Combined Internet-Based Cognitive Behavioral Therapy and Face-to-Face Physiotherapy in Primary Health Care for Chronic Widespread Pain: Randomized Controlled Trial - Summary - MDSpire
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Integration of Online Cognitive Behavioral Therapy with In-Person Physiotherapy for Chronic Widespread Pain in Primary Care: A Randomized Controlled Study

  • By

  • Anna Bergenheim

  • Maria EH Larsson

  • Chan-Mei Ho-Henriksson

  • Anna Grimby-Ekman

  • Anna Caroline Larsson

  • Marie Persson

  • Sandra Weineland

  • Lena Nordeman

  • June 29, 2026

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Objective:

To evaluate the effectiveness of a therapist-guided iCBT program for stress management combined with a face-to-face physiotherapist-guided physical activity plan compared to a control group receiving only the physical activity plan.

Approach:
  • Trial Design: A multicenter randomized controlled trial (RCT) with parallel groups conducted at 4 sites in southwestern Sweden and online, stratified by sex and total score on the Stress and Crisis Inventory (SCI)-93.
  • Recruitment: Recruitment included 129 participants, and was stopped due to challenges posed by the COVID-19 pandemic to ensure study completion within the available funding period.
  • Data Focus: The study focuses on baseline and 6-month follow-up data; 12-month follow-up data were not included in primary analyses due to high attrition.
Key Findings:
  • Chronic widespread pain (CWP) affects 8-11% of the population, with a higher prevalence in women.
  • CWP is linked to various factors including psychological distress, low physical activity, and stress.
  • iCBT has shown positive effects for chronic pain and stress-related illnesses.
Interpretation:

The combination of iCBT targeting stress management and physiotherapist-guided physical activity may address both psychological and physiological mechanisms in CWP.

Limitations:
  • High attrition rate at 12 months (51%) limited the validity of analyses.
  • COVID-19 pandemic affected recruitment and study timelines.
Conclusion:

The study provides insights into the effectiveness of combined interventions for managing CWP.

Original Source(s)

Combined Internet-Based Cognitive Behavioral Therapy and Face-to-Face Physiotherapy in Primary Health Care for Chronic Widespread Pain: Randomized Controlled Trial

  • by Anna Bergenheim, Maria EH Larsson, Chan-Mei Ho-Henriksson, Anna Grimby-Ekman, Anna Caroline Larsson, Marie Persson, Sandra Weineland, Lena Nordeman

  • June 29, 2026

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