Comparison of Emotion-Focused Therapy and Acceptance and Commitment Therapy on Quality of Life, Pain Perception, and Trunk Muscle Endurance in Women with Hand Osteoarthritis
Keywords:
Emotion-Focused Therapy, Acceptance and Commitment Therapy, Quality of Life, Pain Perception, Trunk Muscle Endurance, Hand OsteoarthritisAbstract
Objective: The present study aimed to compare the effects of Emotion-Focused Therapy (EFT) and Acceptance and Commitment Therapy (ACT) on quality of life, pain perception, and trunk muscle endurance in women with hand osteoarthritis.
Methods and Materials: This research employed a quasi-experimental design with pretest, posttest, follow-up stages, and a control group, with a follow-up period of three months. The research population consisted of all women diagnosed with hand osteoarthritis during 2024–2025. A total of 45 individuals were selected from the research population using purposive sampling and randomly assigned to experimental and control groups (15 participants in each group). Data were collected using the World Health Organization Quality of Life Questionnaire, the Melzack Pain Perception Questionnaire (Melzack, 1975), and a trunk muscle endurance test. Participants in the experimental groups received either Emotion-Focused Therapy over 12 sessions or Acceptance and Commitment Therapy over 8 sessions; the control group did not receive any therapeutic intervention. Data analysis was conducted using mixed-design repeated measures analysis.
Findings: The results showed that, after controlling for the pretest effects, there were significant differences between the experimental and control groups in the posttest scores of quality of life, pain perception, and trunk muscle endurance at the 0.05 significance level (p < .05). Moreover, the findings indicated that there were differences between Emotion-Focused Therapy and Acceptance and Commitment Therapy in their effects on quality of life, pain perception, and trunk muscle endurance in women with hand osteoarthritis.
Conclusion: It can be concluded that Emotion-Focused Therapy and Acceptance and Commitment Therapy differently impact quality of life, pain perception, and trunk muscle endurance in women with hand osteoarthritis.
Downloads
References
Abow, F. H., Razak, T. A., Abulkassim, R., Adnan, M., Rahi, A., & Fadhil, A. M. (2023). Comparing the Effectiveness of Acceptance and Commitment Therapy and Hope Therapy on Pain Anxiety and Self-Acceptance in Patients with Leukemia. International Journal of Body, Mind & Culture, 10(1). https://doaj.org/article/b2a380ef404e4cee98481266d98c1567
Al-Jabi, S. W., Seleit, D. I., Badran, A., Koni, A., & Zyoud, S. E. H. (2021). Impact of socio-demographic and clinical characteristics on functional disability and health-related quality of life in patients with rheumatoid arthritis: a cross-sectional study from Palestine. Health and Quality of Life Outcomes, 19, 1-12. https://doi.org/10.1186/s12955-021-01874-x
Beazley, D., Patel, S., Davis, B., Vinson, S., & Bolgla, L. (2017). Trunk and hip muscle activation during yoga poses: Implications for physical therapy practice. Complementary Therapies in Clinical Practice, 29, 130-135. https://doi.org/10.1016/j.ctcp.2017.09.009
Burgess, L. C., Taylor, P., Wainwright, T. W., & Swain, I. D. (2022). Strength and endurance deficits in adults with moderate-to-severe hip osteoarthritis, compared to healthy, older adults. Disability and Rehabilitation, 44(19), 5563-5570. https://doi.org/10.1080/09638288.2021.1939797
Diener, M. H., Golding, L. A., & Diener, D. (1995). Validity and reliability of a one‐minute half sit‐up test of abdominal strength and endurance. Research in Sports Medicine: An International Journal, 6(2), 105-119. https://doi.org/10.1080/15438629509512042
Farrow, M., Biglands, J., Tanner, S., Hensor, E. M., Buch, M. H., Emery, P., & Tan, A. L. (2021). Muscle deterioration due to rheumatoid arthritis: assessment by quantitative MRI and strength testing. Rheumatology, 60(3), 1216-1225. https://doi.org/10.1093/rheumatology/keaa364
Gavin, J. P., Rossiter, L., Fenerty, V., Leese, J., Adams, J., Hammond, A., Davidson, E., & Backman, C. L. (2024). The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review. ACR Open Rheumatology, 6(4), 214-249. https://doi.org/10.1002/acr2.11650
Jia, P. W., Lin, J. Z., Zou, Y. W., Ouyang, Z. M., Yang, Y., Yang, K. M., Liang, L. H., Han, J. Y., Yang, Z. H., Ma, J. D., & Dai, L. (2025). The Characteristic of Muscle Function for Sarcopenia in Patients with Rheumatoid Arthritis: A Large-Scale Real-World Cross-Sectional Study. Medicina, 61(4), 551. https://doi.org/10.3390/medicina61040551
Kim, G. H., Park, S., Choi, I. A., Kwon, H. W., Moon, H., Jung, J. H., & Kim, C. (2025). Finger-aware Artificial Neural Network for predicting arthritis in Patients with hand pain. Artificial Intelligence in Medicine, 103077. https://doi.org/10.1016/j.artmed.2025.103077
Lai, L., Liu, Y., McCracken, L. M., Li, Y., & Ren, Z. (2023). The efficacy of acceptance and commitment therapy for chronic pain: A three-level meta-analysis and a trial sequential analysis of randomized controlled trials. Behaviour Research and Therapy, 165, 104308. https://doi.org/10.1016/j.brat.2023.104308
Lo, J., Chan, L., & Flynn, S. (2021). A systematic review of the incidence, prevalence, costs, and activity and work limitations of amputation, osteoarthritis, rheumatoid arthritis, back pain, multiple sclerosis, spinal cord injury, stroke, and traumatic brain injury in the United States: a 2019 update. Archives of Physical Medicine and Rehabilitation, 102(1), 115-131. https://doi.org/10.1016/j.apmr.2020.04.001
Löfstrand, K., Björk Brämberg, E., Flink, I., Wurm, M., & Bergbom, S. (2024). Providing a new transdiagnostic emotion-focused pain treatment in a clinical context: therapists' experiences of facilitators and barriers. Cognitive behaviour therapy, 1-19. https://doi.org/10.1080/16506073.2024.2417426
Ma, T. W., Yuen, A. S. K., & Yang, Z. (2023). The efficacy of acceptance and commitment therapy for chronic pain: a systematic review and meta-analysis. The Clinical Journal of Pain, 39(3), 147-157. https://doi.org/10.1097/AJP.0000000000001096
Malange, K. F., Navia-Pelaez, J. M., Dias, E. V., Lemes, J. B. P., Choi, S. H., Dos Santos, G. G., Yaksh, T. L., & Corr, M. (2022). Macrophages and glial cells: Innate immune drivers of inflammatory arthritic pain perception from peripheral joints to the central nervous system. Frontiers in Pain Research, 3, 1018800. https://doi.org/10.3389/fpain.2022.1018800
Mao, Y., Imahori, K., Fang, W., Sugimori, H., Kiuch, S., Sutherland, K., & Kamishima, T. (2025). Artificial Intelligence Quantification of Enhanced Synovium Throughout the Entire Hand in Rheumatoid Arthritis on Dynamic Contrast‐Enhanced MRI. Journal of Magnetic Resonance Imaging, 61(2), 771-783. https://doi.org/10.1002/jmri.29463
Marren, C., Mikoška, P., O'Brien, S., & Timulak, L. (2022). A qualitative meta‐analysis of the clients' experiences of emotion‐focused therapy. Clinical Psychology & Psychotherapy, 29(5), 1611-1625. https://doi.org/10.1002/cpp.2745
Prior, Y., Bartley, C., Adams, J., Firth, J., Culley, J., O'Neill, T. W., & Hammond, A. (2022). Does wearing arthritis gloves help with hand pain and function? A qualitative study into patients' views and experiences. Rheumatology Advances in Practice, 6(1), rkac007. https://doi.org/10.1093/rap/rkac007
Romano, F., Di Scipio, F., Baima, G., Franco, F., Aimetti, M., & Berta, G. N. (2025). Health-Related Quality of Life in Juvenile Idiopathic Arthritis: A Systematic Review of Phase III Clinical Trials. Journal of clinical medicine, 14(1), 254. https://doi.org/10.3390/jcm14010254
Rostamnezhad, M., Tayyebi, P. D., A., Abolghasemi, P. D., S., & EbrahimiRad, P. D., R. (2021). Presentation of a Structural Model Explaining MS Patients’ Quality of Life based on their Lifestyle with the Mediating Role of Psychological Capital [Research]. Quarterly Journal Of Family and Research, 18(1), 87-104. http://qjfr.ir/article-1-1827-en.html
Sarac, D. C., Bayram, S., Tore, N. G., Sari, F., Guler, A. A., Tufan, A., & Oskay, D. (2022). Association of core muscle endurance times with balance, fatigue, physical activity level, and kyphosis angle in patients with ankylosing spondylitis. JCR: Journal of Clinical Rheumatology, 28(1), e135-e140. https://doi.org/10.1097/RHU.0000000000001641
Shareh, H., Ghodsi, M., & Keramati, S. (2022). Emotion-focused group therapy among women with premenstrual dysphoric disorder: a randomized clinical trial. Psychotherapy Research, 32(4), 440-455. https://doi.org/10.1080/10503307.2021.1980239
Sheikh Mohammadi, F., Rezaei, A. M., Barzegar, M., & Bogholi, H. (2022). The effectiveness of group counseling based on Acceptance and Commitment Therapy (ACT) on pain perception and death anxiety in women with breast cancer. Growth of Psychology, 11(12), 163-172. https://frooyesh.ir/article-1-4147-en.html
Shokrollahi, M., Hashemi, S. E., Mehrabizadeh Honarmand, M., Zargar, Y., & Naami, A. (2021). Comparison of the effectiveness of Emotion-Focused Therapy and Cognitive Analytic Therapy on anxiety sensitivity, pain catastrophizing, experiential avoidance, and cognitive emotion regulation in patients with chronic pain and alexithymia. Behavioral Sciences Research, 4(66), 739-752. https://doi.org/10.52547/rbs.19.4.739
Slagter, L., Demyttenaere, K., Verschueren, P., & De Cock, D. (2022). The effect of meditation, mindfulness, and yoga in patients with rheumatoid arthritis. Journal of Personalized Medicine, 12(11), 1905. https://doi.org/10.3390/jpm12111905
Tang, W., Khalili, L., Gong, R., Souvignier, M., Wang, X., Murray, S., Chavez, G. R., Nordmann-Gomes, A., Geraldino-Pardilla, L., Gartshteyn, Y., Clancy, R., Nikpour, M., & Askanase, A. (2025). Advanced Imaging in the Evaluation of Lupus Arthritis: A Systematic Literature Review and Meta-Analysis.
Yusefi, R., Hafezi, F., Bakhtiarpoor, S., & Makvandi, B. (2022). Comparing the effectiveness of cognitive- behavioral hypnotherapy and mindfulness therapy on pain perception and self-efficacy in women with breast cancer in Gorgan. Applied Family Therapy Journal (AFTJ), 3(5), 209-227. https://doi.org/10.61838/kman.aftj.3.5.13
Downloads
Additional Files
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Sara Moghadasi (Author); Amin Rafiepoor (Corresponding Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
