在线接受和承诺疗法加锻炼对患有慢性腰痛的老年人的可行性、有效性和患者体验

实验性的：接受在线 ACT 干预的老年人

4周ACT加背部锻炼组

行为的：Acceptance and Commitment Therapy (ACT)

the first hour of ACT intervention followed by 30 minutes of back exercise class, which led by a trained ACT counsellor and a trained exercise trainer

行为的：back exercise

30 minutes of back exercise class led by a trained exercise trainer

有源比较器：未接受 ACT 干预的老年人

4周背部运动对照组

行为的：背部护理教育

为参与者提供 1 小时长的互动课程，内容涉及 LBP 相关病理学、残疾、心理学和疼痛管理技能。

行为的：back exercise

30 minutes of back exercise class led by a trained exercise trainer

4 周治疗后立即心理灵活性基线的变化

接受与行动问卷II（AAQ-II）的7项中文版将用于测量参与者的心理灵活性。 它由 7 个陈述组成，按 7 分制评分，其中 1 表示“从不真实”，7 表示“始终真实”。 总分最高为49分。 总分越高意味着灵活性越低。 AAQII 已在当地青少年中进行了跨文化调整和验证，并表现出令人满意的内部一致性和重测可靠性。

与健康相关的生活质量的变化

中文版 EuroQol-5 维度水平 (EQ-5D-5L) 将用于衡量参与者的健康相关生活质量 (HRQOL)。 它包括与行动能力、自我护理、日常活动、疼痛/不适和焦虑/抑郁相关的 5 个项目。 每个项目有 5 个选项（没问题、轻微问题、中等问题、严重问题、极端问题/无法）。 人们发现它有助于监测 HRQOL 对治疗的反应。

Change of LBP intensity

An 11-point numeric pain rating scale will be used to measure LBP intensity, where 0 means no pain and 10 means the worst imaginable pain. Participants need to report their back pain in the last 7 days.

Change of LBP-related disability

The Chinese version of 24-item Roland Morris Disability Index will be used to evaluate the LBP-related disability in older adults. It consists of 24 yes/no items related to LBP-related functional limitations. The summation of the scores of items with "yes" answer indicates the severity of LBP-related disability. The maximum score is 24.

Change of depression, anxiety, and stress

The Chinese version of 21-item Depression, Anxiety Stress Scales (DASS) will be used to evaluate depression (7 items), anxiety (7 items), and stress (7 items) in older adults. Each item is rated on a 4-point scale ranging from 0 (not at all) to 3 (most of the time). Double the sum of the subscale raw scores to acquire each subscale's total score. The total score for each subscale ranges from 0 to 42. Higher scores imply more mental health issues. It has been cross-culturally adapted to Hong Kong settings. DASS has demonstrated excellent internal consistency for depression, anxiety, and stress subscales.

Overall perceived changes in symptom severity, treatment response and the efficacy of treatment

Global impression of change scale will be used to evaluate the overall perceived changes in symptom severity, treatment response, and the efficacy of treatment immediately after the 4-week interventions. The score ranges from 1 (Very much better) to 7 (Very much worse).

Change of psychological flexibility

The Open and Engaged State Questionnaire will be used to rate participants' experiences over the previous seven days on an 11-point Likert scale (from "not at all" to "very much"). After reverse-scoring Item 3, a total score is calculated by summing all four items. The total score ranges from 0 to 40, with higher scores indicating greater psychological inflexibility.