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Incorporating walking into cognitive behavioral therapy for chronic pain: safety and effectiveness of a personalized walking intervention

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Abstract

We examined the effectiveness and safety of a walking program offered as part of cognitive behavioral therapy for chronic pain (CBT-CP). Participants were randomized to 10 weeks of CBT-CP, delivered either in person or by interactive voice response. Participants reported pedometer-measured step counts daily throughout treatment and received a weekly goal to increase their steps by 10% over the prior week’s average. Walking-related adverse events (AEs) were assessed weekly. Participants (n = 125) were primarily male (72%), and white (80%) with longstanding pain (median: 11 years). There was no significant difference between treatment groups in rate of change in daily steps, but there was a significant increase in steps from baseline to treatment termination in the combined study sample (1648 steps (95% CI 1063–2225)). Participants classified as active doubled. AEs were mostly minor and temporary. Treatment was effective and safe whether the program was delivered in-person or remotely.

Trial registration number: clinicaltrials.gov identifier: NCT01025752.

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Funding

This project was funded through a Veterans Health Administration Health Services Research and Development Service Investigator Initiated Research Award (09–058). Drs. Heapy, Driscoll, Goulet, and Kerns were supported by the Veterans Health Administration Health Services Research and Development Service Center of Innovation (CIN 13–407). Drs. Krein and Piette are VA Career Research Scientists.

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Authors and Affiliations

  1. VA Connecticut Healthcare System Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, 950 Campbell Avenue, West Haven, CT, 06516, USA

    Alicia A. Heapy, Mary Driscoll, Kathryn M. LaChappelle, Joseph L. Goulet & Robert D. Kerns

  2. Yale School of Medicine, New Haven, USA

    Alicia A. Heapy, Mary Driscoll, Joseph L. Goulet, Eugenia Buta & Robert D. Kerns

  3. Wayne State University, Detroit, USA

    Hallie Tankha

  4. VA Boston Healthcare System, Boston, USA

    Diana M. Higgins

  5. Boston University School of Medicine, Boston, USA

    Diana M. Higgins

  6. VA Ann Arbor Center for Clinical Management Research Health Services Research and Development Center of Innovation, Ann Arbor, USA

    John D. Piette & Sarah L. Krein

  7. University of Michigan School of Public Health, Ann Arbor, USA

    John D. Piette

  8. University of Michigan Medical School, Ann Arbor, USA

    John D. Piette & Sarah L. Krein

Authors
  1. Alicia A. Heapy
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  2. Hallie Tankha
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  3. Diana M. Higgins
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  8. John D. Piette
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  9. Robert D. Kerns
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  10. Sarah L. Krein
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Contributions

Drs. Heapy, Tankha, Piette, Higgins, Driscoll, Buta, Goulet, LaChappelle, Krein, Kerns all contributed to the drafting or editing of this manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alicia A. Heapy.

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The authors declare that they have no conflict of interest.

Human and animal rights and informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation of VA Connecticut Healthcare System and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants included in the study.

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Heapy, A.A., Tankha, H., Higgins, D.M. et al. Incorporating walking into cognitive behavioral therapy for chronic pain: safety and effectiveness of a personalized walking intervention. J Behav Med 44, 260–269 (2021). https://doi.org/10.1007/s10865-020-00193-8

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  • DOI: https://doi.org/10.1007/s10865-020-00193-8

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