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Development And Early Feasibility Testing Of A Mind-Body Physical Activity Program For Patients With Heterogeneous Chronic Pain; The GetActive Study

Authors Greenberg J, Lin A, Zale EL, Kulich RJ, James P, Millstein RA, Shapiro H, Schatman ME, Edwards RR, Vranceanu AM

Received 9 July 2019

Accepted for publication 10 October 2019

Published 11 December 2019 Volume 2019:12 Pages 3279—3297

DOI https://doi.org/10.2147/JPR.S222448

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Katherine Hanlon


Jonathan Greenberg,1,2 Ann Lin,1 Emily L Zale,1 Ronald J Kulich,2,3 Peter James,2,4 Rachel A Millstein,1,2 Hannah Shapiro,5 Michael E Schatman,6,7 Robert R Edwards,2,8 Ana-Maria Vranceanu1,2

1Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; 2Harvard Medical School, Boston, MA, USA; 3Center For Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; 4Department of Population Medicine, Harvard T. H. Chan School of Public Health, Boston, MA, USA; 5Department of Biology, Tufts University, Medford, MA, USA; 6Research and Network Development, Boston Pain Care, Waltham, MA, USA; 7Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; 8Pain Management Center, Brigham and Women’s Hospital, Boston, MA, USA

Correspondence: Ana-Maria Vranceanu
Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, One Bowdoin Square, 1 st Floor, Suite 100, Boston, MA, USA
Tel +1 6177244977
Fax +1 617-643-8777
Email avranceanu@mgh.harvard.edu

Background: Increasing physical function is a challenging, yet imperative goal of pain management programs. Physical activity can improve physical function, but uptake is low due to chronic pain misconceptions, poor pain management skills, and doing too much too soon.
Purpose: To increase physical function by 1) adapting an evidence-based, group, mind-body program to address the needs of patients with heterogeneous chronic pain and to facilitate individually tailored quota-based pacing with a Fitbit (GetActive with Fitbit) or without it (GetActive) (phase 1), and 2) assessing preliminary feasibility benchmarks (phase 2).
Methods: We followed evidence based frameworks for developing interventions and for early feasibility testing. In phase 1 we conducted 4 focus groups with 22 patients with heterogeneous chronic pain and adapted the mind-body program. In phase 2 we conducted a nonrandomized pilot trial of the 2 programs (N=7 and 6) with qualitative exit interviews.
Results: Focus groups showed high interest in increasing activity, a preference for walking linked to pleasurable activities, using a Fitbit to track number of steps, and learning skills to manage pain and aid with increased activity. Both programs had good to excellent feasibility markers. Participation in both programs was associated with signal of improvements in physical and emotional function, as well as intervention targets. Exit interviews confirmed high satisfaction and suggested modification.
Conclusion: Results informed subsequent adaptations of the 2 programs and methodology for an ongoing pilot randomized controlled trial (RCT) of the 2 programs, necessary before an efficacy RCT of the 2 programs against an education control.

Keywords: mind-body, chronic pain, fitbit, physical activity, focus groups, feasibility, physical function

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