The Effectiveness of a Mindfulness-Based Intervention Integrated with Physical Therapy (MIND-PT) for Postsurgical Rehabilitation After Lumbar Surgery: A Protocol for a Randomized Controlled Trial as Part of the Back Pain Consortium (BACPAC) Research Program.
Study Goal
The researchers aimed to determine whether integrating physical therapy and mindfulness into an enriched pain management pathway improves outcomes and reduces opioid reliance in patients undergoing surgery for chronic low back pain.
Results Summary
The study compares an enriched pain management pathway (EPM) combining physical therapy and mindfulness with usual care (UC). Primary outcomes include pain impact (PEG scale) and time to opioid discontinuation, but specific results are not yet reported in the abstract.
Population
Persons with chronic low back pain undergoing surgery, specifically from military treatment facilities.
Effective Dosage
Not specified
Duration
10 sessions of physical therapy with integrated mindfulness techniques post-surgery.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
nonpharmacological treatments, including physical therapy and mindfulness | decrease | nonsurgical LBP | - | - | are beneficial | #1 |
enriched pain management (EPM) pathway that integrates physical therapy and mindfulness | neutral | usual-care pain management (UC) | persons undergoing surgery for LBP | - | compares | #2 |
enriched pain management (EPM) pathway | increase | outcomes | persons undergoing lumbar surgery | - | designed to improve | #3 |
enriched pain management (EPM) pathway | decrease | opioid overreliance | persons undergoing lumbar surgery | - | designed to reduce | #4 |
BACKGROUND: Improving pain management for persons with chronic low back pain (LBP) undergoing surgery is an important consideration in improving patient-centered outcomes and reducing the risk of persistent opioid use after surgery. Nonpharmacological treatments, including physical therapy and mindfulness, are beneficial for nonsurgical LBP through complementary biopsychosocial mechanisms, but their integration and application for persons undergoing surgery for LBP have not been examined. This study (MIND-PT) is a multisite randomized trial that compares an enriched pain management (EPM) pathway that integrates physical therapy and mindfulness vs usual-care pain management (UC) for persons undergoing surgery for LBP. DESIGN: Participants from military treatment facilities will be enrolled before surgery and individually randomized to the EPM or UC pain management pathways. Participants assigned to EPM will receive presurgical biopsychosocial education and mindfulness instruction. After surgery, the EPM group will receive 10 sessions of physical therapy with integrated mindfulness techniques. Participants assigned to the UC group will receive usual pain management care after surgery. The primary outcome will be the pain impact, assessed with the Pain, Enjoyment, and General Activity (PEG) scale. Time to opioid discontinuation is the main secondary outcome. SUMMARY: This trial is part of the National Institutes of Health Helping to End Addiction Long-term (HEAL) initiative, which is focused on providing scientific solutions to the opioid crisis. The MIND-PT study will examine an innovative program combining nonpharmacological treatments designed to improve outcomes and reduce opioid overreliance in persons undergoing lumbar surgery.