Abstract
Chronic pain is associated with substantial decreases in physical and emotional health. Psychosocial and physical restoration interventions, although potentially helpful, typically show small-to-moderate improvements that are limited to the short term, and often exhibit problematic adherence. Here, we present GetActive-Fitbit, a novel 10-week group program that integrates mind-body skills, pain coping and gradual increases in activity reinforced by a commercially available digital monitoring device (Fitbit). We illustrate the program among a group of 4 adults with heterogeneous chronic pain. We also highlight pre to post-program improvements in physical function (objective, performance-based and self-report), emotional function (depression and anxiety) and other relevant outcomes targeted by the program (e.g., pain intensity, catastrophizing, mindfulness, coping, kinesiophobia, emotional support, social isolation, pain resilience, program satisfaction and impression of change). Group participants’ experiences suggest that GetActive-Fitbit is credible, useful, and shows potential to improve physical and emotional function among this challenging population.
Clinical trial number: NCT03412916.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
A brief guide to the PROMIS Emotional Support instruments. (2015). https://www.healthmeasures.net/images/PROMIS/manuals/PROMIS_emotional_support_Scoring_Manual.pdf. Accessed 23 Dec 2020.
A brief guide to the PROMIS Social Isolation instruments. (2015). https://www.healthmeasures.net/images/PROMIS/manuals/PROMIS_social_isolation_Scoring_Manual.pdf. Accessed 23 Dec 2020.
A brief guide to the PROMIS anxiety instruments. (2015). https://www.healthmeasures.net/images/PROMIS/manuals/PROMIS_anxiety_Scoring_Manual.pdf. Accessed 23 Dec 2020.
A brief guide to the PROMIS depression instruments. (2015). https://www.healthmeasures.net/images/PROMIS/manuals/PROMIS_depression_Scoring_Manual.pdf. Accessed 23 Dec 2020.
American Thoractic Society. (2002). ATS Statement: The Six-Minute Walk Test. American Journal of Respiratory Critical Care Med, 166(1), 111–117. https://doi.org/10.1164/rccm.166/1/111.
Amorim, A. B., Pappas, E., Simic, M., Ferreira, M. L., Jennings, M., Tiedemann, A., Ferreira, P. H. (2019). Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): A pilot randomised controlled trial. BMC Musculoskeletal Disorders, 20(1). https://doi.org/https://doi.org/10.1186/s12891-019-2454-y
Andersson, G., Johansson, C., Nordlander, A., & Asmundson, G. J. G. (2012). Chronic pain in older adults: A controlled pilot trial of a brief cognitive-behavioural group treatment. Behavioural and Cognitive Psychotherapy, 40(2), 239–244. https://doi.org/10.1017/S1352465811000646.
Anheyer, D., Haller, H., Barth, J., Lauche, R., Dobos, G., & Cramer, H. (2017). Mindfulness-based stress reduction for treating low back pain: A systematic review and meta-analysis. Annals of Internal Medicine. https://doi.org/10.7326/M16-1997.
Attkisson, C. C., & Zwick, R. (1982). The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning, 5(3), 233–237.
Block, V. J., Lizée, A., Crabtree-Hartman, E., Bevan, C. J., Graves, J. S., Bove, R., & Gelfand, J. M. (2017). Continuous daily assessment of multiple sclerosis disability using remote step count monitoring. Journal of Neurology, 264(2), 316–326. https://doi.org/10.1007/s00415-016-8334-6.
Cain, K. L., Conway, T. L., Adams, M. A., Husak, L. E., & Sallis, J. F. (2013). Comparison of older and newer generations of ActiGraph accelerometers with the normal filter and the low frequency extension. International Journal of Behavioral Nutrition and Physical Activity. https://doi.org/10.1186/1479-5868-10-51.
Carver, C. S. (2006). MOCS (Measure of Current Status). http://www.psy.miami.edu/faculty/ccarver/sclMOCS.html. Accessed 19 June 2019
Chandrasekar, A., Hensor, E. M. A., Mackie, S. L., Backhouse, M. R., & Harris, E. (2018). Preliminary concurrent validity of the Fitbit-Zip and ActiGraph activity monitors for measuring steps in people with polymyalgia rheumatica. Gait and Posture, 61, 339–345. https://doi.org/10.1016/j.gaitpost.2018.01.035.
Chu, A. H. Y., Ng, S. H. X., Paknezhad, M., Gauterin, A., Koh, D., Brown, M. S., & Müller-Riemenschneider, F. (2017). Comparison of wrist-worn Fitbit Flex and waist-worn ActiGraph for measuring steps in free-living adults. PLoS ONE, 12(2). https://doi.org/https://doi.org/10.1371/journal.pone.0172535
Compernolle, S., Desmet, A., Poppe, L., Crombez, G., De Bourdeaudhuij, I., Cardon, G., & Van Dyck, D. (2019). Effectiveness of interventions using self-monitoring to reduce sedentary behavior in adults: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity. https://doi.org/10.1186/s12966-019-0824-3.
Copay, A. G., Subach, B. R., Glassman, S. D., Polly, D. W., & Schuler, T. C. (2007). Understanding the minimum clinically important difference: a review of concepts and methods. Spine Journal. https://doi.org/10.1016/j.spinee.2007.01.008.
Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., & Oja, P. (2003). International physical activity questionnaire: 12-Country reliability and validity. Medicine and Science in Sports and Exercise, 35(8), 1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB.
Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W. S., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. Clinical Journal of Pain, 28(6), 475–483. https://doi.org/10.1097/AJP.0b013e3182385392.
Czajkowski, S. M., Powell, L. H., Adler, N., Naar-King, S., Reynolds, K. D., Hunter, C. M., & Charlson, M. E. (2015). From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychology, 34(10), 971–982. https://doi.org/10.1037/hea0000161.
Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist, 69(2), 153–166. https://doi.org/10.1037/a0035747.
Farrar, J. T., Young, J. P., LaMoreaux, L., Werth, J. L., & Poole, R. M. (2001). Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain, 94(2), 149–158. https://doi.org/10.1016/S0304-3959(01)00349-9.
Feehan, L., Clayton, C., Carruthers, E., & Li, L. (2014). FRI0579-HPR Feasibility of Using Fitbit Flex to Motivate People with Rheumatoid Arthritis to BE Physically Active: Table 1. Annals of the Rheumatic Diseases, 73(Suppl 2), 1204.3-1205. https://doi.org/https://doi.org/10.1136/annrheumdis-2014-eular.4010
Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J. P. (2007). Mindfulness and emotion regulation: The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29(3), 177–190. https://doi.org/10.1007/s10862-006-9035-8.
Franzen-Castle, L., Dunker, T., Chai, W., & Krehbiel, M. (2017). Fitbit and fitabase technology: Tracking and evaluating youth physical activity. Journal of Extension, 55(2).
Garin, O., Ayuso-Mateos, J. L., Almansa, J., Nieto, M., Chatterji, S., Vilagut, G., & Ferrer, M. (2010). Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health and Quality of Life Outcomes, 8, 51. https://doi.org/10.1186/1477-7525-8-51.
Geisser, M. E., Clauw, D. J., Strand, V., Gendreau, R. M., Palmer, R., & Williams, D. A. (2010). Contributions of change in clinical status parameters to Patient Global Impression of Change (PGIC) scores among persons with fibromyalgia treated with milnacipran. Pain, 149(2), 373–378. https://doi.org/10.1016/j.pain.2010.02.043.
Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017). Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. The Cochrane Database of Systematic Reviews, 1, CD011279. https://doi.org/https://doi.org/10.1002/14651858.CD011279.pub2
Gewandter, J. S., Dworkin, R. H., Turk, D. C., Devine, E. G., Hewitt, D., Jensen, M. P., & Witter, J. (2019). Improving study conduct and data quality in clinical trials of chronic pain treatments: IMMPACT recommendations. The Journal of Pain. https://doi.org/10.1016/j.jpain.2019.12.003.
Gonzalez, A., Shim, M., Mahaffey, B., Vranceanu, A.-M., Reffi, A., & Park, E. R. (2018). The relaxation response resiliency program (3RP) in patients with headache and musculoskeletal pain: A retrospective analysis of clinical data. Pain Management Nursing. https://doi.org/10.1016/j.pmn.2018.04.003.
Gonzalez, A., Vranceanu, A. M., Mahaffey, B., Laroche, K., & Park, E. R. (2016). Mental and physical health outcomes following the Relaxation Response Resiliency Program (3RP) in a clinical practice setting. European Journal of Integrative Medicine, 8(5), 756–761. https://doi.org/10.1016/j.eujim.2016.05.002.
Gordon, R., & Bloxham, S. (2017). Influence of the Fitbit Charge HR on physical activity, aerobic fitness and disability in non-specific back pain participants. Journal of Sports Medicine and Physical Fitness, 57(12), 1669–1675. https://doi.org/https://doi.org/10.23736/S0022-4707.17.06665-8
Greenberg, J., Braun, T. D., Schneider, M. L., Finkelstein-Fox, L., Conboy, L. A., Schifano, E. D., & Lazar, S. W. (2018). Is less more? A randomized comparison of home practice time in a mind-body program. Behaviour Research and Therapy, 111(October), 52–56. https://doi.org/10.1016/j.brat.2018.10.003.
Greenberg, J., Lin, A., Zale, E. L., Kulich, R. J., James, P., Millstein, R. A., & Vranceanu, A. M. (2019). Development and early feasibility testing of a mind-body physical activity program for patients with heterogeneous chronic pain; the getactive study. Journal of Pain Research, 12, 3279–3297. https://doi.org/10.2147/JPR.S222448.
Greenberg, J., Popok, P. J., Lin, A., Kulich, R. J., James, P., Macklin, E. A., & Vranceanu, A.-M. (2020). A mind-body physical activity program for chronic pain with or without a digital monitoring device: proof-of-concept feasibility randomized controlled trial. JMIR Formative Research, 4(6), e18703. https://doi.org/10.2196/18703.
Haglin, J. M., Godzik, J., Mauria, R., Cole, T. S., Walker, C. T., Kakarla, U., & Turner, J. D. (2019). Continuous activity tracking using a wrist-mounted device in adult spinal deformity: A proof of concept study. World Neurosurgery, 122, 349–354. https://doi.org/10.1016/j.wneu.2018.10.235.
Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., & Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2.
Hurwitz, E. L., Morgenstern, H., & Chiao, C. (2005). Effects of recreational physical activity and back exercises on low back pain and psychological distress: Findings from the UCLA low back pain study. American Journal of Public Health, 95(10), 1817–1824. https://doi.org/10.2105/AJPH.2004.052993.
Jackson, W., Zale, E. L., Berman, S. J., Malacarne, A., Lapidow, A., Schatman, M. E., & Vranceanu, A. M. (2019). Physical functioning and mindfulness skills training in chronic pain: A systematic review. Journal of Pain Research, 12, 179–189. https://doi.org/10.2147/JPR.S172733.
Jaeschke, R., Singer, J., & Guyatt, G. H. (1989). Measurement of health status. Ascertaining the minimal clinically important difference. Controlled Clinical Trials, 10(4), 407–415. https://doi.org/https://doi.org/10.1016/0197-2456(89)90005-6
Jamison, R. N., Jurcik, D. C., Edwards, R. R., Huang, C. C., & Ross, E. L. (2017). A pilot comparison of a smartphone app with or without 2-way messaging among chronic pain patients: who benefits from a pain app? Clinical Journal of Pain, 33(8), 676–686. https://doi.org/10.1097/AJP.0000000000000455.
Kalichman, S. C., & Grebler, T. (2010). Stress and poverty predictors of treatment adherence among people with low-literacy living with HIV/AIDS. Psychosomatic Medicine, 72(8), 810–816. https://doi.org/10.1097/PSY.0b013e3181f01be3.
Keefe, F. J. (1996). Cognitive Behavioral Therapy for Managing Pain. The Clinical Psychologist, 49, 4–5.
Kroll, H. R. (2015). Exercise therapy for chronic pain. Physical Medicine and Rehabilitation Clinics of North America. https://doi.org/10.1016/j.pmr.2014.12.007.
Kulich, R., Berna, C., Backstrom, J., & Mao, J. (2015). The use of a commonly-used digital monitoring device as a post treatment activity measure to encourage function after structured opioid tapering, a case report. The Journal of Pain, 16(4), S95. https://doi.org/10.1016/j.jpain.2015.01.396.
Maijers, M. C., Verschuren, O., Stolwijk-Swüste, J. M., van Koppenhagen, C. F., de Groot, S., & Post, M. W. M. (2018). Is Fitbit Charge 2 a feasible instrument to monitor daily physical activity and handbike training in persons with spinal cord injury? A pilot study. Spinal Cord Series and Cases, 4(1). https://doi.org/https://doi.org/10.1038/s41394-018-0113-4
Mccracken, L. M., & Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress. American Psychologist, 69(2), 178–187. https://doi.org/10.1037/a0035623.
McGrath, R., Vella, C. A., Scruggs, P. W., Peterson, M. D., Williams, C. J., & Paul, D. R. (2017). The impact of low accelerometer wear time on the estimates and application of sedentary behavior and physical activity data in adults. Journal of Physical Activity and Health, 14(12), 919–924. https://doi.org/10.1123/jpah.2016-0584.
Meade, L. B., Bearne, L. M., Sweeney, L. H., Alageel, S. H., & Godfrey, E. L. (2019). Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review. British Journal of Health Psychology, 24(1), 10–30. https://doi.org/10.1111/bjhp.12324.
Monticone, M., Ambrosini, E., Rocca, B., Foti, C., & Ferrante, S. (2017). Responsiveness and minimal clinically important changes for the Tampa Scale of Kinesiophobia after lumbar fusion during cognitive behavioral rehabilitation. European Journal of Physical and Rehabilitation Medicine, 53(3), 351–358. https://doi.org/https://doi.org/10.23736/S1973-9087.16.04362-8
Morin, C. M., Gibson, D., & Wade, J. (1998). Self-reported sleep and mood disturbance in chronic pain patients. Clinical Journal of Pain, 14(4), 311–314. https://doi.org/10.1097/00002508-199812000-00007.
Motl, R. W., Pilutti, L. A., Learmonth, Y. C., Goldman, M. D., & Brown, T. (2013). Clinical Importance of Steps Taken per Day among Persons with Multiple Sclerosis. PLoS ONE, 8(9). https://doi.org/https://doi.org/10.1371/journal.pone.0073247
National Center for Complementary and Integrative Health. (2017). Framework for developing and testing mind and body interventions. https://nccih.nih.gov/grants/mindbody/framework. Accessed 27 June 2019
Nissen, T., & Wynn, R. (2014). The clinical case report: A review of its merits and limitations. BMC Research Notes, 7(1). https://doi.org/https://doi.org/10.1186/1756-0500-7-264
Onken, L. S., Carroll, K. M., Shoham, V., Cuthbert, B. N., & Riddle, M. (2013). Reenvisioning clinical science: Unifying the discipline to improve the public health. Clinical Psychological Science, 2(1), 22–34. https://doi.org/10.1177/2167702613497932.
Park, E. R., Traeger, L., Vranceanu, A. M., Scult, M., Lerner, J. A., Benson, H., & Fricchione, G. L. (2013). The development of a patient-centered program based on the relaxation response: The relaxation response resiliency program (3RP). Psychosomatics, 54(2), 165–174. https://doi.org/10.1016/j.psym.2012.09.001.
Parsons, C. E., Crane, C., Parsons, L. J., Fjorback, L. O., & Kuyken, W. (2017). Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41. https://doi.org/10.1016/j.brat.2017.05.004.
Peek, K., Sanson-Fisher, R., Mackenzie, L., & Carey, M. (2016). Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: A systematic review. Physiotherapy (United Kingdom). https://doi.org/10.1016/j.physio.2015.10.003.
Phan, K., & Mobbs, R. J. (2016). Long-term objective physical activity measurements using a wireless accelerometer following minimally invasive transforaminal interbody fusion surgery. Asian Spine Journal, 10(2), 366–369. https://doi.org/10.4184/asj.2016.10.2.366.
Pincus, T., Burton, A. K., Vogel, S., & Field, A. P. (2002). A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. https://doi.org/10.1097/00007632-200203010-00017.
Rai, S. K., Yazdany, J., Fortin, P. R., & Aviña-Zubieta, J. A. (2015). Approaches for estimating minimal clinically important differences in systemic lupus erythematosus. Arthritis Research and Therapy, 17(1). https://doi.org/https://doi.org/10.1186/s13075-015-0658-6
Redelmeier, D. A., Bayoumi, A. M., Goldstein, R. S., & Guyatt, G. H. (1997). Interpreting small differences in functional status: The six minute walk test in chronic lung disease patients. American Journal of Respiratory and Critical Care Medicine, 155(4), 1278–1282. https://doi.org/10.1164/ajrccm.155.4.9105067.
Reid, R. E. R., Insogna, J. A., Carver, T. E., Comptour, A. M., Bewski, N. A., Sciortino, C., & Andersen, R. E. (2017). Validity and reliability of Fitbit activity monitors compared to ActiGraph GT3X+ with female adults in a free-living environment. Journal of Science and Medicine in Sport, 20(6), 578–582. https://doi.org/10.1016/j.jsams.2016.10.015.
Richeson, N. E., & Croteau, K. A. (2018). A Feasibility Study Examining Use of the FitBit ZipTM vs. the Accusplit Eagle AC 120 XL Pedometer to Increase Physical Activity for Persons with Mild Cognitive Disorder. Activities, Adaptation and Aging, 42(1), 41–53. https://doi.org/https://doi.org/10.1080/01924788.2017.1385367
Rodriguez, C. S. (2001). Pain measurement in the elderly: A review. Pain Management Nursing, 2(2), 38–46. https://doi.org/10.1053/jpmn.2001.23746.
Rollnick, S., & Miller, W. R. (1995). What is Motivational Interviewing? Behavioural and Cognitive Psychotherapy. https://doi.org/10.1017/s135246580001643x.
Salaffi, F., Stancati, A., Alberto Silvestri, C., Ciapetti, A., & Grassi, W. (2004). Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. European Journal of Pain, 8(4), 283–291. https://doi.org/10.1016/j.ejpain.2003.09.004.
Schappert, S. M. (2006). Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02. Vital and Health Statistics. Series 13, Data from the National Health Survey. https://doi.org/europepmc.org/abstract/MED/16471269
Selvarajah, S., Neuman, B. J., & Skolasky, R. L. (2016). Using PROMIS health domains to identify clinically meaningful change in lumbar degenerative spine disease: Concurrent validity and responsiveness. The Spine Journal, 16(10), S369–S370. https://doi.org/10.1016/j.spinee.2016.07.304.
Slepian, P. M., Ankawi, B., Himawan, L. K., & France, C. R. (2016). Development and initial validation of the pain resilience scale. Journal of Pain, 17(4), 462–472. https://doi.org/10.1016/j.jpain.2015.12.010.
Spitzer, A. R., & Broadman, M. (2010). A retrospective review of the sleep characteristics in patients with chronic fatigue syndrome and fibromyalgia. Pain Practice : The Official Journal of World Institute of Pain, 10(4), 294–300. https://doi.org/10.1111/j.1533-2500.2009.00352.x.
Stetson, B. A., Dubbert, P. M., Rahn, J. M., Wilner, B. I., & Mercury, M. G. (1997). Prospective evaluation of the effects of stress on exercise adherence in community-residing women. Health Psychology, 16(6), 515–520. https://doi.org/10.1037/0278-6133.16.6.515.
Stone, A. A., Broderick, J. E., Junghaenel, D. U., Schneider, S., & Schwartz, J. E. (2016). PROMIS fatigue, pain intensity, pain interference, pain behavior, physical function, depression, anxiety, and anger scales demonstrate ecological validity. Journal of Clinical Epidemiology, 74, 194–206. https://doi.org/10.1016/j.jclinepi.2015.08.029.
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and Validation. Psychological Assessment, 7(4), 524–532. https://doi.org/10.1037/1040-3590.7.4.524.
Taylor, A. M., Phillips, K., Patel, K. V., Turk, D. C., Dworkin, R. H., Beaton, D., & Witter, J. (2016). Assessment of physical function and participation in chronic pain clinical trials: IMMPACT/OMERACT recommendations. Pain. https://doi.org/10.1097/j.pain.0000000000000577.
Turk, D., & Okifuji, A. (2001). Pain terms and taxonomies. In D. Loeser, S. Butler, & J. Chapman (Eds.), Bonica’s Management of Pain (3rd ed., pp. 18–25). Hagerstown, MD: Lippincott Williams & Wilkins.
Vranceanu, A. M., Bachoura, A., Weening, A., Vrahas, M., Smith, R. M., & Ring, D. (2014). Psychological factors predict disability and pain intensity after skeletal trauma. Journal of Bone and Joint Surgery - Series A, 96(3). https://doi.org/https://doi.org/10.2106/JBJS.L.00479
Vranceanu, A. M., Merker, V. L., Plotkin, S. R., & Park, E. R. (2014). The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: Results from a pilot study. Journal of Neuro-Oncology. https://doi.org/10.1007/s11060-014-1522-2.
Vranceanu, A. M., Riklin, E., Merker, V. L., Macklin, E. A., Park, E. R., & Plotkin, S. R. (2016). Mind-body therapy via videoconferencing in patients with neurofibromatosis: An RCT. Neurology, 87(8), 806–814. https://doi.org/10.1212/WNL.0000000000003005.
Vranceanu, A. M., Shaefer, J. R., Saadi, A. F., Slawsby, E., Sarin, J., Scult, M., & Denninger, J. W. (2013). The relaxation response resiliency enhancement program in the management of chronic refractory temporomandibular joint disorder: Results from a pilot study. Journal of Musculoskeletal Pain, 21(3), 224–230. https://doi.org/10.3109/10582452.2013.827289.
Walders-Abramson, N., Venditti, E. M., Ievers-Landis, C. E., Anderson, B., El Ghormli, L., Geffner, M., Yasuda, P. (2014). Relationships among stressful life events and physiological markers, treatment adherence, and psychosocial functioning among youth with type 2 diabetes. Journal of Pediatrics, 165(3). https://doi.org/https://doi.org/10.1016/j.jpeds.2014.05.020
Washburn, R. A., Zhu, W., McAuley, E., Frogley, M., & Figoni, S. F. (2002). The physical activity scale for individuals with physical disabilities: Development and evaluation. Archives of Physical Medicine and Rehabilitation, 83(2), 193–200. https://doi.org/10.1053/apmr.2002.27467.
Weisberg, M. B., & Clavel, J. (1999). Why is chronic pain so difficult to treat? Psychological considerations from simple to complex care. In Postgraduate Medicine (Vol. 106, pp. 141–164). https://doi.org/https://doi.org/10.3810/pgm.1999.11.771
Wideman, T. H., Asmundson, G. G. J., Smeets, R. J. E. M., Zautra, A. J., Simmonds, M. J., Sullivan, M. J. L., & Edwards, R. R. (2013). Rethinking the fear avoidance model: Toward a multidimensional framework of pain-related disability. Pain. https://doi.org/10.1016/j.pain.2013.06.005.
Woby, S. R., Roach, N. K., Urmston, M., & Watson, P. J. (2005). Psychometric properties of the TSK-11: A shortened version of the Tampa Scale for Kinesiophobia. Pain, 117(1–2), 137–144. https://doi.org/10.1016/j.pain.2005.05.029.
World Health Organization. (2001). International Classification of Functioning. Geneva: Disability and Health (ICF).
Zale, E. L., Pierre-Louis, C., Macklin, E. A., Riklin, E., & Vranceanu, A. M. (2018). The impact of a mind–body program on multiple dimensions of resiliency among geographically diverse patients with neurofibromatosis. Journal of Neuro-Oncology, 137(2), 321–329. https://doi.org/10.1007/s11060-017-2720-5.
Funding
This study was funded by an R34 grant from the National Center for Complementary and Integrative Health (1R34AT009356-01A1) to the senior author and by a K23 grant from the National Center for Complementary and Integrative Health (1K23AT010653-01A1) to the first author.
Author information
Authors and Affiliations
Contributions
AMV conceptualized the study. JG delivered the intervention, conducted the analyses, and wrote the manuscript. AMV guided the interpretation and writing. AL collected data. PJP assisted with data and manuscript preparation. RJK and RRE provided input with data interpretation and manuscript writing. All authors reviewed and agreed with the final manuscript prior to submission.
Corresponding author
Ethics declarations
Conflict of interest
Jonathan Greenberg, Ann Lin, Paula J. Popok, Ronald J. Kulich, Robert R. Edwards and Ana‑Maria Vranceanu declare that they have no conflict of interest.
Ethical Approval
Approval was obtained from the Institutional Review Board at Massachusetts General Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
Informed Consent
All participants provided written informed consent to participate in the study and that data from their participation be published anonymously.
Human and Animal Rights and Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of Massachusetts General Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Greenberg, J., Lin, A., Popok, P.J. et al. Getting Active Mindfully: Rationale and Case Illustration of a Group Mind-body and Activity Program for Chronic Pain. J Clin Psychol Med Settings 28, 706–719 (2021). https://doi.org/10.1007/s10880-020-09758-w
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-020-09758-w