Graham Christopher D, Rose Michael, Edwards Victoria, Vari Chiara, O'Connell Nicola, Taylor Emma, McCracken Lance M, Radunovic Aleksander, Rakowicz Wojtek, Norton Sam, Chalder Trudie
Department of Psychological Sciences & Health, Graham Hills Building, University of Strathclyde, Glasgow, Scotland.
Department of Neurology, King's College Hospital, London, UK.
Muscle Nerve. 2025 Mar;71(3):398-405. doi: 10.1002/mus.28322. Epub 2024 Dec 29.
INTRODUCTION/AIMS: A previous randomized controlled trial showed that guided self-help acceptance and commitment therapy plus standard medical care (ACT+SMC) was superior to standard medical care alone (SMC) for improving quality of life (QoL) and mood at 9-weeks post randomization in a sample of people with muscle disorders (MD). This follow-up study evaluated whether these effects were maintained in the longer term alongside individual patterns of response.
The original study was a two-arm parallel group randomized controlled trial, which compared ACT+SMC to SMC. The primary outcome of QoL was assessed with the Individualized Neuromuscular Quality of Life Questionnaire. We recruited people with different MDs from UK National Health Service clinics and patient registries. In this follow-up study, we re-administered all outcome measures to participants at 6 months post randomization.
Questionnaires were completed by 109 participants (70.3% of the original sample). At six months, the adjusted group difference in QoL continued to favor ACT+SMC, which was significant with moderate effect size. Improvements in secondary outcomes of mood and aspects of psychological flexibility also favored ACT+SMC. Reliable improvement was evident in 33.9% of the ACT+SMC group and 5.7% of the SMC group. Reliable deterioration was uncommon following ACT+SMC (1.8% of participants.) DISCUSSION: The beneficial impacts of guided self-help ACT for QoL and mood were maintained in the longer-term. A third of participants showed response to this brief intervention, and negative individual outcomes were very rare. As is common in psychological interventions, there was a considerable group of non-responders.
引言/目的：先前一项随机对照试验表明，在一组肌肉疾病（MD）患者中，随机分组后9周时，引导式自助接纳与承诺疗法加标准医疗护理（ACT+SMC）在改善生活质量（QoL）和情绪方面优于单纯标准医疗护理（SMC）。这项随访研究评估了这些效果在更长时间内是否得以维持以及个体的反应模式。
原研究是一项双臂平行组随机对照试验，将ACT+SMC与SMC进行比较。使用个体化神经肌肉生活质量问卷评估生活质量这一主要结局。我们从英国国家医疗服务体系诊所和患者登记处招募了患有不同肌肉疾病的患者。在这项随访研究中，我们在随机分组后6个月对参与者重新进行了所有结局测量。
109名参与者（占原样本的70.3%）完成了问卷调查。在6个月时，生活质量的调整组间差异继续有利于ACT+SMC，具有中等效应量且差异显著。情绪和心理灵活性方面的次要结局改善也有利于ACT+SMC。ACT+SMC组中33.9%的参与者有明显改善，SMC组为5.7%。接受ACT+SMC治疗后出现明显恶化的情况并不常见（1.8%的参与者）。讨论：引导式自助ACT对生活质量和情绪的有益影响在长期内得以维持。三分之一的参与者对这种简短干预有反应，负面个体结局非常罕见。与心理干预中常见的情况一样，有相当一部分无反应者。
