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- Bergbom, Sofia, 1982-, et al.
(författare)
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Relationship Among Pain Catastrophizing, Depressed Mood, and Outcomes Across Physical Therapy Treatments
- 2011
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Ingår i: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 91:5, s. 754-764
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain catastrophizing and emotional distress can act as prognosticfactors for pain and disability. Research on how these variables interact withinindividuals and over time is in an early stage. Understanding various patterns ofprognostic factors and how these factors change during treatment is important fordeveloping treatments targeting important factors.Objective: The primary aim of this study was to investigate relationships betweenpain catastrophizing and depressed mood in people seeking primary care for mus-culoskeletal pain. An additional aim was to relate these patterns of prognostic factorsto outcomes during a 6-month period.Design: The design was prospective; data were obtained at baseline and atfollow-up.Methods: Forty-two physical therapists taking part in an educational programrecruited, from their clinical practices in primary care, consecutive patients whowere currently experiencing a pain problem. Patients received various physicaltherapy interventions between baseline and follow-up.Results: On the basis of patterns of scoring for pain catastrophizing and depressedmood, 4 subgroups of participants were found. Belonging to a subgroup withelevated levels of either pain catastrophizing or depressed mood at baseline wasrelated to the absence of improvement and elevated levels of disability after physicaltherapy interventions. Furthermore, elevated levels of both variables were related tothe highest levels of disability.Limitations: The analyses relied on self-report. Neither treatment content norpain-related fear was measured. The sample was a mixture of participants reportingacute pain and subacute pain.Conclusions: The results stress the importance of assessing and targeting prog-nostic factors. Moreover, the results suggest the need to tailor treatments to matchpatterns of prognostic factors and the need to target depressed mood and paincatastrophizing in physical therapy interventions.
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- Overmeer, Thomas, 1960-, et al.
(författare)
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Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? : A randomized controlled trial
- 2011
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Ingår i: Physical Therapy. - 0031-9023 .- 1538-6724. ; 91:5, s. 804-819
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Tidskriftsartikel (refereegranskat)abstract
- Background. Psychosocial prognostic factors are important in the development of chronic pain, but treatment providers often lack knowledge and skills to assess and address these risk factors. Objective. The aim of this study was to examine the effects on outcomes (pain and disability) in patients of a course about psychosocial prognostic factors for physical therapists. Design. This study was a randomized, controlled trial. Setting. The setting was primary care practice. Participants. Forty-two primary care physical therapists attended an 8-day university course (over 8 weeks) aimed at identifying and addressing psychosocial risk factors. Intervention. The physical therapists were randomly assigned to either the course or a waiting list. They treated consecutive patients with acute and subacute musculoskeletal pain both before and after the course. Measurements. We measured physical therapists' attitudes and beliefs about psychosocial factors, knowledge, and skills before and after the course. We measured patients' pain, disability, catastrophizing, and mood at the start of treatment and at a 6-month follow-up. Methods. The physical therapists were randomly assigned to either the course or a waiting list. They treated consecutive patients with acute and subacute musculoskeletal pain both before and after the course. Results. Pain and disability outcomes in all patients of physical therapists who had participated in the course or in patients at risk of developing long-term disability who had higher levels of catastrophizing or depression were not significantly different from those outcomes in patients of physical therapists who had not participated in the course. Pain and disability outcomes in patients with a low risk of developing long-term disability-and pain outcomes in patients with a high risk of developing long-term disability-were not dependent upon whether the attitudes and beliefs of their physical therapists changed during the course. However, disability outcomes in patients with a high risk of developing long-term disability may have been influenced by whether the attitudes and beliefs of their physical therapists changed. Limitations. A limitation of this study was that actual practice behavior was not measured. Conclusions. An 8-day university course for physical therapists did not improve outcomes in a group of patients as a whole or in patients with a risk of developing long-term disability. However, patients who had a risk of developing long-term disability and had higher levels of catastrophizing or depression may have shown greater reductions in disability if the attitudes and beliefs of their physical therapists changed during the course.
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- Overmeer, Thomas, 1960-, et al.
(författare)
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Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? : A randomized controlled trial
- 2011
-
Ingår i: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 91:5, s. 804-819
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Psychosocial risk factors are important in the development of chronic pain but treatment providers often lack knowledge and skills to assess and address these risk factors.Objectives: We examined the effects of a course on psychosocial factors for physical therapists on patient outcome in terms of pain and disability. Design: A randomised controlled trail.Participants: Forty-two primary care physical therapists attended an eight-day university course over eight weeks aimed at identifying and addressing psychosocial risk factors.Methods: They were randomised to either the course or a waiting list. The physical therapists collected consecutive acute and sub-acute patients with musculoskeletal pain both before and after the course.Results: There were no significant differences in outcome for pain or disability for allpatients of physical therapists who had participated in the course or for risk patients with higher levels of catastrophizing or depression compared to patients of physical therapists who had not participated in the course. Outcome for low risk patients on pain and disability and for high risk patients on pain was not dependent on if their physical therapists changed their attitudes and beliefs during the course. Yet, outcome on disability for high risk patients may have been influenced if their physical therapists change their attitudes and beliefs.Limitations: no measure of actual practice behaviour.Conclusions: An eight-day university course for physiotherapists did not improve outcome for the group of patients as a whole or patients at risk of developing long term disability. Yet, risk patients with higher levels of catastrophizing or depression may have had a greater improvement in disability if their physical therapist changed attitudes and beliefs during the course.
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