Cognitive Behavioral Therapy for Hip Pain

Overseen By Michael C Willey

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Michael C Willey

Disqualifiers: Age <15 or >40, others

Compensation: Varies

Number of Visits: Unknown

Duration: 8 weeks

150 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Cell Phone Based Cognitive Based Therapy (Pacifica App) for hip pain?

Research shows that digital interventions, including cognitive-behavioral therapy (CBT), can improve outcomes for chronic hip pain, with significant improvements in pain and function. Additionally, smartphone apps using CBT principles have been identified as promising for pain management, suggesting potential benefits for hip pain when using the Pacifica App. ^{1 2 3 4 5}

Is Cognitive Behavioral Therapy delivered via smartphone apps safe for humans?

Cognitive Behavioral Therapy (CBT) delivered through smartphone apps is generally considered safe for humans, as it is based on well-established psychological principles. However, the quality and effectiveness of these apps can vary, and they are often developed without input from healthcare professionals. ^{4 6 7 8 9}

How does the Pacifica App treatment for hip pain differ from other treatments?

The Pacifica App offers a unique approach to managing hip pain by providing cognitive behavioral therapy (CBT) through a smartphone app, making it more accessible and convenient compared to traditional in-person therapy sessions. This app-based treatment allows users to engage in self-management of their pain, potentially increasing adherence and engagement with the therapy. ^{1 4 10 11 12}

What is the purpose of this trial?

Psychosocial conditions are common in young adults with hip pain including depression, anxiety, pain catastrophizing, and narcotic use. The incidence of these conditions is not well defined. Interventions to optimize psychosocial conditions with non-surgical or surgical treatments has not been investigated. The goal of this project is to determine the incidence of psychosocial conditions in the young adult population with hip pain and determine if cognitive based therapy can improve clinical outcomes in these individuals.

Research Team

Elizabeth Scott, MD

Principal Investigator

University of Iowa

Eligibility Criteria

This trial is for young adults aged 15-39 in Iowa with nonarthritic hip pain, specifically those diagnosed with conditions like labral tear or femoroacetabular impingement. Participants must understand written English and not be receiving treatment for other issues such as hip dislocation or avascular necrosis.

Inclusion Criteria

I am 15-39 years old and seeking treatment in Iowa for hip pain not caused by arthritis.

I have hip pain or problems without arthritis, including conditions like labral tear or FAI.

Exclusion Criteria

Difficulty with written English

I am between 15 and 40 years old.

I am receiving treatment for conditions like hip issues or bone death.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive cognitive-based therapy delivered via cell phone to address psychosocial conditions during physical therapy

8 weeks

Weekly virtual sessions

Follow-up

Participants are monitored for changes in anxiety, depression, stress, and physical function using various scales

8 weeks

Treatment Details

Interventions

• Cell Phone Based Cognitive Based Therapy (Pacifica App)
• Control

Trial Overview The study tests if a cell phone-based cognitive therapy app (Pacifica) can help improve the mental health of young adults with hip pain. It compares outcomes between those using the app and a control group without this intervention.

Participant Groups

Group I: Cell Phone Based Cognitive Based Therapy Experimental Treatment 1 Intervention

Young adults with hip pain

Group II: Placebo Placebo Group 1 Intervention

Young adults with hip pain

Who Is Running the Clinical Trial?

Michael C Willey

Lead Sponsor

Trials

4

Recruited

730+

Findings from Research

Standalone smartphone-based ecological momentary interventions (EMIs) based on cognitive behavioral therapy (CBT) principles have been shown to significantly improve well-being and reduce mental health symptoms among users, according to a review of 26 studies.

Users rated these EMIs as helpful and satisfying, indicating their potential as scalable and accessible mental health support, especially important during global crises like the COVID-19 pandemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Standalone Smartphone Cognitive Behavioral Therapy-Based Ecological Momentary Interventions to Increase Mental Health: Narrative Review. Marciniak, MA., Shanahan, L., Rohde, J., et al.[2020]

A 4-week smartphone intervention that included daily diary entries and therapist feedback significantly reduced catastrophizing in women with chronic widespread pain, showing a large effect size (Cohen's d=0.87) immediately after the intervention.

At a 5-month follow-up, the intervention continued to show moderate effects on reducing catastrophizing, improving pain acceptance, and maintaining functioning levels, indicating its long-term efficacy in supporting self-management after inpatient rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain: randomized controlled trial. Kristjánsdóttir, OB., Fors, EA., Eide, E., et al.[2022]

Cognitive Behavioral Therapy (CBT) is effective in addressing various factors that influence chronic low back pain (CLBP), but the term itself is too broad for future research, necessitating specific definitions based on the problems being addressed.

Despite its proven effectiveness, CBT is not widely implemented in clinical practice for CLBP, highlighting the need for early adoption and a public health approach to operationalize these treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Defining the Role of Cognitive Behavioral Therapy in Treating Chronic Low Back Pain: An Overview. Hanscom, DA., Brox, JI., Bunnage, R.[2020]

Internet-based cognitive behavioral therapy (CBT) interventions for chronic pain have shown significant efficacy, with improvements in disability/interference (Hedge's g = -0.39) and pain intensity (Hedge's g = -0.33) across 22 trials involving various chronic pain diagnoses.

The interventions also positively impacted psychological factors such as catastrophizing (Hedge's g = -0.49) and depression (Hedge's g = -0.26), indicating that these online treatments can effectively address both physical and mental health aspects of chronic pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet interventions for chronic pain including headache: A systematic review. Buhrman, M., Gordh, T., Andersson, G.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Digital Care Programs for Chronic Hip Pain: A Prospective Longitudinal Cohort Study. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Mobile Phone Administration of Hip-Specific Patient-Reported Outcome Instruments Correlates Highly With In-office Administration. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Physiotherapist-led treatment for young to middle-aged active adults with hip-related pain: consensus recommendations from the International Hip-related Pain Research Network, Zurich 2018. [2020]

4. England pubmed.ncbi.nlm.nih.gov

A quality review of smartphone applications for the management of pain. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Effects of internet-based pain coping skills training before home exercise for individuals with hip osteoarthritis (HOPE trial): a randomised controlled trial. [2021]

6. Canada pubmed.ncbi.nlm.nih.gov

Standalone Smartphone Cognitive Behavioral Therapy-Based Ecological Momentary Interventions to Increase Mental Health: Narrative Review. [2020]

7. Canada pubmed.ncbi.nlm.nih.gov

Usage and Dose Response of a Mobile Acceptance and Commitment Therapy App: Secondary Analysis of the Intervention Arm of a Randomized Controlled Trial. [2018]

8. England pubmed.ncbi.nlm.nih.gov

Reducing depressive symptomatology with a smartphone app: study protocol for a randomized, placebo-controlled trial. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

Dr. Smartphone, can you support my trauma? An informatics analysis study of App Store apps for trauma- and stressor-related disorders. [2023]

10. Canada pubmed.ncbi.nlm.nih.gov

A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain: randomized controlled trial. [2022]

11. England pubmed.ncbi.nlm.nih.gov

Defining the Role of Cognitive Behavioral Therapy in Treating Chronic Low Back Pain: An Overview. [2020]

12. Netherlands pubmed.ncbi.nlm.nih.gov

Internet interventions for chronic pain including headache: A systematic review. [2022]