Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization

• Type of Material: Article
• Authors: Marlysa B. Sullivan, Atlanta VA Health Care System; Kelsea Hill, Veterans Administration Maryland Health Care System; Lindsay A. Ballengee, Duke University; Daniel Knoblach, Veterans Administration Maryland Health Care System; Christopher Fowler, University of South Florida; Jolie Haun, University of Utah; Michael Saenger, Emory University
• Language: English
• Date: 2023-10-25
• Publisher: Sage Journals
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): https://doi.org/10.1177%2F27536130231209751
• Title of Journal or Parent Work: Global Advances in Integrative Medicine and Health
• Volume: 12
• Start Page: 27536130231209751
• Grant/Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
• Keywords: whole person care; psychologically informed physical therapy; chronic pain; self-regulation; mindfulness; mindful movement
• Research Categories: Health Sciences, Rehabilitation and Therapy

Abstract

Background While there is recognition by the greater medical community and physical therapists to address the biopsychosocial needs of people with chronic, persistent pain, there are challenges in implementation and delivery including wide variability in interventions, lack of clear rationale, and absence of clinical models that are feasible and acceptable on a large scale. Important components for psychologically informed physical therapy (PiPT) for pain care include behavioral approaches (e.g., Acceptance and Commitment Therapy), mindfulness, pain neuroscience education, motivational interviewing (MI), and interoceptive skills-building. The Empower Veterans Program (EVP) Mindful Movement framework blends these components and emphasizes a mindfulness and self-compassion approach with MI and body-based experiential learning. This program was offered in-person at the Atlanta and Maryland VA Health Care Centers with published positive Patient Reported Outcomes (PRO) pre-COVID 19 crisis and shifted to entirely remote delivery in March 2020. Objective This paper offers an evidence-based and theory driven framework to operationalize a remotely delivered group-based psychologically informed mindful movement physical therapy intervention as part of an interdisciplinary pain care program. Methods Since 2021 PRO and demographics are collected using a survey administered through Qualtrics over a 12-month period at baseline, immediately post TelePain EVP, at 6 months, and at 12 months, with findings forthcoming. Discussion/Results Tele-pain EVP offers 6-9 groups a week with 7-9 veterans from Atlanta based team and 3-4 groups a week with 5-9 veterans from Maryland based team. Adaptations for remote delivery optimized mindfulness and active learning strategies including interoceptive skills-building and use of MI to support self-efficacy to trust, restore a sense of safety in the body, and explore adaptations for safe movement. Conclusion TelePain-EVP Mindful Movement provides a framework for other programs to translate for their populations and systems to further develop best practices in PiPT for pain care and integration into interdisciplinary care.