Physiotherapy informed by acceptance and commitment therapy for chronic low back pain: A randomized trial.
Marketa Nevelikova, Filip Zlamal, Filip Dosbaba and 2 others
ACT-informed physiotherapy produced higher exercise motivation and adherence than standard care in 50 people with chronic low back pain, but both groups improved equally on disability.
The motivation shift favored more internal, values-driven reasons for exercising.
Key findings
1At post-intervention, the PACT group had significantly higher introjected and identified exercise motivation than the usual-care group, while external and intrinsic motivation did not differ between groups.
2Adherence to the prescribed exercise programme was significantly higher in the PACT group than in the usual-care group, measured on a scale from 0 to 24.
3Both groups showed significant within-group improvement in functional disability and pain acceptance from baseline to post-intervention, but neither outcome differed significantly between the PACT and usual-care groups.
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What it does not show
The study was underpowered to detect moderate between-group differences, as the authors acknowledge in a post-hoc analysis. Outcomes were measured only at post-intervention, immediately after the last session. The authors note that functional changes may take longer to appear, and no follow-up was conducted. The same physiotherapist delivered both interventions, which the authors flag as a risk of cross-contamination between the two approaches. Participants and therapists were not blinded, which the authors acknowledge as unavoidable given the nature of the intervention. The sample was small (50 people) and drawn from a single hospital, limiting generalisability.
Declared interests
The authors declare no conflict of interest. The work was funded by the Ministry of Health of the Czech Republic (University Hospital Brno) and an internal grant (NIG 02/22).
The easy way to misread this
Do not read the higher motivation and adherence scores as evidence that ACT-informed physiotherapy reduces back pain or improves function. The primary outcome was exercise motivation, and the functional disability scores did not differ between the two groups at post-intervention.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →