Evaluation of a group acceptance commitment therapy intervention for people with knee or hip osteoarthritis: A pilot randomized controlled trial
Open accessAbstract
OBJECTIVES: The aim was to evaluate an Acceptance commitment therapy (ACT) intervention for people with knee or hip osteoarthritis; a related aim was to compare treatment effects from Rasch-transformed and standard scales. METHODS: Participants were recruited from a research database and outpatient rheumatology and orthopaedic clinics at two hospitals. Eligible participants were randomly allocated to either intervention or usual care. Intervention comprised six-sessions of group ACT. Outcomes were assessed two and four months after randomization. Rasch-transformed and standard self-report measures were compared. Qualitative interviews also explored the acceptability of the intervention. RESULTS: Of 87 people assessed for eligibility, 31 (36%) were randomized. The main reason for non-randomization was that participants received surgery. Of the 16 participants randomized to intervention, 64% completed ≥50% of the scheduled group sessions. Follow-up data was complete for 84% participants at two months and 68% at four months. Outcome analysis demonstrated important differences between the Rasch-transformed and standard scales. There were significant differences between the groups in pain. Qualitative interviews with seven participants suggested the intervention was acceptable. CONCLUSIONS: ACT for osteoarthritis is likely to be an acceptable treatment option for people with osteoarthritis. Progress to a definitive trial is warranted. Rasch-transformed outcome scales are preferable in clinical trials where possible. Implications for Rehabilitation Acceptance commitment therapy (ACT) is an effective treatment for many pain conditions andcould be a useful intervention for people with osteoarthritis who have high levels of pain. Rasch analysis is a measurement technique that may enable greater precision in detectingmeaningful treatment effects in routine clinical outcomes. The ACT intervention was successful in reducing pain and sleep difficulties and there werenotable differences in effects between standard and Rasch-transformed scales. In a relatively small trial, ACT may to be an acceptable intervention for people with osteoarthritisand progress to a definitive trial is warranted.
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Working on dysfunctional cognitive and emotional mechanisms may notably alleviate distress in patients with chronic pain.
“Multiple investigations resembled these findings, proving that working on dysfunctional cognitive and emotional mechanisms may notably alleviate distress in patients with chronic pain [122,123,124,125,126].”
From A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders (2024) · cites this paper as [123]
The Introduction describes ACT as targeting psychological flexibility and pain-related anxiety. In Outcome data (page not available), the intervention group had significantly lower pain-related anxiety at two and four months, but there was no significant difference on the GHQ-12 measure of general psychological distress. The pilot studied people with knee or hip osteoarthritis, so it does not establish a notable reduction in distress across patients with chronic pain generally. (LLM, conf=0.88)
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- Authors
- Clarke, S. P., Poulis, N., Moreton, B. J., Walsh, D. A., & Lincoln, N. B.
- Affiliations
- University of Nottingham (GB)
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK;
- Corresponding author
- Clarke, Simon P.
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2016-03-25
- Volume
- 39
- Issue
- 7
- Pages
- 663-670
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W2326558747
- Cited by
- 23
- References
- 36
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 5 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 2
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- other-oa
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Lincoln Repository (University of Lincoln) (acceptedVersion)
- Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (acceptedVersion)
- Open Research Online (The Open University) (acceptedVersion)
- Repository@Nottingham (University of Nottingham) (acceptedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Nottingham ePrints (University of Nottingham) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- University of Nottingham
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, knee osteoarthritis, hip osteoarthritis, group therapy, pain, sleep disorders, Rasch analysis, outcome measure comparison, treatment acceptability
- MeSH terms
- Aged, Female, Group Processes, Humans, Male, Patient Acceptance of Health Care, Pilot Projects, Osteoarthritis, Hip, Outcome Assessment, Health Care, Osteoarthritis, Knee, Acceptance and Commitment Therapy
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