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NCT Number: NCT07766616

Acceptance and Commitment Therapy Plus Physiotherapy for Chronic Low Back Pain

This study is a randomized controlled trial (RCT) investigating whether adding Acceptance and Commitment Therapy (ACT) to standard physiotherapy provides greater benefits for adults with chronic low back pain than physiotherapy alone.

A total of 60 participants will be randomly allocated into two groups: ACT plus physiotherapy and physiotherapy alone. Both groups will receive a 8-weeks program with two sessions per week. The ACT component focuses on acceptance, psychological flexibility, mindfulness, cognitive defusion, values, and committed action.

The main outcomes are pain catastrophizing, functional disability, perceived stress, and sleep quality, assessed using the PCS, ODI, PSS, and PSQI. The study aims to determine whether combining psychological and physical rehabilitation produces better outcomes than physiotherapy alone.

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Key information

Conditions

Low Back Pain Back Pain Behavior Motor Activity Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–55 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

A_Aged between 18-55 years. B_Clinically diagnosed with non-specific chronic low back pain (CLBP). C_Low back pain persisting for more than 3 months.

Exclusion criteria

A. History of previous spinal surgeries or invasive interventions in the lumbar region.

B. Presence of "Red Flags" or serious underlying pathologies, such as spinal tumors, infections, or vertebral fractures.

C. Current or recent (within the last 6 months) participation in structured psychological rehabilitation or behavioral therapy programs.

D. Clinical evidence of neurological deficits, radiculopathy, or cauda equina syndrome.

E. Pregnancy, due to the physiological changes affecting musculoskeletal mechanics.

F. Severe behavioral or communication impairments preclude the ability to follow the intervention protocol or complete the self-report assessments.

G. Patients who take any sleep medication or for mental health medication. H. Patients who have done physiotherapy program last 3 months.

Treatment and study plan

Acceptance and Commitment Therapy (ACT)

Behavioral

Participants in the experimental group will receive Acceptance and Commitment Therapy (ACT) as part of the integrated rehabilitation program. ACT will be delivered for 15 minutes per session, twice weekly for 8 weeks . The intervention will focus on functional acceptance, psychological flexibility, cognitive defusion, mindfulness and present-moment awareness, values clarification, and committed action. The program aims to reduce pain catastrophizing and avoidance behaviors and promote engagement in meaningful activities despite chronic low back pain. ACT will be followed by 30 minutes of physiotherapy during each session.

Standard Physiotherapy Program

Other

Participants will receive a standard physiotherapy program twice weekly for 8 weeks . The program will include lumbar stabilization exercises, core strengthening, flexibility and mobility exercises, aerobic conditioning, soft tissue release, and TENS. The physiotherapy component aims to improve physical function, mobility, and functional ability in individuals with chronic low back pain. The same physiotherapy program will be provided to participants in both study arms.

Primary outcomes

  1. Sleep Quality

    Time frame: Pre and 8 weeks post intervention

    Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), which evaluates several aspects of sleep during the previous month. The global score ranges from 0 to 21, with higher scores indicating poorer sleep quality.

  2. Pain intensity

    Time frame: Pre and 8 weeks post intervention

    VAS_Pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity.

  3. Disability

    Time frame: Pre and 8 weeks post intervention

    Functional disability related to chronic low back pain will be assessed using the Oswestry Disability Index (ODI). The questionnaire evaluates limitations in daily activities, with the total score expressed as a percentage. Higher scores indicate greater disability.

  4. Stress

    Time frame: pre and 8 weeks post intervention

    Perceived stress will be assessed using the Perceived Stress Scale (PSS), which measures the extent to which situations in an individual's life are perceived as unpredictable, uncontrollable, and overwhelming. Higher scores indicate greater perceived stress.

  5. Pain Catastrophizing

    Time frame: Pre and 8 weeks post intervention

    Pain catastrophizing will be assessed using the 13-item Pain Catastrophizing Scale (PCS), which evaluates rumination, magnification, and helplessness related to pain. Higher scores indicate greater pain catastrophizing.

Study contacts

Contact information is provided by the study sponsor or research team.

Mosab M Aldabbas, PhD

CONTACT

[email protected]

00972597451222

Sponsors and collaborators

Lead sponsor

Al-Azhar University

Other

Registry information

Official study title

Effects of Adding Acceptance and Commitment Therapy to Physiotherapy Program on Pain Catastrophizing, Stress, Disability, and Sleep Quality in Individuals With Chronic Low Back Pain

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Aug 14, 2026
Registry last updated
Aug 14, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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