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Lutke Schipholt IJ, Coppieters MW, Diepens M, Hoekstra T, Ostelo RWJG, Barbe MF, Meijer OG, Bontkes HJ, Scholten-Peeters GGM. Systemic Inflammation, Sleep, and Psychological Factors Determine Recovery Trajectories for People With Neck Pain: An Exploratory Study. THE JOURNAL OF PAIN 2024; 25:104496. [PMID: 38342190 DOI: 10.1016/j.jpain.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Abstract
We conducted an explorative prospective cohort study with 6 months follow-up to 1) identify different pain and disability trajectories following an episode of acute neck pain, and 2) assess whether neuroimmune/endocrine, psychological, behavioral, nociceptive processing, clinical outcome, demographic and management-related factors differ between these trajectories. Fifty people with acute neck pain (ie, within 2 weeks of onset) were included. At baseline, and at 2, 4, 6, 12, and 26 weeks follow-up, various neuroimmune/endocrine (eg, inflammatory cytokines and endocrine factors), psychological (eg, stress symptoms), behavioral (eg, sleep disturbances), nociceptive processing (eg, condition pain modulation), clinical outcome (eg, trauma), demographic factors (eg, age), and management-related factors (eg, treatment received) were assessed. Latent class models were performed to identify outcome trajectories for neck pain and disability. Linear mixed models or the Pearson chi-square test were used to evaluate differences in these factors between the trajectories at baseline and at each follow-up assessment and over the entire 6 months period. For pain, 3 trajectories were identified. The majority of patients were assigned to the "Moderate pain - Favourable recovery" trajectory (n = 25; 50%) with smaller proportions assigned to the "Severe pain - Favourable recovery" (n = 16; 32%) and the "Severe pain - Unfavourable recovery" (n = 9; 18%) trajectories. For disability, 2 trajectories were identified: "Mild disability - Favourable recovery" (n = 43; 82%) and "Severe disability - Unfavourable recovery" (n = 7; 18%). Ongoing systemic inflammation (increased high-sensitive C-reactive protein), sleep disturbances, and elevated psychological factors (such as depression, stress and anxiety symptoms) were mainly present in the unfavorable outcome trajectories compared to the favorable outcome trajectories. PERSPECTIVE: Using exploratory analyses, different recovery trajectories for acute neck pain were identified based on disability and pain intensity. These trajectories were influenced by systemic inflammation, sleep disturbances, and psychological factors.
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Affiliation(s)
- Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location Vrije Universiteit, Amsterdam, Noord Holland, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; School of Health Sciences and Social Work, and Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Queensland, Australia
| | - Maaike Diepens
- Department Family Medicine, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and the Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Noord Holland, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute Amsterdam, Amsterdam, Noord Holland, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Movement Sciences Research Institute, Amsterdam, Noord Holland, The Netherlands
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Onno G Meijer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China
| | - Hetty J Bontkes
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location Vrije Universiteit, Amsterdam, Noord Holland, The Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands
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Martins Silva GZ, de Lira MR, Garcêz LR, George SZ, Neblett R, Pezolato A, Lima TC, Chaves TC. Measurement Properties of Two Questionnaires Assessing Fear-Avoidance in Patients With Chronic Low Back Pain. Eval Health Prof 2024:1632787241264588. [PMID: 39037438 DOI: 10.1177/01632787241264588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
The Fear-Avoidance Components Scale (FACS) and the Fear of Daily Activities Questionnaire (FDAQ) assess fear-avoidance model components. However, the questionnaires are not available in Brazilian Portuguese. This study aimed to translate the original English FACS and FDAQ into Brazilian (Br) Portuguese and assess their measurement properties in patients with Chronic Low Back Pain (CLBP). One hundred thirty volunteers with CLBP participated in this study. Structural validity, internal consistency, test-retest reliability, and hypothesis testing for construct validity were analyzed. Results indicated a 2-factor solution for the FACS-Br, while the FDAQ-Br had a one-factor solution. Internal consistency showed acceptable Cronbach's alpha (alpha >.8). Suitable reliability was found for the FDAQ-Br (Intraclass Correlation Coefficient [ICC] = .98). For both FACS-Br factors, suitable reliability was found as well (ICC = .95 and .94). Hypothesis testing for construct validity confirmed more than 75% of the hypotheses proposed a priori for the FACS maladaptive pain/movement-related beliefs domain and the FDAQ-Br. In conclusion, the FACS-Br and FDAQ-Br demonstrated acceptable reliability, internal consistency, and structural validity measurement properties and their correlation (r < .50) suggests that the tools are not interchangeable measures.
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Affiliation(s)
| | | | | | | | | | | | | | - Thais Cristina Chaves
- University of São Paulo - USP, Brazil
- Federal University of São Carlos - UFSCar, Brazil
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Kragting M, Pool-Goudzwaard AL, Pezzica C, Voogt L, Coppieters MW. Does having an external focus in immersive virtual reality increase range of motion in people with neck pain? Musculoskelet Sci Pract 2024; 71:102940. [PMID: 38537389 DOI: 10.1016/j.msksp.2024.102940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND When instructing exercises to improve Range of Motion (ROM), clinicians often create an internal focus of attention, while motor performance may improve more when using an external focus. OBJECTIVES Using Virtual Reality (VR), we investigated the effect of tasks with an internal and external focus on maximal ROM in people with neck pain and explored whether this effect was associated with fear of movement. METHOD In this cross-over experimental design study, the cervical ROM of 54 participants was measured while performing a target-seeking exercise in a VR-environment (external focus task) and during three maximal rotation and flexion-extension movements with the VR-headset on, without signal (internal focus task). The main statistical analysis included two dependent T-tests. Pearson correlation coefficients were calculated to investigate whether the differences in ROM in both conditions were correlated to fear of movement. RESULTS Maximal neck rotation was larger in the external focus condition than in the internal focus condition (mean difference: 26.4°, 95% CI [20.6, 32.3]; p < 0.001, d = 1.24). However, there was a difference favouring the internal focus condition for flexion-extension (mean difference: 8.2°, 95% CI [-14.9, -1.5]; p = 0.018, d = 0.33). The variability in ROM was not explained by variability in fear of movement (for all correlations p ≥ 0.197). CONCLUSION An external focus resulted in a larger range of rotation, but our flexion-extension findings suggest that the task has to be specific to elicit such an effect. Further research, using a task that sufficiently elicits movement in all directions, is needed to determine the value of an external focus during exercise.
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Affiliation(s)
- Maaike Kragting
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands.
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands; Somt University of Physiotherapy, Softwareweg 5, 3821 BN, Amersfoort, the Netherlands.
| | - Carlotta Pezzica
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands.
| | - Lennard Voogt
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands; Menzies Health Insitute Queensland, Griffith University, Brisbane and Gold Coast, 170 Kessels Road, QLD, 4111, Nathan, Australia; School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, 170 Kessels Road, QLD, 4111, Nathan, Australia.
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Turci AM, Spavieri JHP, Lima TCD, Silva APD, Cristofolletti A, Chaves TC. Which Scale to Assess Pain Self-efficacy Shows Better Measurement Properties in Chronic Low Back Pain? A Head-To-Head Comparison Study. Arch Phys Med Rehabil 2024:S0003-9993(24)01003-7. [PMID: 38763345 DOI: 10.1016/j.apmr.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 04/12/2024] [Accepted: 05/09/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To compare the quality of the measurement properties of Pain Self-Efficacy Questionnaire (PSEQ)-10, PSEQ-4, PSEQ-2, Chronic Pain Self-Efficacy Scale (CPSS) long-form, and CPSS short-form (CPSS-SF) in patients with chronic low back pain (CLBP). DESIGN Cross-sectional and longitudinal studies (measurement properties). SETTING Outpatient rehabilitation. PARTICIPANTS Participants (N=245) with nonspecific CLBP (18-60y, 63% women) were enrolled in this study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Pain self-efficacy questionnaires were administered on 3 occasions: baseline assessment, 1 week after the first assessment (reliability), and after an 8-week exercise program (responsiveness). The intraclass correlation coefficient (ICC) and Cronbach α were used to assess reliability and internal consistency, respectively. Pearson correlation and confirmatory factor analyses were used to assess construct validity. The area under the curve and hypothesis testing were used to assess responsiveness. RESULTS No difference was observed for all the questionnaires regarding internal consistency (Cronbach α>.7), criterion validity (r>.88), and reliability (ICC>.7). The scales confirmed >75% of the hypotheses for the construct validity, except for CPSS-SF. PSEQ-2 did not meet the criterion for structural validity. PSEQ-10 met all the criteria for good measurement properties according to Consensus-Based Standards for the Selection of Health Measurement Instruments. CONCLUSIONS It was not possible to calculate structural validity for PSEQ-2, CPSS-SF did not meet the criterion for suitable hypothesis testing for construct validity, and all the questionnaires did not show suitable measurement error, except for the PSEQ-10. Hence, the PSEQ-10 was the unique scale that met all the criteria for good measurement properties for assessing pain self-efficacy in CLBP.
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Affiliation(s)
- Aline Mendonça Turci
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo; Laboratory of Research on Movement and Pain (LabMovePain), Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo
| | - Juliana Homem Padilha Spavieri
- Laboratory of Research on Movement and Pain (LabMovePain), Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo; Department of Physical Therapy, University Federal of São Carlos, São Paulo, Brazil
| | - Thamiris Costa de Lima
- Laboratory of Research on Movement and Pain (LabMovePain), Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo; Department of Physical Therapy, University Federal of São Carlos, São Paulo, Brazil
| | - Alexsander Pereira da Silva
- Laboratory of Research on Movement and Pain (LabMovePain), Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo
| | - Amanda Cristofolletti
- Laboratory of Research on Movement and Pain (LabMovePain), Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo
| | - Thais Cristina Chaves
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo; Laboratory of Research on Movement and Pain (LabMovePain), Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo; Department of Physical Therapy, University Federal of São Carlos, São Paulo, Brazil.
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Ekhammar A, Numanovic P, Grimby-Ekman A, Larsson MEH. The Swedish version of the pain self-efficacy questionnaire short form, PSEQ-2SV: Cultural adaptation and psychometric evaluation in a population of patients with musculoskeletal disorders. Scand J Pain 2024; 24:sjpain-2023-0059. [PMID: 38452195 DOI: 10.1515/sjpain-2023-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/29/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Measuring pain self-efficacy is suggested as relevant in patients with musculoskeletal disorders (MSDs) in a primary care setting. However, there is no pain self-efficacy questionnaire (PSEQ) available in Swedish. The aim of this study was to translate and culturally adapt PSEQ-2 to Swedish and evaluate reliability and validity in a population of patients with MSDs. METHODS A translation and cultural adaptation together with psychometric evaluation of reliability and validity were performed according to guidelines with three groups of participants with MSDs. First, a convenient sample of 25 individuals were interviewed in the translation process. Next, 61 participants completed the test-retest survey via social media or QR codes in waiting rooms in rehabilitation clinics. Finally, to evaluate construct validity questionnaires were obtained from 132 participants with MSDs in an ongoing randomized controlled trial. RESULTS The Swedish version of PSEQ-2 showed adequate face and content validity. The results of 0.805 on Cohen's weighted kappa indicate that the reliability of PSEQ-2SV in a group of adults with MSDs is on the border between substantial and almost perfect. The point estimate regarding relative rank variance, measuring the individual variation within the group, and relative concentration, the systematic change in how the assessments are concentrated on the scale's categories, shows minor systematic differences and some random differences not neglectable. The construct validity of pre-defined hypotheses was met to some degree. CONCLUSION The PSEQ-2SV has been accurately linguistically translated and tested for reliability and validity, in a population of MSDs, and is deemed to be able to be used in the clinic and in research. As there were some concerns regarding measurement error and systematic bias, more research could be of value.
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Affiliation(s)
- Annika Ekhammar
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Primary Care Rehabilitation, Närhälsan Eriksberg, Gothenburg, Sweden
| | - Patrik Numanovic
- Region Västra Götaland, Primary Care Rehabilitation, Närhälsan Sannegården, Gothenburg, Sweden
| | - Anna Grimby-Ekman
- Chronic Pain, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria E H Larsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development & Innovation, Primary Health Care, Gothenburg, Sweden
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Pedersen MM, Carstensen TBW, Ørnbøl E, Fink P, Jørgensen T, Dantoft TM, Frostholm L. Translation and examination of construct validity of the Danish version of the Tampa Scale for Kinesiophobia. Scand J Pain 2024; 24:sjpain-2024-0022. [PMID: 39099219 DOI: 10.1515/sjpain-2024-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/26/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES This study investigates the construct validity of the Danish Tampa Scale for Kinesiophobia (TSK). METHODS The English 17-item scale was translated into Danish adhering to WHO's guidelines. The construct validity of the TSK was examined in a random general population sample of 4,884 18- to 72-year olds with pain within the past 4 weeks. Examination of construct validity adhered to the COSMIN checklist. Structural validity was examined by splitting the sample and conducting exploratory factor analysis on one half and confirmatory factor analysis on the other half. Convergent validity was examined through associations with self-report measures and objective physical performance tests. Reference scores for the TSK were calculated. RESULTS After translation, all respondents felt confident that they understood the meaning of the items. All but one found the questionnaire acceptable. The exploratory factor analysis suggested that a 1-factor 13-item version without 4 reversed items resulted in the most consistent fit across subgroups of gender, age, and severe pain report. Five different models of the TSK were tested in the confirmatory factor analysis. While none were excellent fits, both one- and two-factor models of the TSK-13 and TSK-11 were acceptable. Two-factor models marginally outperformed one-factor models on goodness of fit. There was no association between TSK scores and muscular fitness or self-reported physical activity. Cardiorespiratory fitness, self-perceived physical fitness, and self-efficacy had weak correlations with TSK scores. Scores showed modest associations with self-report measures of anxiety, illness worry, pain interference, and daily limitations. CONCLUSIONS Based on an overall consideration of results, we recommend using the TSK-13 as a one-dimensional construct for both research and clinical purposes pending further examinations of the TSK in clinical samples. TSK scores from the present study can serve as a standard of reference for levels of Kinesiophobia in the general population.
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Affiliation(s)
- Majbritt Mostrup Pedersen
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
| | - Tina Birgitte Wisbech Carstensen
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Eva Ørnbøl
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Per Fink
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Torben Jørgensen
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Meinertz Dantoft
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
| | - Lisbeth Frostholm
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
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Kragting M, Voogt L, Coppieters MW, Pool-Goudzwaard AL. Visual feedback manipulation in virtual reality to influence pain-free range of motion. Are people with non-specific neck pain who are fearful of movement more susceptible? PLoS One 2023; 18:e0287907. [PMID: 37406021 DOI: 10.1371/journal.pone.0287907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Movement-evoked pain may have a protective or learned component, influenced by visual cues which suggest that the person is moving towards a position that may be perceived as threatening. We investigated whether visual feedback manipulation in virtual reality (VR) had a different effect on cervical pain-free range of motion (ROM) in people with fear of movement. METHOD In this cross-sectional study, seventy-five people with non-specific neck pain (i.e., neck pain without a specific underlying pathology) rotated their head until the onset of pain, while wearing a VR-headset. Visual feedback about the amount of movement was equal, 30% smaller or 30% larger than their actual rotation. ROM was measured using the VR-headset sensors. The effect of VR manipulation in fearful (N = 19 using the Tampa Scale for Kinesiophobia (TSK) and N = 18 using the Fear Avoidance Beliefs Questionnaire-physical activity (FABQpa)) and non-fearful (N = 46; non-fearful on both scales) people was compared using mixed-design ANOVAs. RESULTS Fear of movement, influenced the effect of visual feedback manipulation on cervical pain-free ROM (TSK: p = 0.036, ղp2 = 0.060; FABQpa: p = 0.020, ղp2 = 0.077); a greater amplitude of pain-free movement was found when visual feedback reduced the perceived rotation angle compared to the control condition (TSK: p = 0.090, ղp2 = 0.104; FABQpa: p = 0.030, ղp2 = 0.073). Independent of the presence of fear, visual feedback manipulation reduced the cervical pain-free ROM in the overstated condition (TSK: p< 0.001, ղp2 = 0.195; FABQpa: p<0.001, ղp2 = 0.329). DISCUSSION Cervical pain-free ROM can be influenced by visual perception of the amount of rotation and people with fear of movement seem to be more susceptible to this effect. Further research in people with moderate/severe fear is needed to determine whether manipulating visual feedback may have clinical applicability to make patients aware that ROM may be influenced more by fear than tissue pathology.
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Affiliation(s)
- Maaike Kragting
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lennard Voogt
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Menzies Health Insitute Queensland, Griffith University, Brisbane, Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Gold Coast, Australia
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Somt University of Physiotherapy, Amersfoort, The Netherlands
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De Baets L, Meulders A, Van Damme S, Caneiro JP, Matheve T. Understanding Discrepancies in a Person's Fear of Movement and Avoidance Behavior: A Guide for Musculoskeletal Rehabilitation Clinicians Who Support People With Chronic Musculoskeletal Pain. J Orthop Sports Phys Ther 2023; 53:307–316. [PMID: 36884314 DOI: 10.2519/jospt.2023.11420] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND: Generic self-report measures do not reflect the complexity of a person's pain-related behavior. Since variations in a person's fear of movement and avoidance behavior may arise from contextual and motivational factors, a person-centered evaluation is required-addressing the cognitions, emotions, motivation, and actual behavior of the person. CLINICAL QUESTION: Most musculoskeletal rehabilitation clinicians will recognize that different people with chronic pain have very different patterns of fear and avoidance behavior. However, an important remaining question for clinicians is "How can I identify and reconcile discrepancies in fear of movement and avoidance behavior observed in the same person, and adapt my management accordingly?" KEY RESULTS: We frame a clinical case of a patient with persistent low back pain to illustrate the key pieces of information that clinicians may consider in a person-centered evaluation (ie, patient interview, self-report measures, and behavioral assessment) when working with patients to manage fear of movement and avoidance behavior. CLINICAL APPLICATION: Understanding the discrepancies in a person's fear of movement and avoidance behavior is essential for musculoskeletal rehabilitation clinicians, as they work in partnership with patients to guide tailored approaches to changing behaviors. J Orthop Sports Phys Ther 2023;53(5):1-10. Epub: 9 March 2023. doi:10.2519/jospt.2023.11420.
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Nudelman Y, Pincus T, Nicholas MK, Ben Ami N. Cross-cultural adaptation, reliability, and validity of the pain self-efficacy questionnaire - Hebrew version. Musculoskelet Sci Pract 2023; 64:102749. [PMID: 36965246 DOI: 10.1016/j.msksp.2023.102749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE This study aims to translate, culturally adapt, and evaluate the psychometric properties of the Hebrew Pain Self-Efficacy Questionnaire (PSEQ). METHODS The study was designed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations for patient-reported outcome measurement instruments. The PSEQ was initially translated into Hebrew and cross-culturally adapted. The Hebrew version of the PSEQ (PSEQ-H) was administered to participants suffering from chronic musculoskeletal pain, along with other self-report measures of pain (NPRS, FABQ, HADS, PCS, and SF-12). Eight hypotheses on expected correlations of the PSEQ-H with other instruments were formulated a priori to assess construct validity. Structural validity was assessed using confirmatory factor analysis. Floor and ceiling effects, test-retest, and internal consistency reliability were also assessed. RESULTS The translation process retained the unidimensional model of the PSEQ. The PSEQ-H demonstrates excellent internal consistency (Cronbach's α = 0.97) and test-retest reliability (ICC = 0.88), and no significant floor and ceiling effects were observed. Construct validity was found satisfactory as 75% (six) of the analyses between the PSEQ-H and the other self-reported measures met the hypotheses. Factor analysis confirmed the single-factor structure of the questionnaire. CONCLUSIONS The PSEQ-H version was found to have excellent reliability, good construct, and structural validity, and can be used with heterogeneous chronic musculoskeletal pain populations. Future studies should test the PSEQ-H's responsiveness and psychometric properties with specific pain populations.
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Affiliation(s)
- Yaniv Nudelman
- Department of Physiotherapy, Ariel University, Ariel, Israel; Maccabi Healthcare Services, Tel-aviv, Israel.
| | - Tamar Pincus
- University of Southampton, Southampton, United Kingdom
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School, The University of Sydney, Royal North Shore, Australia
| | - Noa Ben Ami
- Department of Physiotherapy, Ariel University, Ariel, Israel
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Eiger B, Errebo M, Straszek CL, Vaegter HB. Less is more: reliability and measurement error for three versions of the Tampa Scale of Kinesiophobia (TSK-11, TSK-13, and TSK-17) in patients with high-impact chronic pain. Scand J Pain 2023; 23:217-224. [PMID: 35191276 DOI: 10.1515/sjpain-2021-0200] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/01/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The Tampa Scale of Kinesiophobia (TSK) is a valid and reliable tool to assess somatic focus and activity avoidance in patients. Currently, the test-retest reliability and measurement error for the Danish version is unknown. The aim of the study was to determine standard error of measurement (SEM) and smallest detectable change (SDC) for three Danish lengths of the TSK in patients with chronic pain. METHODS Waiting-list patients (n = 77) completed the TSK-17 twice from home with a test interval between 7 and 14 days. Based on COSMIN recommendations, the test-retest reliability was estimated using intraclass correlation coefficient (ICC2,1), and measurement error in terms of standard error of measurement (SEMagreement) and SDC95% were calculated. RESULTS All three versions showed good test-retest reliability with ICC2,1-values (CI95%) of 0.86(0.79-0.91), 0.88(0.82-0.92) and 0.87(0.81-0.92) for the TSK-17, TSK-13, and TSK-11. The SEM-values were 3.08, 2.42 and 2.10 respectively and SDC95%-values were 8.53, 6.71 and 5.82. CONCLUSIONS The Danish versions of TSK-11, TSK-13 and TSK-17 showed good to excellent test-retest reliability. SEM and SDC95% values in patients with chronic pain are reported. The TSK-11 did not show systematic bias between test and retest and may be preferred to minimize responder burden.
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Affiliation(s)
- Bettina Eiger
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Køge Municipality Rehabilitation Center, Køge, Denmark
| | - Mette Errebo
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Lund Straszek
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for General Practice at Aalborg University, Aalborg, Denmark
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Henrik Bjarke Vaegter
- Department of Anesthesiology and Intensive Care Medicine, Pain Research Group, Pain Center, University Hospital Odense, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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11
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Verwoerd MJ, Wittink H, Maissan F, van Kuijk SMJ, Smeets RJEM. A study protocol for the validation of a prognostic model with an emphasis on modifiable factors to predict chronic pain after a new episode of acute- or subacute nonspecific idiopathic, non-traumatic neck pain presenting in primary care. PLoS One 2023; 18:e0280278. [PMID: 36649242 PMCID: PMC9844852 DOI: 10.1371/journal.pone.0280278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/25/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The primary objective of this study is to identify which modifiable and non-modifiable factors are independent predictors of the development of chronic pain in patients with acute- or subacute nonspecific idiopathic, non-traumatic neck pain, and secondly, to combine these to develop and internally validate a prognostic prediction model. METHODS A prospective cohort study will be conducted by physiotherapists in 30 primary physiotherapy practices between January 26, 2020, and August 31, 2022, with a 6-month follow-up until March 17, 2023. Patients who consult a physiotherapist with a new episode of acute- (0 to 3 weeks) or subacute neck pain (4 to 12 weeks) will complete a baseline questionnaire. After their first appointment, candidate prognostic variables will be collected from participants regarding their neck pain symptoms, prior conditions, work-related factors, general factors, psychological and behavioral factors. Follow-up assessments will be conducted at six weeks, three months, and six months after the initial assessment. The primary outcome measure is the Numeric Pain Rating Scale (NPRS) to examine the presence of chronic pain. If the pain is present at six weeks, three months, and six months with a score of NPRS ≥3, it is classified as chronic pain. An initial exploratory analysis will use univariate logistic regression to assess the relationship between candidate prognostic factors at baseline and outcome. Multiple logistic regression analyses will be conducted. The discriminative ability of the prognostic model will be determined based on the Area Under the receiver operating characteristic Curve (AUC), calibration will be assessed using a calibration plot and formally tested using the Hosmer and Lemeshow goodness-of-fit test, and model fit will be quantified as Nagelkerke's R2. Internal validation will be performed using bootstrapping-resampling to yield a measure of overfitting and the optimism-corrected AUC. DISCUSSION The results of this study will improve the understanding of prognostic and potential protective factors, which will help clinicians guide their clinical decision making, develop an individualized treatment approach, and predict chronic neck pain more accurately.
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Affiliation(s)
- Martine J. Verwoerd
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- * E-mail:
| | - Harriet Wittink
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Francois Maissan
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Sander M. J. van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rob J. E. M. Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, CIR Rehabilitation, Eindhoven, The Netherlands, Pain in Motion International Research Group (PiM), www.paininmotion.be
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12
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Köke AJA, Bastiaenen CHG, Kleijnen J, Telgenkamp I, Smeets RJEM, Beckers LWME. Measurement properties of patient-reported outcome measures used in rehabilitation of adults with chronic musculoskeletal pain: A mapping review. J Back Musculoskelet Rehabil 2022; 36:595-607. [PMID: 36565099 DOI: 10.3233/bmr-220133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Choosing measurement tools for diagnostic, prognostic, or evaluative purposes in a chronic musculoskeletal pain (CMP) population is challenging for rehabilitation practice. Implementation of measurement tools for clinical practice is impaired by gaps in knowledge about measurement properties. OBJECTIVE Identifying evidence about the measurement properties of tools frequently used in Dutch pain rehabilitation practice. METHODS A mapping review was conducted of eligible studies that investigated reliability, validity, or responsiveness, and interpretability, as defined by the COSMIN taxonomy, of original versions or Dutch translations of predefined Patient-Reported Outcome Measures (PROMs) in a CMP population. MEDLINE, PsycINFO, EMBASE, and CINAHL were searched in March 2021. Results were visually mapped. RESULTS Thirty-five studies were included. The results show many knowledge gaps in both original and translated versions. In general, aspects of validity were most frequently reported. The Pain Disability Index, Pain Catastrophizing Scale, and the 12-Item Short Form Health Survey were the most studied measurement tools. No results were found for the Checklist Individual Strength, Illness Perception Questionnaire, and Utrecht Coping List. CONCLUSION Little evidence of the measurement properties of PROMs used in rehabilitation of patients with CMP in the Netherlands was found. PROMs need to be used and interpreted with caution in daily practice.
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Affiliation(s)
- A J A Köke
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.,Faculty Health and Technology, Zuyd University for Applied Sciences, Heerlen, The Netherlands.,Pain in Motion International Research Group (PiM), Belgium
| | - C H G Bastiaenen
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - J Kleijnen
- Kleijnen Systematic Reviews Ltd, York, UK
| | - I Telgenkamp
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - R J E M Smeets
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Pain in Motion International Research Group (PiM), Belgium.,Centre for Integral Rehabilitation (CIR), Eindhoven, The Netherlands
| | - L W M E Beckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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13
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Lutke Schipholt IJ, Scholten-Peeters GGM, Koop MA, Bonnet P, Bontkes HJ, Coppieters MW. Systemic neuroimmune responses in people with non-specific neck pain and cervical radiculopathy, and associations with clinical, psychological, and lifestyle factors. Front Mol Neurosci 2022; 15:1003821. [PMID: 36311017 PMCID: PMC9608367 DOI: 10.3389/fnmol.2022.1003821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 08/09/2023] Open
Abstract
Neuroimmune responses remain understudied in people with neck pain. This study aimed to (1) compare a broad range of systemic neuroimmune responses in people with non-specific neck pain (N = 112), cervical radiculopathy (N = 25), and healthy participants (N = 23); and (2) explore their associations with clinical, psychological and lifestyle factors. Quantification of systemic neuroimmune responses involved ex vivo serum and in vitro evoked-release levels of inflammatory markers, and characterization of white blood cell phenotypes. Inflammatory indices were calculated to obtain a measure of total immune status and were considered the main outcomes. Differences between groups were tested using analyses of covariance (ANCOVA) and multivariable regression models. Compared to healthy participants, the ex vivo pro-inflammatory index was increased in people with non-specific neck pain (β = 0.70, p = 0.004) and people with cervical radiculopathy (β = 0.64, p = 0.04). There was no difference between non-specific neck pain and cervical radiculopathy (β = 0.23, p = 0.36). Compared to non-specific neck pain, people with cervical radiculopathy showed lower numbers of monocytes (β = -59, p = 0.01). There were no differences between groups following in vitro whole blood stimulation (p ≥ 0.23) or other differences in the number and phenotype of white blood cells (p ≥ 0.07). The elevated ex vivo neuroimmune responses in people with non-specific neck pain and radiculopathy support the contention that these conditions encompass inflammatory components that can be measured systemically. There were multiple significant associations with clinical, psychological and lifestyle factors, such as pain intensity (β = 0.25) and anxiety (β = 0.23) in non-specific neck pain, visceral adipose tissue (β = 0.43) and magnification (β = 0.59) in cervical radiculopathy, and smoking (β = 0.59) and visceral adipose tissue (β = 0.52) in healthy participants. These associations were modified by sex, indicating different neuroimmune associations for females and males.
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Affiliation(s)
- Ivo J. Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
- Department of Rehabilitation Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Gwendolyne G. M. Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Meghan A. Koop
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Petra Bonnet
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Hetty J. Bontkes
- Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Michel W. Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
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14
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Luque-Suarez A, Falla D, Barbero M, Pineda-Galan C, Marco D, Giuffrida V, Martinez-Calderon J. Digital pain extent is associated with pain intensity but not with pain-related cognitions and disability in people with chronic musculoskeletal pain: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:727. [PMID: 35906575 PMCID: PMC9338608 DOI: 10.1186/s12891-022-05700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background To evaluate whether digital pain extent is associated with an array of psychological factors such as optimism, pessimism, expectations of recovery, pain acceptance, and pain self-efficacy beliefs as well as to analyse the association between digital pain extent and pain intensity and pain-related disability in people with chronic musculoskeletal pain. Methods A descriptive cross-sectional study conducted in a primary health care setting was carried out including 186 individuals with chronic musculoskeletal pain. Patient-reported outcomes were used to assess psychological factors, pain intensity, and pain-related disability. Digital pain extent was obtained from pain drawings shaded using a tablet and analysed using novel customized software. Multiple linear regression models were conducted to evaluate the association between digital pain extent and the aforementioned variables. Results Digital pain extent was statistically significantly associated with pain intensity. However, digital pain extent was not associated with any psychological measure nor with pain-related disability. Discussion The results did not support an association between digital pain extent and psychological measures.
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Affiliation(s)
- Alejandro Luque-Suarez
- Facultad de Ciencias de La Salud, Departamento de Fisioterapia, Universidad de Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, Sciences and Arts of Southern Switzerland, University of Applied, Manno/Landquart, Switzerland.
| | - Consolacion Pineda-Galan
- Facultad de Ciencias de La Salud, Departamento de Fisioterapia, Universidad de Malaga, Malaga, Spain
| | - Derboni Marco
- Istituto Dalle Molle Di Studi Sull'Intelligenza Artificiale (IDSIA), Scuola Universitaria Professionale Della Svizzera Italiana (SUPSI), Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - Vincenzo Giuffrida
- Istituto Dalle Molle Di Studi Sull'Intelligenza Artificiale (IDSIA), Scuola Universitaria Professionale Della Svizzera Italiana (SUPSI), Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - Javier Martinez-Calderon
- Facultad de Ciencias de La Salud, Departamento de Fisioterapia, Universidad de Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
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15
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Dubé MO, Roos M, Desmeules F, Roy JS. Reliability, validity, and responsiveness of a Canadian French adaptation of the pain self-efficacy questionnaire (PSEQ). Disabil Rehabil 2022:1-8. [PMID: 35867979 DOI: 10.1080/09638288.2022.2102254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE The objectives of this study were to translate the Pain Self-Efficacy Questionnaire (PSEQ) into Canadian French (PSEQ-F) and to evaluate its validity, reliability and responsiveness in a French-Canadian sample of patients with persistent rotator cuff related shoulder pain (RCRSP). METHODS Translation and cross-cultural adaptation of the original English version of the PSEQ into Canadian French were performed according to standard procedures. Thereafter, 78 adults with RCRSP completed the PSEQ-F on three occasions: baseline, 2 days later to evaluate the reliability and 6 weeks later to evaluate responsiveness. RESULTS Cross-cultural adaptation was performed without problems with content or language. The PSEQ-F was found to be reliable (Intraclass Correlation Coefficient = 0.96; Minimal Detectable Change = 3 points [5%]), valid (moderate correlations with an abbreviated version of Disability of the Arm, Shoulder and Hand [QuickDASH] and Brief Pain Inventory [BPI] Questionnaires) and responsive (Standardized Response Mean = 0.96; Effect Size = 0.81; Minimal Clinically Important Difference = 6 points [10%]). CONCLUSION The PSEQ-F is a reliable, valid and responsive questionnaire that can be used to assess pain self-efficacy in French-speaking individuals with RCRSP. Further studies should use a self-efficacy-specific Global Rating of Change scale to estimate its responsiveness more thoroughly.Implications for rehabilitationHigher levels of pain self-efficacy have been associated with increased odds of symptom resolution in those with persistent rotator cuff related shoulder pain (RCRSP).The Pain Self-Efficacy Questionnaire (PSEQ) has been identified as the most frequently used tool by clinicians to assess pain self-efficacy in patients at risk of developing persistent musculoskeletal pain.The Canadian French version of the PSEQ (PSEQ-F) is a reliable, valid and responsive questionnaire that can be used to assess pain self-efficacy in French-speaking individuals with RCRSP.
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Affiliation(s)
- Marc-Olivier Dubé
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada.,Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Marianne Roos
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada.,Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - François Desmeules
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada.,Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
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16
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Schroeter AC, MacDonald DA, Scholten-Peeters GGM, Goubert L, Kendall E, Coppieters MW. Preferred self-administered questionnaires to assess resilience, optimism, pain acceptance and social support in people with pain. A modified Delphi study. PAIN MEDICINE 2022; 23:1891-1901. [DOI: 10.1093/pm/pnac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
The plethora of self-administered questionnaires to assess positive psychosocial factors complicates questionnaire selection. This study aimed to identify and reach consensus on the most suitable self-administered questionnaires to assess resilience, optimism, pain acceptance and social support in people with pain.
Design
A three-round modified Delphi study.
Participants
Forty international experts.
Methods
In Round 1, the experts suggested questionnaires deemed appropriate to assess resilience, optimism, pain acceptance and/or social support. In Round 2, experts indicated whether they considered the suggested questionnaires to be suitable (Yes/No/Don’t know) to assess these psychosocial factors, taking into consideration content, feasibility, personal experience and the measurement properties which we provided for each questionnaire. Questionnaires that were considered suitable by the majority of experts (≥60%) were retained for Round 3. In Round 3, the suitability of each questionnaire was rated on a 0–10 Likert scale. Consensus was reached if ≥ 75% of experts rated the questionnaire ≥7.
Results
From the 67 questionnaires suggested in Round 1, one questionnaire could be recommended per domain. For resilience: Pain Resilience Scale; for optimism: Revised Version of the Life Orientation Test; for pain acceptance: 8-item and Revised Versions of the Chronic Pain Acceptance Questionnaire; for social support: Emotional Support Item Bank of the PROMIS tool. Consensus for these questionnaires was also reached in a sensitivity analysis which excluded the ratings of experts involved in the development, translation and/or validation of relevant questionnaires.
Conclusion
We advocate the use of these recommended questionnaires so data can be compared and pooled more easily.
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Affiliation(s)
- Andrea C Schroeter
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | - David A MacDonald
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | | | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Elizabeth Kendall
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
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17
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Lutke Schipholt IJ, Scholten-Peeters G, Bontkes H, Coppieters MW. Neuroimmune responses following joint mobilisation and manipulation in people with persistent neck pain: a protocol for a randomised placebo-controlled trial. BMJ Open 2022; 12:e055748. [PMID: 35260459 PMCID: PMC8905979 DOI: 10.1136/bmjopen-2021-055748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Joint mobilisation and manipulation often results in immediate pain relief in people with neck pain. However, the biological mechanisms behind pain relief are largely unknown. There is preliminary evidence that joint mobilisation and manipulation lessens the upregulated neuroimmune responses in people with persistent neck pain. METHODS AND ANALYSIS This study protocol describes a randomised placebo-controlled trial to investigate whether joint mobilisation and manipulation influence neuroimmune responses in people with persistent neck pain. People with persistent neck pain (N=100) will be allocated, in a randomised and concealed manner, to the experimental or control group (ratio 3:1). Short-term (ie, baseline, immediately after and 2 hours after the intervention) neuroimmune responses will be assessed, such as inflammatory marker concentration following in vitro stimulation of whole blood cells, systemic inflammatory marker concentrations directly from blood samples, phenotypic analysis of peripheral blood mononuclear cells and serum cortisol. Participants assigned to the experimental group (N=75) will receive cervical mobilisations targeting the painful and/or restricted cervical segments and a distraction manipulation of the cervicothoracic junction. Participants assigned to the control group (N=25) will receive a placebo mobilisation and placebo manipulation. Using linear mixed models, the short-term neuroimmune responses will be compared (1) between people in the experimental and control group and (2) within the experimental group, between people who experience a good outcome and those with a poor outcome. Furthermore, the association between the short-term neuroimmune responses and pain relief following joint mobilisation and manipulation will be tested in the experimental group. ETHICS AND DISSEMINATION This trial is approved by the Medical Ethics Committee of Amsterdam University Medical Centre, location VUmc (Approval number: 2018.181). TRIAL REGISTRATION NUMBER NL6575 (trialregister.nl.
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Affiliation(s)
- Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam UMC, Location VU Medical Centre, Amsterdam, Netherlands
| | - Gwendolyne Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Hetty Bontkes
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam UMC, Location VU Medical Centre, Amsterdam, Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Queensland, Australia
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18
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Dubé MO, Langevin P, Roy JS. Measurement properties of the Pain Self-Efficacy Questionnaire in populations with musculoskeletal disorders: a systematic review. Pain Rep 2021; 6:e972. [PMID: 34963996 PMCID: PMC8701870 DOI: 10.1097/pr9.0000000000000972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/13/2021] [Accepted: 09/29/2021] [Indexed: 12/03/2022] Open
Abstract
A higher level of pain self-efficacy has been suggested as a predictor of a better outcome in patients with musculoskeletal disorders. The Pain Self-Efficacy Questionnaire (PSEQ) is one of the most frequently used patient-reported outcome measures for pain self-efficacy. The purpose of this study was to conduct a systematic review that would identify, appraise, and synthetize the psychometric properties of the PSEQ. Embase, MEDLINE, and CINAHL databases were searched for publications reporting on psychometric properties of the PSEQ in populations with musculoskeletal disorders. After applying selection criteria on identified citations, 28 studies (9853 participants) were included. The methodological quality as measured with the COSMIN risk of bias tool varied from adequate to very good for most measurement properties. The results showed a weighted mean intraclass correlation coefficient of 0.86 (range: 0.75-0.93) for test-retest reliability for the original 10-item PSEQ and the minimal detectable change at 95% confidence interval was 11.52 out of 60 points. Effect size and standardized response mean values were 0.53 and 0.63, respectively, whereas the minimal clinically important difference ranged from 5.5 to 8.5 in patients with chronic low back pain. Internal consistency (Cronbach alpha) ranged from 0.79 to 0.95. The results also showed that the PSEQ has low to moderate correlations with measures of quality of life, disability, pain, pain interference, anxiety, depression, and catastrophizing. Finally, the PSEQ has been adapted and validated in 14 languages. Overall, the results demonstrate that the PSEQ has excellent validity, reliability, and responsiveness. Further high-quality studies are needed to determine responsiveness in populations other than chronic low back pain.
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Affiliation(s)
- Marc-Olivier Dubé
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), Quebec City, QC, Canada
- Physio Interactive, Québec, QC, Canada
| | - Pierre Langevin
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), Quebec City, QC, Canada
- Physio Interactive, Québec, QC, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), Quebec City, QC, Canada
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19
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Vanti C, Ferrari S, Guccione AA, Pillastrini P. Lumbar spondylolisthesis: STATE of the art on assessment and conservative treatment. Arch Physiother 2021; 11:19. [PMID: 34372944 PMCID: PMC8351422 DOI: 10.1186/s40945-021-00113-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/21/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION There is weak relationship between the presence of lumbar spondylolisthesis [SPL] and low back pain that is not always associated with instability, either at the involved lumbar segment or at different spinal levels. Therefore patients with lumbar symptomatic SPL can be divided into stable and unstable, based on the level of mobility during flexion and extension movements as general classifications for diagnostic and therapeutic purposes. Different opinions persist about best treatment (conservative vs. surgical) and among conservative treatments, on the type, dosage, and progression of physical therapy procedures. PURPOSE AND IMPORTANCE TO PRACTICE The aim of this Masterclass is to provide clinicians evidence-based indications for assessment and conservative treatment of SPL, taking into consideration some subgroups related to specific clinical presentations. CLINICAL IMPLICATIONS This Masterclass addresses the different phases of the assessment of a patient with SPL, including history, imaging, physical exam, and questionnaires on disability and cognitive-behavioral components. Regarding conservative treatment, self- management approaches and graded supervised training, including therapeutic relationships, information and education, are explained. Primary therapeutic procedures for pain control, recovery of the function and the mobility through therapeutic exercise, passive mobilization and antalgic techniques are suggested. Moreover, some guidance is provided on conservative treatment in specific clinical presentations (lumbar SPL with radiating pain and/or lumbar stenosis, SPL complicated by other factors, and SPL in adolescents) and the number/duration of sessions. FUTURE RESEARCH PRIORITIES Some steps to improve the diagnostic-therapeutic approach in SPL are to identify the best cluster of clinical tests, define different lumbar SPL subgroups, and investigate the effects of treatments based on that classification, similarly to the approach already proposed for non-specific LBP.
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Affiliation(s)
- Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Silvano Ferrari
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Andrew A. Guccione
- Department of Rehabilitation Science, College of Health and Human Services, George Mason University, Fairfax, VA 22030 USA
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
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Koop MA, Lutke Schipholt IJ, Scholten-Peeters GGM, Coppieters MW. Identifying the most important confounders when assessing the association between low-grade systemic inflammation and musculoskeletal pain: A modified Delphi study. PAIN MEDICINE 2021; 22:2661-2669. [PMID: 34343332 PMCID: PMC8633774 DOI: 10.1093/pm/pnab243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective The association between low-grade systemic inflammation and musculoskeletal pain may be influenced by multiple factors. However, little is known about the relative importance of these factors, and few studies account for them. This Delphi study aimed to reach consensus on the most important confounders which influence the association between low-grade systemic inflammation and musculoskeletal pain. Methods The panel consisted of 48 experts. In Round 1, the experts proposed what they believed were important confounders. In Round 2, the experts indicated for each confounder whether they believed it was important (yes/no). At least 50% of experts had to indicate the confounder was important to be considered in the final round. In Round 3, the experts rated the importance of each confounder on a 7-point Likert scale. Consensus was reached if ≥75% of the experts considered the factor either extremely or moderately important. Results In Round 1, 120 confounders were proposed, which were synthesized into 38 distinct factors. In Round 2, 33 confounders met the criterion to be considered important. In Round 3, consensus was reached for 14 confounders: acute illness/trauma, immune disease, medication use, endocrine, nutritional, or metabolic disease, other musculoskeletal conditions, age, handling of blood samples, sex, cancer, body composition, pregnancy, cardiovascular disease, physical activity, and pain characteristics. Conclusions These findings provide insight in the complexity of the association between low-grade systemic inflammation and musculoskeletal pain. Some factors currently listed as confounders may be re-classified as moderators or mediators as insights progress.
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Affiliation(s)
- Meghan A Koop
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 1081 BT Amsterdam, The Netherlands
| | - Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 1081 BT Amsterdam, The Netherlands.,Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam UMC, Location VU Medical Centre, De Boelelaan 1117 1081 HV Amsterdam, The Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 1081 BT Amsterdam, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7 1081 BT Amsterdam, The Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast Campus (G40; LVL 8.82), Parklands Drive, Southport, QLD 4215, Australia
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21
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Pontifex A, Savin C, Park C, Nunes AF, Chalmers KJ, Neumann PB, Ng L, Thompson JA. How Might We Screen for Psychological Factors in People With Pelvic Pain? An e-Delphi Study. Phys Ther 2021; 101:6126511. [PMID: 33533398 DOI: 10.1093/ptj/pzab015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/20/2020] [Accepted: 11/22/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Persistent pelvic pain (PPP) is a complex condition often influenced by psychological factors that can alter treatment outcomes. These factors are potentially modifiable; however, currently there is no instrument to screen for them. The purpose of this study was to determine: (1) which psychological factors should be screened in individuals with PPP, and (2) the most appropriate statements to represent these psychological factors. METHODS The study used a focus group design followed by an electronic-Delphi (e-Delphi) process. A focus group consisting of 8 experts was conducted to determine the relevant psychological factors to screen. These results informed round 1 of the e-Delphi process, consisting of a panel of 14 pain/pelvic pain experts. The e-Delphi process consisted of 3 rounds of online surveys and 2 teleconference discussions to establish consensus on the most appropriate statement to screen for each of the psychological factors. RESULTS The focus group identified 13 relevant psychological factors. During the e-Delphi process, relevant screening statements were assessed using a 100-point allocation system. Experts could reword and suggest new statements. Statements were assessed for consensus and stability and were eliminated as the rounds progressed if they met the exclusion criteria. At the termination of round 3, there were 15 statements remaining. CONCLUSION The final list of 15 statements will assist clinicians in screening for psychological factors and is an important step for clinicians in providing psychologically informed care to people with PPP. Future research should determine the psychometric properties of the statements to determine their clinical utility as a questionnaire. IMPACT This study has refined a list of statements to help screen for psychological factors in individuals with PPP. Developed robustly using an e-Delphi method, this list is an important first step forward for clinicians to provide psychologically informed care to these individuals.
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Affiliation(s)
- Angela Pontifex
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - Caris Savin
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - Caitlin Park
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - Alina Filipe Nunes
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - K Jane Chalmers
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia.,IIMPACT in Health, University of South Australia, North Terrace, Adelaide, SA, Australia
| | - Patricia B Neumann
- School of Health Sciences, University of South Australia, North Terrace, Adelaide, SA, Australia
| | - Leo Ng
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - Judith A Thompson
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
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Lin LL, Li HP, Yang JW, Hao XW, Yan SY, Wang LQ, Yu FT, Shi GX, Liu CZ. Acupuncture for Psychological Disorders Caused by Chronic Pain: A Review and Future Directions. Front Neurosci 2021; 14:626497. [PMID: 33584181 PMCID: PMC7873369 DOI: 10.3389/fnins.2020.626497] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/21/2020] [Indexed: 12/11/2022] Open
Abstract
Accumulating evidence supports an association between chronic pain and psychological disorders, a connection that seems to be bidirectional. Treating both the pain and psychological conditions together is essential for effective treatment outcomes. Acupuncture is a somatosensory-guided mind-body therapy that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. In this review, we discuss the use of acupuncture in some conditions with a high incidence of psychological disorders caused by chronic pain: headache, musculoskeletal pain, low back pain, and cancer pain, focusing on the effect and potential mechanisms of acupuncture. Overall clinical studies indicated that acupuncture might effectively contribute to management of psychological disorders caused by chronic pain. Mechanistic studies showed that acupuncture significantly alleviated such psychological disorders by regulating the activity of amygdala and insula, and regulating functional connectivity of insular and limbic regions/medial prefrontal cortex in humans and the corresponding animal models. In addition, 5-HT in the dorsal raphe nucleus, opioid receptors in the cingulate cortex, and plasma met-enkephalin are involved in acupuncture relief of pain and psychological symptoms. Substantial evidences from animal and human research support a beneficial effect of acupuncture in psychological disorders caused by chronic pain.
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Affiliation(s)
- Lu-Lu Lin
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Ping Li
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Wan Hao
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Fang-Ting Yu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Kragting M, Voogt L, Neijenhuijs KI, Pool-Goudzwaard AL, Coppieters MW. Cross-cultural adaptation and validation of the Dutch language version of the Pictorial Fear of Activity Scale - Cervical. BMC Musculoskelet Disord 2020; 21:708. [PMID: 33115471 PMCID: PMC7594286 DOI: 10.1186/s12891-020-03724-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 10/15/2020] [Indexed: 11/23/2022] Open
Abstract
Background The Pictorial Fear of Activity Scale-Cervical (PFActS-C) is a reliable and valid instrument to assess fear of movement in people with whiplash associated disorders. It is not available in Dutch and has not been evaluated in other neck pain populations. This study aimed to systematically translate the PFActS-C into Dutch and evaluate the psychometric properties of this Dutch Language Version (DLV) in people with non-specific neck pain. Methods The PFActS-C was translated according to international guidelines. Internal consistency, test-retest reliability, floor and ceiling effects, face validity and construct validity (convergent and discriminant validity by hypotheses testing and structural validity by confirmatory and exploratory factor-analyses) of the PFActS-C-DLV were tested in 125 people with non-specific neck pain. Results The PFActS-C-DLV showed good to excellent internal consistency (Cronbach’s alpha: 0.98) and stability over time (ICC: 0.90 [95%CI: 0.82–0.93). Four out of five a priori formulated hypotheses regarding related (convergent validity) and unrelated (discriminant validity) constructs were confirmed. However, the confirmatory factor analysis could not confirm the expected 1-factor solution. Furthermore, the exploratory factor analyses revealed that also a higher factor solution would not lead to a good fit of the model. Conclusions The PFActS-C-DLV is a reliable region-specific instrument for people with non-specific neck pain. The construct validity was supported, based on hypotheses testing. However, factor analyses could not confirm a 1-factor solution, so the underlying construct of the PFActS-C-DLV remains unclear. Given the PFActS-C’s photographic format, we believe these findings also have relevance for the original English version. Supplementary information Supplementary information accompanies this paper at 10.1186/s12891-020-03724-1.
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Affiliation(s)
- Maaike Kragting
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015, EK, Rotterdam, The Netherlands. .,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Lennard Voogt
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015, EK, Rotterdam, The Netherlands
| | - Koen I Neijenhuijs
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Somt University of Physiotherapy, Amersfoort, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Menzies Health Insitute Queensland, Griffith University, Brisbane and Gold Coast, Australia
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Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy. Spine (Phila Pa 1976) 2020; 45:E885-E891. [PMID: 32118698 PMCID: PMC7337113 DOI: 10.1097/brs.0000000000003448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVE To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy. SUMMARY OF BACKGROUND DATA Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce. METHODS We included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses. RESULTS At 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included: younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3-L4. The model for poor recovery included: lower educational level, prior back surgery, and disc herniation at L3-L4. Following internal validation, the explained variance (Nagelkerke R) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor. CONCLUSION The outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated. LEVEL OF EVIDENCE 3.
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Which Psychological Factors Are Involved in the Onset and/or Persistence of Musculoskeletal Pain? An Umbrella Review of Systematic Reviews and Meta-Analyses of Prospective Cohort Studies. Clin J Pain 2020; 36:626-637. [PMID: 32379072 DOI: 10.1097/ajp.0000000000000838] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this study was to summarize the current status of knowledge about the longitudinal association between vulnerability or protective psychological factors and the onset and/or persistence of musculoskeletal (MSK) pain. METHODS PubMed, CINAHL, PsycINFO, PubPsych, Scopus, Web of Science, gray literature, and manual screening of references were searched from inception to June 15, 2019. Systematic reviews with or without meta-analysis that explored the longitudinal association between psychological factors and the onset and/or persistence of MSK pain were identified. The AMSTAR-2 tool was used to assess the risk of bias. RESULTS Fifty-nine systematic reviews that included 286 original research studies were included, with a total of 249,657 participants (127,370 with MSK pain and 122,287 without MSK pain at baseline). Overall, our results found that exposure to many psychological vulnerability factors such as depression, anxiety, psychological distress, and fear, among others, may increase the risk of the onset and persistence of MSK pain across time. In addition, our results also showed that a range of psychological factors considered to be "protective" such as self-efficacy beliefs, better mental health, active coping strategies, or favorable expectations of recovery may reduce the risk of the onset and persistence of MSK pain. However, all these systematic reviews were evaluated to have critically low confidence based on the AMSTAR-2 tool, indicating that findings from these reviews may be informative, but should be interpreted with caution. DISCUSSION The large number of methodological flaws found across reviews gives rise to a call to action to develop high-quality systematic reviews in this field.
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26
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Oostendorp RAB, Elvers JWH, van Trijffel E, Rutten GM, Scholten–Peeters GGM, Heijmans M, Hendriks E, Mikolajewska E, De Kooning M, Laekeman M, Nijs J, Roussel N, Samwel H. Relationships Between Context, Process, and Outcome Indicators to Assess Quality of Physiotherapy Care in Patients with Whiplash-Associated Disorders: Applying Donabedian's Model of Care. Patient Prefer Adherence 2020; 14:425-442. [PMID: 32184572 PMCID: PMC7060032 DOI: 10.2147/ppa.s234800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/28/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Quality indicators (QIs) are measurable elements of practice performance and may relate to context, process, outcome and structure. A valid set of QIs have been developed, reflecting the clinical reasoning used in primary care physiotherapy for patients with whiplash-associated disorders (WAD). Donabedian's model postulates relationships between the constructs of quality of care, acting in a virtuous circle. AIM To explore the relative strengths of the relationships between context, process, and outcome indicators in the assessment of primary care physiotherapy in patients with WAD. MATERIALS AND METHODS Data on WAD patients (N=810) were collected over a period of 16 years in primary care physiotherapy practices by means of patients records. This routinely collected dataset (RCD-WAD) was classified in context, process, and outcome variables and analyzed retrospectively. Clinically relevant variables were selected based on expert consensus. Associations were expressed, using zero-order, as Spearman rank correlation coefficients (criterion: rs >0.25 [minimum: fair]; α-value = 0.05). RESULTS In round 1, 62 of 85 (72.9%) variables were selected by an expert panel as relevant for clinical reasoning; in round 2, 34 of 62 (54.8%) (context variables 9 of 18 [50.0%]; process variables 18 of 34 [52.9]; outcome variables 8 of 10 [90.0%]) as highly relevant. Associations between the selected context and process variables ranged from 0.27 to 0.53 (p≤0.00), between selected context and outcome variables from 0.26 to 0.55 (p≤0.00), and between selected process and outcome variables from 0.29 to 0.59 (p≤0.00). Moderate associations (rs >0.50; p≤0.00) were found between "pain coping" and "fear avoidance" as process variables, and "pain intensity" and "functioning" as outcome variables. CONCLUSION The identified associations between selected context, process, and outcome variables were fair to moderate. Ongoing work may clarify some of these associations and provide guidance to physiotherapists on how best to improve the quality of clinical reasoning in terms of relationships between context, process, and outcome in the management of patients with WAD.
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Affiliation(s)
- Rob A B Oostendorp
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, the Netherlands
| | - J W Hans Elvers
- Department of Public Health and Research, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- Methodological Health-Skilled Institute, Beuningen, the Netherlands
| | - Emiel van Trijffel
- SOMT University of Physiotherapy, Amersfoort, the Netherlands
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Geert M Rutten
- Institute of Health Studies, Faculty of Health and Social Studies, HAN University of Applied Science, Nijmegen, the Netherlands
- Faculty of Science and Engineering, Maastricht University, Maastricht, the Netherlands
| | - Gwendolyne G M Scholten–Peeters
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Free University Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Marcel Heijmans
- Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, the Netherlands
| | - Erik Hendriks
- Department of Epidemiology, Center of Evidence Based Physiotherapy, Maastricht University, Maastricht, the Netherlands
- Practice Physiotherapy ‘Klepperheide’, Druten, the Netherlands
| | - Emilia Mikolajewska
- Department of Physiotherapy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus Univerisity, Toruń, Poland
- Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland
| | - Margot De Kooning
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Marjan Laekeman
- Department of Nursing Sciences, Ph.D.-Kolleg, Faculty of Health, University Witten/Herdecke, Witten, Germany
| | - Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Nathalie Roussel
- Department of Physiotherapy and Rehabilitation Sciences (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Han Samwel
- Revalis Pain Rehabilitation Centre, ‘s Hertogenbosch, the Netherlands
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Bijker L, Sleijser-Koehorst M, Coppieters M, Cuijpers P, Scholten-Peeters G. Preferred Self-Administered Questionnaires to Assess Depression, Anxiety and Somatization in People With Musculoskeletal Pain – A Modified Delphi Study. THE JOURNAL OF PAIN 2020; 21:409-417. [DOI: 10.1016/j.jpain.2019.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/17/2019] [Accepted: 08/29/2019] [Indexed: 12/29/2022]
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Developing a preliminary questionnaire for the faculty development programme needs of medical teachers using Delphi technique. J Taibah Univ Med Sci 2020; 14:495-501. [PMID: 31908636 PMCID: PMC6940618 DOI: 10.1016/j.jtumed.2019.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/21/2019] [Accepted: 09/27/2019] [Indexed: 12/14/2022] Open
Abstract
Objective The study aimed to develop a preliminary medical teachers' faculty development programme (FDP) needs questionnaire through two rounds of Delphi technique. Methods This study utilised the Delphi study between April to June 2019. Face-to-face interviews and a literature review were conducted to propose a set of domains and items for the FDP needs of medical teachers. Two rounds of the Delphi technique were incorporated to obtain a consensus for the proposed questionnaire by 10 expert panels from their respective fields. The consensus was pre-defined as a mean score of four or above and with a percent agreement of 75%. Results Initially, four domains and 26 items were proposed. Finally, a total of six domains and 38 items were endorsed by the expert panels. The selected domains included six competencies, including teaching, assessment, research, curriculum, publication, and public service. These domains consisted of seven, nine, six, seven, four, and five items, respectively. Conclusion This study developed the first preliminary FDPs needs questionnaire specifically designed for medical teachers. It would be an effective instrument to measure the needs of the FDPs in medical education.
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Ziegler FG, Cabrera MAS, Almeida ASD, Alexandre TM, Pereira ADS, Wesgueber J, Aoyagui KM. Evaluation of self-efficacy determinants in community-dwelling older adults with chronic musculoskeletal pain. GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-212320202000039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION: Self-efficacy is defined as the strength of a person’s convictions in being able to perform a given activity and obtain the expected result. It may act as a potent mediator between chronic musculoskeletal pain and how older adults cope with their disabilities. OBJECTIVE: To evaluate the determinants of self-efficacy beliefs and fear of physical exercise in community-dwelling older adults with chronic musculoskeletal pain. METHODS: This cross-sectional study recruited older adults with chronic musculoskeletal pain. Only individuals living in an urban area in southern Brazil and who reported pain for more than 3 months were included. A convenience sample was selected in a nonprobabilistic fashion. The study variables consisted of sociodemographic data; pain based on the Brief Pain Inventory and the Leeds Assessment of Neuropathic Symptoms and Signs for Patients with Chronic Pain; and self-efficacy based on the Chronic Pain Self-Efficacy Scale. Also, simple questions were created for physical exercise beliefs. For statistical analysis, absolute and relative frequency, χ2 test, and Mann-Whitney U test were used as appropriate. RESULTS: The sample consisted of 193 older adults, mostly women with low level of education. Self-efficacy was best rated by older adults living alone and by those who were classified as exclusively nociceptive pain. CONCLUSION: Despite having chronic pain, older adults with higher self-efficacy feel confident in performing their tasks and have greater ability to cope with changes related to aging and to engage in self-care.
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Thomson H, Evans K, Dearness J, Kelley J, Conway K, Morris C, Bisset L, Scholten-Peeters G, Cuijpers P, Coppieters MW. Identifying psychosocial characteristics that predict outcome to the UPLIFT programme for people with persistent back pain: protocol for a prospective cohort study. BMJ Open 2019; 9:e028747. [PMID: 31401599 PMCID: PMC6701637 DOI: 10.1136/bmjopen-2018-028747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/24/2019] [Accepted: 06/21/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Prognostic screening of people with low back pain (LBP) improves utilisation of primary healthcare resources. Whether this also applies to secondary healthcare remains unclear. Therefore, this study aims to develop prognostic models to determine at baseline which patients with persistent LBP are likely to have a good and poor outcome to a 5-week programme of combined education and exercise ('UPLIFT') delivered in a secondary healthcare setting. METHODS AND ANALYSIS A prospective cohort study of 246 people with persistent LBP will be conducted in a secondary healthcare outpatient setting. Patients will be recruited from a physiotherapy-led neurosurgical screening clinic. Demographic data, medical history and psychosocial characteristics will be recorded at baseline. Fear avoidance beliefs, pain self-efficacy, LBP treatment beliefs, pain catastrophising, perceived injustice, depression, anxiety and stress, disability level, pain intensity and interference, health status and social connectedness will be considered as potential prognostic variables, which will be assessed using self-reported questionnaires. Participants will attend the UPLIFT programme, consisting of weekly 90 min group sessions that combine interactive education sessions and a graded exercise programme. The outcome measure to identify good and poor outcome is the Global Rating of Change scale, assessed at completion of the UPLIFT programme and at 6 months follow-up. Multiple imputation analyses will be performed for missing values. Prognostic models will be developed using multivariable logistic regression analyses, with bootstrapping techniques for internal validation. We will calculate the explained variance of the models and the area under the receiver operating characteristic curve. Furthermore, we will determine whether participation in the UPLIFT programme is associated with changes in psychosocial characteristics. ETHICS AND DISSEMINATION Gold Coast Health Service Human Research Ethics Committee (HREC/18/QGC/41) and the Griffith University Human Research Ethics Committee (GU Ref No: 2018/408) approved the study. Dissemination of findings will occur via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12618001525279.
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Affiliation(s)
- Hayley Thomson
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Australia
- School of Medical Science, Griffith University, Gold Coast, Australia
| | - Kerrie Evans
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- School of Allied Health Sciences, Griffith University, Brisbane & Gold Coast, Australia
- Allsports Physiotherapy and Sports Medicine Clinics, Healthia Limited, Brisbane, Australia
| | - Jonathon Dearness
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Australia
| | - John Kelley
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Australia
| | - Kylie Conway
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Australia
| | - Collette Morris
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Australia
| | - Leanne Bisset
- School of Allied Health Sciences, Griffith University, Brisbane & Gold Coast, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
| | - Gwendolijne Scholten-Peeters
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michel W Coppieters
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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