Physical therapists will train to use mindfulness to reduce chronic pain at Brooks Rehabilitation outpatient clinics.

One-third of adults in the United States have chronic musculoskeletal pain. Opioids are commonly prescribed for pain management; however, prescription opioids can pose risks of opioid misuse, addiction, overdose, and even death. Physical therapy is a non-pharmacological approach that can help mitigate these risks, and researchers from Brooks Rehabilitation and the University of Utah believe mindfulness training could be a key addition to a physical therapist’s toolkit.

Jason Beneciuk, PT, DPT, PhD, MPH, clinical research scientist of the Brooks/UF-PHHP Research Collaboration, and a multi-disciplinary team have received a $1.6 million R01 grant from the National Institutes of Health (NIH) and National Center for Complementary and Integrative Health (NCCIH). University of Utah Research Associate Professor Jake Magel, PT, PhD, DSc, will be leading the study in collaboration with Dr Beneciuk, who is the site principal investigator at Brooks Rehabilitation and research assistant professor in the Department of Physical Therapy at the University of Florida College of Public Health and Health Professions. The grant funds a feasibility study to train physical therapists to use mindfulness-based interventions to manage patients with chronic musculoskeletal pain and long-term opioid use.

According to the NCCIH, the practice of mindfulness involves maintaining attention or awareness on the present moment without making judgments. Recent studies have investigated if mindfulness helps manage anxiety, stress, pain, or symptoms related to withdrawal from opioids. For example, mindfulness-based interventions can help people experiencing chronic pain by reappraising the way in which they commonly think about pain as being threatening and harmful. Mindfulness interventions can positively impact functional outcomes in people experiencing chronic pain by limiting unproductive ways of thinking about pain while also enhancing their self-efficacy for adaptive coping strategies. These interventions may also impact the amount of opioids used to manage chronic pain.


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The three-year, multi-site study, “Physical Therapy Integrated with Mindfulness for Patients with Chronic Musculoskeletal Pain and Long-term Opioid Treatment,” combines faculty expertise from the University of Utah and UF with the robust rehabilitation system of Brooks Rehabilitation. As Site PI for Florida, Beneciuk will engage the Orlando outpatient clinics under the purview of Brooks Rehabilitation Outpatient Regional Director of Orlando, Tom Langer, PT, CSCS.

“There’s evidence that mindfulness-based interventions are effective in reducing chronic pain and opioid use in some patients,” Magel says. “But to our knowledge, it’s never been implemented or studied before in the physical therapy setting.”

The need is pressing. Due to social distancing recommendations during the COVID-19 pandemic, physicians increasingly prescribed opioids for pain management, rather than in-person treatment like physical therapy. And drug overdoses from prescription opioids killed 16,416 people in the US in 2020, a spike of more than 2,000 from the previous year.

Promisingly, combining exercise with mindfulness has been found to be effective for patients with chronic musculoskeletal pain, and mindfulness practices have been associated with a reduction in opioid dosage in patients with chronic pain and long-term opioid treatment.

“This study is exciting for our team as it may provide further opportunities for physical therapists to positively impact patients with chronic pain,” says Beneciuk. “Our overall goal is to optimize the effectiveness of physical therapists in managing patients with chronic musculoskeletal pain and long-term opioid treatment. However, to achieve this goal, we first need to evaluate the feasibility of integrating mindfulness with evidence-based physical therapy treatment in outpatient physical therapy settings.”

The study will help the team identify barriers and determine viability of integrating mindfulness interventions into clinical practice. Researchers are interested to know if they 1) can enroll physical therapists in a trial, 2) randomize them to different levels of training, and 3) randomize patients to physical therapists who attended the training and collect patient outcomes over time. Results from the study will further support future projects, including testing the effectiveness of integrating mindfulness in the physical therapy setting.

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