Co-occurrence of chronic musculoskeletal pain and long-term opioid treatment is well-established. Despite the very common use of physical therapy by persons with chronic musculoskeletal pain, these providers have not engaged efforts to manage co-occurring long-term opioid treatment.
Physical therapy and mindfulness interventions can operate along common mechanistic pathways to disrupt the downward spiral of pain, catastrophic appraisal, and unconscious behavioral response including long-term opioid treatment. Strong scientific premise suggests that integrating physical therapy and mindfulness treatments may be especially beneficial for persons with co-occurring chronic musculoskeletal pain and long-term opioid treatment.
PT-IN-MIND refines an intervention that combines physical therapy and mindfulness interventions using the principles of Mindfulness-Oriented Recovery Enhancement (MORE) for patients with chronic musculoskeletal pain and long-term opioid treatment, then assesses the competency with which physical therapists provide the combined intervention and, finally, and evaluates the feasibility of this combined intervention in preparation for PT-IN-MIND’s future clinical trial.
A multi-site randomized feasibility trial is in preparation for conducting our future fully powered trial. Our 3 aims will be carried out sequentially.
- Aim 1 refines a mindfulness-based intervention protocol currently being used by physical therapists with patients after spine surgery. We need stakeholder feedback to refine this protocol for patients with chronic musculoskeletal pain and long-term opioid treatment being managed by physical therapists in outpatient setting. Our future trial will require the training of physical therapists to provide this refined mindfulness-based intervention protocol.
- Aim 2 evaluates 2 different intensities of this mindfulness-based protocol training program for consideration for our future trial.
- Aim 3 will evaluate physical therapists’ fidelity to the refined mindfulness-based treatment protocol while assessing key feasibility outcomes.
- Principal Investigator (PI) & University of Utah Site PI: Jake Magel, PT, PhD, DSc
- University of Florida & Brooks Rehabilitation Site PI: Jason Beneciuk, PhD, PT, DPT
- Julie Fritz, PhD, PT
- Adam J. Gordon, MD, MPH, FACP, DFASAM
- Eric Garland, PhD, LCSW
- Adam Hanley, PhD
- Jinching Shen, PhD
- Elizabeth Siantz, PhD, MSW
- Study Coordinator: Priscilla Blosser, RN, BSN
- Department of Physical Therapy and Athletic Training at the University of Utah Hospital and Clinics
- Brooks Rehabilitation and the Department of Physical Therapy at the University of Florida College of Public Health and Health Professions