates
- Inititation of patient recruitment: June 2023;
- End of patient follow-up period: December 2024;
- Publication of results: June 2025.
2.4. Treatments
2.4.1. Intervention Group (TAU + ACT)
2.4.2. Control Group (TAU)
2.5. Study Measures
2.5.1. Measures
Clinical Features and Screening Measures
Primary Outcome Measure
Secondary Outcome Measures
2.6. Statistical Analysis
3. Discussion
4. Conclusions
- A two-arm RCT is planned to address the potential effectiveness of ACT compared to TAU.
- ACT postulates the need to abandon efforts to control aversive thoughts or feelings and accept them as they are. It also promotes a commitment in a valuable vital direction for the person in relation to detecting and promoting actions that bring them closer to the important things in their life; this is useful in a life with meaning.
- It is hoped that ACT can improve the results in the various variables studied in relation to chronic pain in this population with a high postsurgical risk of LBP.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Session | ACT |
---|---|
1 | Participants’ and clinician’s presentation. Psychoeducation and introduction to ACT (basics; scientific advances in chronic pain and depression management; psychological theories of pain, suffering, and stress; stressors, fears, and indicators; identification of values; and breathing exercises). |
2 | Value analysis I. Problems of experiential avoidance. Creative hopelessness through metaphors: control is the problem and not the solution. Anxiety, fight, and flight, and its effects. Accepting the risk of the life’s journey: experiences, feelings, and emotions. |
3 | Value analysis II. Objectives. Laws of thought and consequences of language. Mind and deactivation of thought (cognitive defusion): creating distance with thoughts. Learning meditation techniques and effects. Practicing meditation exercises. |
4 | Value analysis III. Psychological barriers and obstacles. Emotional distress and its consequences. Emotional phenomena, personality variables, and health states. Discovering commitments with committed actions. |
5 | Values and feelings. Taking the initiative with a “Plan of action and willingness”. Psychological flexibility, resilience, and self-motivation. Expansion and body scan exercises. Learning to relax. |
6 | Taking a direction. The self as context, process, and content. Awareness of the present: “here and now”. The brain and emotions: managing situations and overwhelming emotional responses. |
7 | Dare and change. Willingness and determination. Self-awareness, assertiveness, and self-esteem. Experiential expansion exercises; felt sensations. Happiness according to positive psychology. Benefits of physical exercise: movement. |
8 | Ready to take action with ACT. Final reflections and review of what was seen in the previous sessions. How can we apply what we have worked on, oriented to spinal surgery? Farewell and Thanks. |
Measures | Pre | Post | 3-Months | 6-Months | 12-Months |
---|---|---|---|---|---|
Sociodemographic, clinical, and screening measures | |||||
Sociodemographic and clinical questionnaire | X | ||||
Primary outcome measure | |||||
BPI (pain interference) | X | X | X | X | X |
Secondary outcome measures | |||||
BPI (pain intensity) | X | X | X | X | X |
HADS (anxiety and depression) | X | X | X | X | X |
PCS (pain catastrophizing) | X | X | X | X | X |
PIPS (psychological inflexibility to pain) | X | X | X | X | X |
TSK-11SV (fear of movement) | X | X | X | X | X |
CPAQ-20 (pain acceptance) | X | X | X | X | X |
SF-12 (health-related quality life) | X | X | X | X | X |
OLBPDQ (functional status) | X | X | X | X | X |
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Castaño-Asins, J.R.; Sanabria-Mazo, J.P.; Luciano, J.V.; Barceló-Soler, A.; Martín-López, L.M.; Del Arco-Churruca, A.; Lafuente-Baraza, J.; Bulbena, A.; Pérez-Solà, V.; Montes-Pérez, A. Effectiveness of Acceptance and Commitment Therapy (ACT) for the Management of Postsurgical Pain: Study Protocol of a Randomized Controlled Trial (SPINE-ACT Study). J. Clin. Med. 2023, 12, 4066. https://doi.org/10.3390/jcm12124066
Castaño-Asins JR, Sanabria-Mazo JP, Luciano JV, Barceló-Soler A, Martín-López LM, Del Arco-Churruca A, Lafuente-Baraza J, Bulbena A, Pérez-Solà V, Montes-Pérez A. Effectiveness of Acceptance and Commitment Therapy (ACT) for the Management of Postsurgical Pain: Study Protocol of a Randomized Controlled Trial (SPINE-ACT Study). Journal of Clinical Medicine. 2023; 12(12):4066. https://doi.org/10.3390/jcm12124066
Chicago/Turabian StyleCastaño-Asins, Juan R., Juan P. Sanabria-Mazo, Juan V. Luciano, Alberto Barceló-Soler, Luis M. Martín-López, Alejandro Del Arco-Churruca, Jesús Lafuente-Baraza, Antonio Bulbena, Víctor Pérez-Solà, and Antonio Montes-Pérez. 2023. "Effectiveness of Acceptance and Commitment Therapy (ACT) for the Management of Postsurgical Pain: Study Protocol of a Randomized Controlled Trial (SPINE-ACT Study)" Journal of Clinical Medicine 12, no. 12: 4066. https://doi.org/10.3390/jcm12124066