Osteopathy, mindfulness and acceptance for persistent pain

ISRCTN ISRCTN04892266
DOI https://doi.org/10.1186/ISRCTN04892266
ClinicalTrials.gov number NCT02121587
Secondary identifying numbers 16731
Submission date
06/06/2014
Registration date
08/07/2014
Last edited
10/05/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Signs and Symptoms
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Research has found that people with persistent pain often suffer from anxiety, depression and isolation, which can lead to loss of mobility, loss of independence and unemployment. People with long-term conditions can benefit from multidisciplinary healthcare where health care professionals with different areas of medical expertise work together to make a complete healthcare plan. Self-management programmes can also improve emotional health and result in the patient taking less medication. However, at the moment there are few programmes that offer both physical treatment and psychological support for individual patients living with persistent pain. The British School of Osteopathy (BSO) is developing a new course as part of the OsteoMAP project, to help people to live more flexible and fulfilling lives, despite ongoing pain. The aim of this study is to explore whether providing a healthcare course which includes osteopathic treatment, mindfulness skills and self-care exercises can help people to cope better with long-term pain. We will be collecting feedback from patients and assessing how successful it is in order to improve the course.

Who can participate?
Adult patients that have suffered from persistent musculoskeletal pain for more than 6 months, who are suitable for manual therapy and whose pain is stopping them from doing their usual daily life activities

What does this study involve?
Patients are offered personalised courses that deal with their own needs, which they attend for one hour, once a week for six weeks. Each session includes tailored manual therapy, mindfulness breathing and meditation and mindful movement exercises to improve body awareness. Home practices are also suggested to develop skills to help live better with pain. The patients continue with their usual medical care during the course but are asked not to start new treatments which aim to control pain, unless recommended by the GP. Treatment is provided by teams consisting of a qualified osteopath and up to three student osteopaths. Each patient is asked to complete a set of questionnaires about their pain and general health before the course starts and then six months later. About 5% of participants are also asked for permission for a member of the study team to observe a course session for evaluation purposes, or to take part in a follow-up research interview after six months.

What are the possible risks and benefits of participating?
The course is considered to be low risk as it does not involve invasive treatment and is based on activities that are regularly used in pain management courses in the UK. All patients are screened by the clinic team to check that manual therapy is suitable and their GPs are asked if unsure. Around half of patients may feel minor muscle soreness lasting less than 24 hours after the first treatment but they will be given advice as to how to treat this if it happens. All physical treatment and movement-based activities will be adapted for each patients personal capabilities and they will not be asked to do anything they are uncomfortable with. The course encourages patients to think about how pain is affecting their life, which they may find emotionally upsetting. Mindfulness and mindful movements have been used successfully on similar pain management programmes and carry little risk of harm as they consist of the movements of normal daily living. There are no guaranteed specific benefits for individual participants but previous research has shown that some people on mindfulness pain management courses report feeling able to cope better with their symptoms. This course may encourage patients to do activities they may have been avoiding because of pain, so potential benefits could include a more active, enjoyable life.

Where is the study run from?
The British School of Osteopathy (UK)

When is the study starting and how long is it expected to run for?
September 2014 to May 2015

Who is funding the study?
Department of Health (UK)

Who is the main contact?
Mrs Hilary Abbey
H.Abbey@bso.ac.uk

Contact information

Mrs Hilary Abbey
Scientific

The British School of Osteopathy
275 Borough High Street
London
SE1 1JE
United Kingdom

Study information

Study designNon-randomised; Observational; Design type: Cohort study
Primary study designObservational
Secondary study designCohort study
Study setting(s)Other
Study typeQuality of life
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleDeveloping OsteoMAP: an integrated osteopathy, mindfulness and acceptance-based programme for patients with persistent pain
Study objectives1. Do patients with persistent musculoskeletal pain report improvements in quality of life, well-being and ability to engage in personally-valued activities six months after participating in an individually delivered pain self-management course, which integrates Mindfulness and Acceptance-based approaches to self-care with Osteopathic manual therapy treatment?
2. Are changes in quality of life, well-being and physical activity associated with increased pain acceptance and/or mindfulness skills.
3. Does this new, integrated approach to promoting more effective self-care strategies appear to be feasible for further evaluations of effectiveness for patients in primary care?
Ethics approval(s)NRES Committee London: City Road and Hampstead, 28/05/2014, ref: 14/LO/0828
Health condition(s) or problem(s) studiedTopic: Primary Care; Subtopic: Not Assigned; Disease: All Diseases
InterventionMindfulness exercises: In each one hour session, participants will be encouraged to develop and practice new mindfulness skills to promote their own self and body awareness, as part of the healthcare approaches of Acceptance and Commitment Therapy (3rd wave CBT). Interventions will include mindfulness breathing meditations and mindful movement practices, as well as acceptance-based activities to promote resilience and encourage re-engagement with personally valued activities and social roles.
Osteopathic treatment, Manual therapy treatment in each one hour session will be pragmatic and personalised for that patient's musculoskeletal condition, physical capabilities and personal life goals. Treatment for long-term pain patients is usually conservative, consisting of massage, stretching, and passive and active joint articulation techniques and home exercises.
Follow Up Length: 6 month(s); Study Entry : Registration only
Intervention typeOther
Primary outcome measureEuropean Quality of Life Questionnaire EQ5D; Timepoint(s): Pre intervention and after 6 months
Secondary outcome measures1. Bournemouth Pain Questionnaire; Timepoint(s): Pre intervention and after 6 months
2. Freiburg Mindfulness Inventory; Timepoint(s): Pre intervention and after 6 months
3. The Activity Avoidance Questionnaire AAQ-II; Timepoint(s): Pre intervention and after 6 months
Overall study start date01/09/2014
Completion date29/05/2015

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participantsPlanned Sample Size: 320; UK Sample Size: 320
Total final enrolment208
Key inclusion criteria1. Adult patients with persistent musculoskeletal pain for more than 6 months
2. Suitable for manual therapy
3. With pain-related limitations to daily life activities
4. Willing to participate actively in exploring new approaches to self-care
5. Have scope for increasing their physical activity levels
Key exclusion criteria1. Aged under 18, unsuitable for osteopathy
2. Uncontrolled alcohol or substance dependency, which would limit ability to participate in mindfulness exercises
3. Active, uncontrolled psychosis for the same reason
4. Unwilling to participate in enhancing their own well-being
5. Speaking insufficient English to participate in their own healthcare consultations without an interpreter
Date of first enrolment01/09/2014
Date of final enrolment29/05/2015

Locations

Countries of recruitment

  • United Kingdom

Study participating centre

The British School of Osteopathy
London
SE1 1JE
United Kingdom

Sponsor information

The British School of Osteopathy (UK)
University/education

275 Borough High Street
London
SE1 1JE
England
United Kingdom

ROR logo "ROR" https://ror.org/05tnja216

Funders

Funder type

Government

Department of Health (UK) - Voluntary Sector Investment Programme; Grant Codes: IESD AIMS 2527190

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/06/2017 10/05/2019 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

10/05/2019: Publication reference and total final enrolment number added.
10/08/2017: No publications found, verifying study status with principal investigator.