The Psychological Inflexibility in Pain Scale (PIPS): Validity and Reliability of the Japanese Version for Chronic Low Back Pain and Knee Pain

Physical therapist-delivered acceptance and commitment therapy and exercise for older outpatients with knee osteoarthritis: a pilot randomized controlled trial

[Purpose] In this pilot study, we investigated the effectiveness of physical therapist-delivered acceptance and commitment therapy in older outpatients with knee osteoarthritis and chronic pain. [Participants and Methods] This single-center, open-label, parallel-group pilot randomized controlled trial included 30 patients assigned to the physical therapist-delivered acceptance and commitment therapy group (n=15) and the usual care physical therapy-only group (n=15). Both treatments were administered once a week for 8 weeks. Evaluation was performed 4 weeks before intervention, pre-intervention, post-intervention, and 4 weeks after intervention. The primary outcome was diagnosis of a physical disability, and secondary outcomes included psychological inflexibility, pain intensity, anxiety, depression, physical function, and objectively measured physical activity. [Results] Physical therapist-delivered acceptance and commitment therapy had a limited effect on physical disability, although we observed a favorable tendency. With regard to secondary outcomes, physical therapist-delivered acceptance and commitment therapy did not show significant effects. Notably, 15 patients withdrew from this study and 6 were diagnosed with coronavirus disease. [Conclusion] Physical therapist-delivered acceptance and commitment therapy did not appear to show significant effects in the present study. It is necessary to correct these issues in this study, and future studies are warranted to investigate the effects of this therapy.

Psychological inflexibility and physical disability in older patients with chronic low back pain and knee pain

Aim: This study examined the associations between psychological inflexibility (PI) and physical disability (PD) among older patients with chronic low back and knee pain. Methods: Pain avoidance and cognitive fusion were assessed in outpatients as components of PI and PD, and sociodemographic and pain-related variables were used as covariates. Hierarchical multiple linear regression was used. The covariates were first entered, followed by PI. Results: Age and pain intensity had significant positive associations with PD. After adding PI, only pain avoidance was significantly and positively associated with PD. Conclusion: Focusing on pain avoidance may be effective for physical disability when acceptance and commitment therapy is administered to older patients with chronic low back and knee pain.