| 1. |
- Overmeer, Thomas, et al.
(författare)
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The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-Associated disorders A randomized controlled trial with a 2-year follow-up
- 2016
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Ingår i: Medicine. - : LIPPINCOTT WILLIAMS & WILKINS. - 0025-7974 .- 1536-5964. ; 95:34
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Tidskriftsartikel (refereegranskat)abstract
- Background: To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-Associated disorders (WAD), grade 2 and 3, with a 2-year follow-up. Methods:A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models. Results: General pain disability decreased by 28% in the NSEB group from baseline to 3 months (P<0.001) and the improvements in disability were maintained over time (6, 12 and 24 months P<0.01) compared to the NSE (P>0.42) and PPA groups (P>0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (P<0.01) and in the NSEB group from baseline to 3 and 24 months (P<0.01) compared to the PPA group (P>0.82) that showed no change over time. The NSE group improved in kinesiophobia over time from baseline to12 months (P<0.01) compared to the NSEB (P=0.052) and the PPA groups (P>0.74). Anxiety decreased over time from baseline to 12 and 24 months in the NSE group (P>0.02), but not in the NSEB (P>0.25) or the PPA (P>0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors. Conclusion: This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.
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| 2. |
- Overmeer, Thomas, et al.
(författare)
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What Messages Do Patients Remember? : Relationships Among Patients' Perceptions of Physical Therapists' Messages, Patient Characteristics, Satisfaction, and Outcome.
- 2016
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 96:3, s. 275-283
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Based on a behavioral medicine perspective, modern recommendations for physical therapists treating patients with spinal pain include performing a trustworthy physical examination, conveying the message that back pain is benign, and stressing that activity is a key to recovery. However, little evidence is available on how patients perceive these biopsychosocial messages and how patients' perceptions of these messages relate to their recovery.OBJECTIVES: The aim of this study was to explore the relationships between perceptions of treatment delivery that are related to an evidence-based approach and psychological factors, treatment outcome, and treatment satisfaction.DESIGN: A cohort study with 3 measurement points was conducted.METHODS: Data on 281 participants were collected.RESULTS: High catastrophizing and lower mood in the participants were correlated to "not perceiving the biopsychosocial message" measured at 6 weeks after treatment start. Participants who did not perceive the biopsychosocial message were at higher risk for disability and had lower treatment satisfaction 6 months after treatment start even when controlling for pretreatment pain intensity. "Not perceiving the biopsychosocial message" was not a mediator for treatment outcome and treatment satisfaction. Physical therapists' treatment orientations or attitudes were not related to the perception of the message by the patients.LIMITATIONS: There was no measure of actual practice behavior.CONCLUSIONS: Maladaptive cognitions and negative emotions appear to affect the way information provided during treatment is perceived by patients. The way information is perceived by patients influences treatment outcome and treatment satisfaction. Physical therapists are advised to check that patients with higher levels of catastrophizing and lower mood are correctly perceiving and interpreting a biopsychosocial message.
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| 3. |
- Overmeer, Thomas, et al.
(författare)
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What messages do patients remember? : The relationship between patient perception of physical therapist’s messages, patient characteristics, satisfaction and outcome
- 2016
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Ingår i: Physical Therapy. - : American Physical Therapy Association. - 0031-9023 .- 1538-6724. ; 96:3, s. 275-283
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Tidskriftsartikel (refereegranskat)abstract
- Background: Based on a behavioral medicine perspective, modern recommendations for physical therapists treating patients with spinal pain include performing a trustworthy physical examination, conveying the message that back pain is benign, and stressing that activity is a key to recovery. However, little evidence is available on how patients perceive these biopsychosocial messages and how patients' perceptions of these messages relate to their recovery.Objectives: The aim of this study was to explore the relationships between perceptions of treatment delivery that are related to an evidence-based approach and psychological factors, treatment outcome, and treatment satisfaction.Design: A cohort study with 3 measurement points was conducted.Methods: Data on 281 participants were collected.Results: High catastrophizing and lower mood in the participants were correlated to "not perceiving the biopsychosocial message" measured at 6 weeks after treatment start. Participants who did not perceive the biopsychosocial message were at higher risk for disability and had lower treatment satisfaction 6 months after treatment start even when controlling for pretreatment pain intensity. "Not perceiving the biopsychosocial message" was not a mediator for treatment outcome and treatment satisfaction. Physical therapists' treatment orientations or attitudes were not related to the perception of the message by the patients.Limitations: There was no measure of actual practice behavior.Conclusions: Maladaptive cognitions and negative emotions appear to affect the way information provided during treatment is perceived by patients. The way information is perceived by patients influences treatment outcome and treatment satisfaction. Physical therapists are advised to check that patients with higher levels of catastrophizing and lower mood are correctly perceiving and interpreting a biopsychosocial message.
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