Background: Interoceptive sensibility (IS), the self-reported experience of internal
states, involves individuals' capacity to sense, interpret, integrate, and regulate their
own bodily information. Disruptions in interoceptive processes are often associated with
various health conditions, including mental illness and chronic pain (CP). Individuals
with chronic musculoskeletal pain present disruptions in IS associated with worse pain
adjustment.
While there is a growing body of research testing interoceptive-based interventions on
both healthy and clinical samples, interventions specifically tailored for individuals
with CP are limited. Furthermore, despite evidence that interventions such as mindfulness
or meditation improve IS in incividuals with CP, the mechanisms contributing to enhanced
pain-related outcomes remain unknown. Additionally, in Portugal, there is a lack of
cost-effective interventions for CP in both public health services and the community.
This study aims to address these gaps by evaluating the feasibility of a program designed
for a community setting. The program is specifically developed to enhance IS, potentially
improving pain adjustment in individuals with chronic musculoskeletal pain - one of the
most prevalent and burdensome types of pain globally. The study compares a group
receiving an interoception-based intervention, intending to improve IS, against a control
group on a waiting list, examining the intervention's acceptability, feasibility,
appropriateness, and estimated treatment effects.
Method: The recruitment process will be conducted through the study website, providing
information about the research team, study objectives, and general details about the
intervention structure and session schedules. Potential participants must register on the
website to enroll in the study. Measurements will be collected anonymously and online
(via Qualtrics) using self-report questionnaires at four points in time: before (T0), in
the middle (T1), at the end (T2), and one month after the intervention (T3).
Additionally, participants in the intervention group will complete an anonymous
evaluation checklist after each session and a final evaluation checklist assessing the
study's acceptability, appropriateness, and feasibility. Block-stratified randomization
of participants for each group (intervention/control), based on sex and geographical area
(Lisbon/Évora), will be conducted using randomization software.
The intervention includes four stages addressing different IS skills with 8 weekly
sessions (4-6 participants), each lasting 1.5 hours. These sessions will be delivered by
two trained psychomotor therapists with clinical experience, supplemented by daily home
exercises. To ensure fidelity of the procedures during sessions, recordings will be made
for later review (therapists cross-confirm each other's sessions).
Discussion: It is expected that, with or without protocol modifications: 1) The protocol
components are suitable to conduct a larger study; 2) the program has good acceptability,
appropriateness, feasibility, and participant adherence.