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Acceptance and Commitment Therapy Plus Physiotherapy for Chronic Low Back Pain

11. august 2026 oppdatert av: Mosab ALdabbas, Al-Azhar University

Effects of Adding Acceptance and Commitment Therapy to Physiotherapy Program on Pain Catastrophizing, Stress, Disability, and Sleep Quality in Individuals With Chronic Low Back Pain

This study is a randomized controlled trial (RCT) investigating whether adding Acceptance and Commitment Therapy (ACT) to standard physiotherapy provides greater benefits for adults with chronic low back pain than physiotherapy alone.

A total of 60 participants will be randomly allocated into two groups: ACT plus physiotherapy and physiotherapy alone. Both groups will receive a 8-weeks program with two sessions per week. The ACT component focuses on acceptance, psychological flexibility, mindfulness, cognitive defusion, values, and committed action.

The main outcomes are pain catastrophizing, functional disability, perceived stress, and sleep quality, assessed using the PCS, ODI, PSS, and PSQI. The study aims to determine whether combining psychological and physical rehabilitation produces better outcomes than physiotherapy alone.

Studieoversikt

Studietype

Intervensjonell

Registrering (Antatt)

64

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

A_Aged between 18-55 years. B_Clinically diagnosed with non-specific chronic low back pain (CLBP). C_Low back pain persisting for more than 3 months.

Exclusion Criteria:

A. History of previous spinal surgeries or invasive interventions in the lumbar region.

B. Presence of "Red Flags" or serious underlying pathologies, such as spinal tumors, infections, or vertebral fractures.

C. Current or recent (within the last 6 months) participation in structured psychological rehabilitation or behavioral therapy programs.

D. Clinical evidence of neurological deficits, radiculopathy, or cauda equina syndrome.

E. Pregnancy, due to the physiological changes affecting musculoskeletal mechanics.

F. Severe behavioral or communication impairments preclude the ability to follow the intervention protocol or complete the self-report assessments.

G. Patients who take any sleep medication or for mental health medication. H. Patients who have done physiotherapy program last 3 months.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: ACT + Physiotherapy
Participants will receive an integrated Acceptance and Commitment Therapy (ACT) and physiotherapy program for 8 weeks, with two sessions per week . Each session will last approximately 45 minutes, including 15 minutes of ACT and 30 minutes of physiotherapy. ACT will include acceptance, cognitive defusion, mindfulness, values clarification, and committed action. Physiotherapy will include lumbar stabilization, core strengthening, aerobic conditioning, soft tissue techniques, and TENS.
Participants in the experimental group will receive Acceptance and Commitment Therapy (ACT) as part of the integrated rehabilitation program. ACT will be delivered for 15 minutes per session, twice weekly for 8 weeks . The intervention will focus on functional acceptance, psychological flexibility, cognitive defusion, mindfulness and present-moment awareness, values clarification, and committed action. The program aims to reduce pain catastrophizing and avoidance behaviors and promote engagement in meaningful activities despite chronic low back pain. ACT will be followed by 30 minutes of physiotherapy during each session.
Participants will receive a standard physiotherapy program twice weekly for 8 weeks . The program will include lumbar stabilization exercises, core strengthening, flexibility and mobility exercises, aerobic conditioning, soft tissue release, and TENS. The physiotherapy component aims to improve physical function, mobility, and functional ability in individuals with chronic low back pain. The same physiotherapy program will be provided to participants in both study arms.
Aktiv komparator: Standard Physiotherapy
Participants will receive standard physiotherapy for 8 weeks, with two sessions per week . The physiotherapy program will include lumbar stabilization exercises, core strengthening, flexibility and mobility exercises, aerobic conditioning, soft tissue techniques, and TENS. Participants in this group will not receive Acceptance and Commitment Therapy or other ACT-based psychological interventions.
Participants will receive a standard physiotherapy program twice weekly for 8 weeks . The program will include lumbar stabilization exercises, core strengthening, flexibility and mobility exercises, aerobic conditioning, soft tissue release, and TENS. The physiotherapy component aims to improve physical function, mobility, and functional ability in individuals with chronic low back pain. The same physiotherapy program will be provided to participants in both study arms.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Sleep Quality
Tidsramme: Pre and 8 weeks post intervention
Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), which evaluates several aspects of sleep during the previous month. The global score ranges from 0 to 21, with higher scores indicating poorer sleep quality.
Pre and 8 weeks post intervention
Pain intensity
Tidsramme: Pre and 8 weeks post intervention
VAS_Pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity.
Pre and 8 weeks post intervention
Disability
Tidsramme: Pre and 8 weeks post intervention
Functional disability related to chronic low back pain will be assessed using the Oswestry Disability Index (ODI). The questionnaire evaluates limitations in daily activities, with the total score expressed as a percentage. Higher scores indicate greater disability.
Pre and 8 weeks post intervention
Stress
Tidsramme: pre and 8 weeks post intervention
Perceived stress will be assessed using the Perceived Stress Scale (PSS), which measures the extent to which situations in an individual's life are perceived as unpredictable, uncontrollable, and overwhelming. Higher scores indicate greater perceived stress.
pre and 8 weeks post intervention
Pain Catastrophizing
Tidsramme: Pre and 8 weeks post intervention
Pain catastrophizing will be assessed using the 13-item Pain Catastrophizing Scale (PCS), which evaluates rumination, magnification, and helplessness related to pain. Higher scores indicate greater pain catastrophizing.
Pre and 8 weeks post intervention

Samarbeidspartnere og etterforskere

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Publikasjoner og nyttige lenker

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Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

20. august 2026

Primær fullføring (Antatt)

1. februar 2027

Studiet fullført (Antatt)

1. februar 2027

Datoer for studieregistrering

Først innsendt

11. august 2026

Først innsendt som oppfylte QC-kriteriene

11. august 2026

Først lagt ut (Faktiske)

14. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

14. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

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UBESLUTTE

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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