"practice Makes Perfect"? Associations between Home Practice and Physical and Emotional Function Outcomes among Patients with Chronic Pain Enrolled in a Mind-Body Program

Objectives: To summarize the characteristics of home practice adherence in patients with chronic pain randomized to a 10-week group mind-body activity program with (GetActive-Fitbit) and without (GetActive) a digital monitoring device, and test the association between home practice adherence and improvement in physical and emotional treatment outcomes. Methods: Data were collected in a pilot randomized controlled trial (RCT) of the GetActive (n = 41) and GetActive-Fitbit (n = 41) programs. Participants submitted weekly home practice logs depicting their daily physical activity and practice of relaxation and gratitude skills. Participants completed assessments of physical (patient-reported, performance-based, and accelerometer-measured) and emotional function outcomes both before and after the programs. Participants in both programs were combined due to the identical session and home practice content. Results: Participants reported engaging in physical activity on average 30.62 days (SD = 20.28, 48.6% of intervention days), relaxation skill practice on average 29.87 days (SD = 21.16, 47.4% of intervention days), and gratitude practice on average 32.10 days (SD = 22.12, 51.0% of intervention days). The average duration of physical activity and relaxation skill practice were 44.40 min a day (SD = 59.44) and 11.15 min a day (SD = 12.00), respectively. The duration of physical activity was significantly associated with decrease depression symptoms (p = 0.049, η2 = 0.056). No other association was found between home practice and change in outcomes. Conclusions: Patients with chronic pain are generally able and willing to engage in home practice during a mind-body activity intervention. Emphasizing longer duration of physical activity practice may contribute to an improvement in depression. Future fully powered RCTs with rigorous assessment of home practice adherence and dose-response designs may further elucidate the role of home practice in improvements in treatment outcomes. ClinicalTrials.gov identifier: NCT03412916.