Physiotherapy informed by acceptance and commitment therapy for chronic low back pain: A randomized trial.

Study Summary

50 patients with chronic low back pain (CLBP) were randomized to receive physiotherapy informed by Acceptance and Commitment Therapy (PACT) combined with DNS-based graded exercise or usual physiotherapy care (UC) consisting of individualized dynamic neuromuscular stabilization (DNS)-based graded exercise and manual therapy for 6 weeks. The primary outcome of interest was exercise motivation measured using the Exercise Self-Regulation Questionnaire. Secondary outcomes included exercise adherence, perceived autonomy support from the physiotherapist, disability measured using the Roland–Morris Disability Questionnaire (RMQ), and pain acceptance measured using the Chronic Pain Acceptance Questionnaire-8 (CPAQ-8). Outcomes were assessed at baseline and immediately after the 6-week intervention, while adherence and autonomy support were assessed post-intervention. Overall, the results of the study revealed that PACT improved several motivational outcomes, exercise adherence, and perceived autonomy support compared with UC, while between-group differences in disability and pain acceptance were not significant. These findings suggested that integrating ACT principles into physiotherapy may enhance engagement with exercise without providing additional short-term functional benefit.