Physiotherapy informed by acceptance and commitment therapy for persistent low back pain: The PACT study

Background: Many persistent low back pain (LBP) interventions have small-moderate effects on pain and disability with none clearly superior. Cognitive behavioural therapy approaches are popular but often incorporates many methods without attention to key therapeutic processes leading to less focused and effective treatment. Acceptance and Commitment Therapy (ACT) is a promising theory-based form of cognitive behavioural therapy effective in persistent pain. It is particularly appropriate for physiotherapist-led delivery since it emphasises goal setting, behavioural activation, and improving function despite pain, mirroring many physiotherapy management strategies. Physiotherapist-delivered management based on ACT has not been evaluated.