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Lorimer G Moseley - One of the best experts on this subject based on the ideXlab platform.
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how good is the Neurophysiology of Pain questionnaire a rasch analysis of psychometric properties
The Journal of Pain, 2013Co-Authors: Mark J Catley, Lorimer G Moseley, Neil E OconnellAbstract:The Neurophysiology of Pain Questionnaire (NPQ) was devised to assess how an individual conceptualizes the biological mechanisms that underpin his or her Pain. Despite its widespread use, its psychometric properties have not been comprehensively interrogated. Rasch analysis was undertaken on NPQ data from a convenience sample of 300 spinal Pain patients, and test-retest reliability was as- sessed in a sample of 45 low back Pain patients. The NPQ effectively targeted the ability of the sample and had acceptable internal consistency and test-retest reliability. However, some items functioned er- ratically for persons of differingabilities or were psychometrically redundant. The NPQ wasreanalyzed with 7 questionable items excluded, and superior psychometric properties were observed. These find- ings suggest that the NPQ could be improved but future prospective studies including qualitative mea- sures areneeded. In summary, the NPQ isa useful tool for assessing apatient's conceptualization ofthe biological mechanisms that underpin his or her Pain and for evaluating the effects of cognitive inter- ventions in clinical practice and research. These findings suggest that it has adequate psychometric properties for use with chronic spinal Pain patients. Perspective: Rasch analysis was used to analyze the NPQ. Despite several limitations, these results suggest that it is a useful tool with which to assess a patient's conceptualization of the biological mechanisms that underpin his or her Pain and to evaluate the effects of cognitive interventions in clinical practice and research. a 2013 by the American Pain Society
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a randomized controlled trial of intensive Neurophysiology education in chronic low back Pain
The Clinical Journal of Pain, 2004Co-Authors: Lorimer G Moseley, Michael K Nicholas, Paul W HodgesAbstract:Objectives: Cognitive-behavioral Pain management programs typically achieve improvements in Pain cognitions, disability, and physical performance. However, it is not known whether the Neurophysiology education component of such programs contributes to these outcomes. In chronic low back Pain patients, we investigated the effect of Neurophysiology education on cognitions, disability, and physical performance. Methods: This study was a blinded randomized controlled trial. Individual education sessions on Neurophysiology of Pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal drawing-in task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. Results: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. Discussion: Education about Pain Neurophysiology changes Pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that Pain Neurophysiology education, but not back school type education, should be included in a wider Pain management approach.
Steven Truijen - One of the best experts on this subject based on the ideXlab platform.
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Pain Neurophysiology education improves cognitions Pain thresholds and movement performance in people with chronic whiplash a pilot study
Journal of Rehabilitation Research and Development, 2011Co-Authors: Jessica Van Oosterwijck, Jo Nijs, Mira Meeus, Steven Truijen, Julie Craps, Nick Van Den Keybus, Lorna PaulAbstract:Chronic whiplash is a debilitating condition characterized by increased sensitivity to Painful stimuli, maladaptive illness beliefs, inappropriate attitudes, and movement dysfunctions. Previous work in people with chronic low back Pain and chronic fatigue syndrome indicates that Pain Neurophysiology education is able to improve illness beliefs and attitudes as well as movement performance. This single-case study (A-B-C design) with six patients with chronic whiplash associated disorders (WAD) was aimed at examining whether education about the Neurophysiology of Pain is accompanied by changes in symptoms, daily functioning, Pain beliefs, and behavior. Periods A and C represented assessment periods, while period B consisted of the intervention (Pain Neurophysiology education). Results showed a significant decrease in kinesiophobia (Tampa Scale for Kinesiophobia), the passive coping strategy of resting (Pain Coping Inventory), self-rated disability (Neck Disability Index), and photophobia (WAD Symptom List). At the same time, significantly increased Pain pressure thresholds and improved Pain-free movement performance (visual analog scale on Neck Extension Test and Brachial Plexus Provocation Test) were established. Although the current results need to be verified in a randomized, controlled trial, they suggest that education about the physiology of Pain is able to increase Pain thresholds and improve Pain behavior and Pain-free movement performance in patients with chronic WAD.
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Pain physiology education improves Pain beliefs in patients with chronic fatigue syndrome compared with pacing and self management education a double blind randomized controlled trial
Archives of Physical Medicine and Rehabilitation, 2010Co-Authors: Mira Meeus, Jo Nijs, Jessica Van Oosterwijck, Veerle Van Alsenoy, Steven TruijenAbstract:Abstract Meeus M, Nijs J, Van Oosterwijck J, Van Alsenoy V, Truijen S. Pain physiology education improves Pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Objective To examine whether Pain physiology education was capable of changing Pain cognitions and Pain thresholds in patients with chronic fatigue syndrome (CFS) and chronic widespread Pain. Design Double-blind randomized controlled trial. Setting Specialized chronic fatigue clinic in university hospital. Participants A random sample of patients (N=48) with CFS patients (8 men, 40 women) experiencing chronic Pain, randomly allocated to the control group (n=24) or experimental group (n=24). Two women in the experimental group did not complete the study because of practical issues (lack of time and restricted mobility). Interventions One individual Pain physiology education session (experimental) or 1 pacing and self-management education session (control). Main Outcome Measures Algometry, the Neurophysiology of Pain Test, and questionnaires evaluating Pain cognitions—the Pain Coping Inventory, the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia–version CFS—were completed immediately before and immediately after the intervention. Results After the intervention, the experimental group demonstrated a significantly better understanding of the Neurophysiology of Pain ( P P =.009) compared with controls. For these variables, moderate to large Cohen d effect sizes were revealed (.79–2.53). Conclusions A 30-minute educational session on Pain physiology imparts a better understanding of Pain and brings about less rumination in the short term. Pain physiology education can be an important therapeutic modality in the approach of patients with CFS and chronic Pain, given the clinical relevance of inappropriate Pain cognitions.
John Harbis - One of the best experts on this subject based on the ideXlab platform.
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changes in Pain knowledge attitudes and beliefs of osteopathy students after completing a clinically focused Pain education module
Chiropractic & Manual Therapies, 2018Co-Authors: Kylie Fitzgerald, Brett Vaughan, Michael Fleischmann, Kevin De Waal, Sarah L Slater, John HarbisAbstract:Background Chronic Pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic Pain. Knowledge of the Neurophysiology and multidimensional aspects of Pain is imperative to ensure health professionals apply a biopsychosocial approach to Pain. Questionnaires may be used to assess learner changes in Neurophysiology knowledge and beliefs and attitudes towards Pain after education interventions. The aim of this study was to evaluate changes in Pain Neurophysiology knowledge, beliefs and attitudes following a 12 week clinically-focused Pain module in year 3 osteopathy students as measured by the Neurophysiology of Pain (NPQ) Questionnaire and Health Care Providers Pain and Impairment Relationship scale (HC-PAIRS).
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changes in Pain knowledge attitudes and beliefs of osteopathy students after completing a clinically focused Pain education module
Chiropractic & Manual Therapies, 2018Co-Authors: Kylie Fitzgerald, Brett Vaughan, Michael Fleischmann, Kevin De Waal, Sarah L Slater, John HarbisAbstract:Chronic Pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic Pain. Knowledge of the Neurophysiology and multidimensional aspects of Pain is imperative to ensure health professionals apply a biopsychosocial approach to Pain. Questionnaires may be used to assess learner changes in Neurophysiology knowledge and beliefs and attitudes towards Pain after education interventions. The aim of this study was to evaluate changes in Pain Neurophysiology knowledge, beliefs and attitudes following a 12 week clinically-focused Pain module in year 3 osteopathy students as measured by the Neurophysiology of Pain (NPQ) Questionnaire and Health Care Providers Pain and Impairment Relationship scale (HC-PAIRS). A pre-post design was utilised. Learners completed a demographic information survey pre-module, and completed the NPQ & HC-PAIRS prior to undertaking, and after completing, a twelve week clinically-focused Pain module. Learners (n = 55) completed the NPQ & HC-PAIRS at both time points. The median NPQ score was significantly increased with a large effect size (p < 0.001, z = − 5.71, r = 0.78) following the completion of the module. In contrast, the HC-PAIRS total score was significantly increased after the completion of the module (p < 0.01, z = − 6.95, r = 0.91) suggesting an increase in negative Pain attitudes and beliefs. Results indicate that a clinically-focused Pain module can increase Pain Neurophysiology knowledge. However the HC-PAIRS results suggest an increase in negative Pain attitudes and beliefs. The HC-PAIRS questionnaire was developed for use with chronic low back Pain attitudes & beliefs in practitioners, rather than pre-clinical students. Students were provided with general principles of Pain management, rather than condition specific Pain management. This study is the first comparing Pain Neurophysiology knowledge and changes in attitudes and beliefs towards Pain pre-post a clinically-focused Pain module using the NPQ & HC-PAIRS. There was a significant improvement in NPQ score after the 12 week clinically-focused Pain module. The HC-PAIRS result was paradoxical and may reflect issues with the module design or the measurement tool. The module duration is longer than that reported in the literature and demonstrates effectiveness in increasing Pain Neurophysiology knowledge.
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Changes in Pain knowledge, attitudes and beliefs of osteopathy students after completing a clinically focused Pain education module
BMC, 2018Co-Authors: Kylie Fitzgerald, Brett Vaughan, Michael Fleischmann, Kevin De Waal, Sarah Slater, John HarbisAbstract:Abstract Background Chronic Pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic Pain. Knowledge of the Neurophysiology and multidimensional aspects of Pain is imperative to ensure health professionals apply a biopsychosocial approach to Pain. Questionnaires may be used to assess learner changes in Neurophysiology knowledge and beliefs and attitudes towards Pain after education interventions. The aim of this study was to evaluate changes in Pain Neurophysiology knowledge, beliefs and attitudes following a 12 week clinically-focused Pain module in year 3 osteopathy students as measured by the Neurophysiology of Pain (NPQ) Questionnaire and Health Care Providers Pain and Impairment Relationship scale (HC-PAIRS). Methods A pre-post design was utilised. Learners completed a demographic information survey pre-module, and completed the NPQ & HC-PAIRS prior to undertaking, and after completing, a twelve week clinically-focused Pain module. Results Learners (n = 55) completed the NPQ & HC-PAIRS at both time points. The median NPQ score was significantly increased with a large effect size (p
Paul W Hodges - One of the best experts on this subject based on the ideXlab platform.
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a randomized controlled trial of intensive Neurophysiology education in chronic low back Pain
The Clinical Journal of Pain, 2004Co-Authors: Lorimer G Moseley, Michael K Nicholas, Paul W HodgesAbstract:Objectives: Cognitive-behavioral Pain management programs typically achieve improvements in Pain cognitions, disability, and physical performance. However, it is not known whether the Neurophysiology education component of such programs contributes to these outcomes. In chronic low back Pain patients, we investigated the effect of Neurophysiology education on cognitions, disability, and physical performance. Methods: This study was a blinded randomized controlled trial. Individual education sessions on Neurophysiology of Pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal drawing-in task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. Results: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. Discussion: Education about Pain Neurophysiology changes Pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that Pain Neurophysiology education, but not back school type education, should be included in a wider Pain management approach.
Mira Meeus - One of the best experts on this subject based on the ideXlab platform.
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clinical biopsychosocial physiotherapy assessment of patients with chronic Pain the first step in Pain neuroscience education
Physiotherapy Theory and Practice, 2016Co-Authors: Amarins J Wijma, Mira Meeus, Paul C Van Wilgen, Jo NijsAbstract:Pain neuroscience education (PNE) is increasingly used as part of a physical therapy treatment in patients with chronic Pain. A thorough clinical biopsychosocial assessment is recommended prior to PNE to allow proper explanation of the Neurophysiology of Pain and the biopsychosocial interactions in an interactive and patient-centered manner. However, without clear guidelines, clinicians are left wondering how a biopsychosocial assessment should be administered. Therefore, we provided a practical guide, based on scientific research and clinical experience, for the biopsychosocial assessment of patients with chronic Pain in physiotherapy practice. The purpose of this article is to describe the use of the Pain - Somatic factors - Cognitive factors - Emotional factors - Behavioral factors - Social factors - Motivation - model (PSCEBSM-model) during the intake, as well as a Pain analysis sheet. This model attempts to clearly establish what the dominant Pain mechanism is (predominant nociceptive, neuropathic, or non-neuropathic central sensitization Pain), as well as to assess the provoking and perpetuating biopsychosocial factors in patients with chronic Pain. Using this approach allows the clinician to specifically classify patients and tailor the plan of care, including PNE, to individual patients.
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Pain Neurophysiology education improves cognitions Pain thresholds and movement performance in people with chronic whiplash a pilot study
Journal of Rehabilitation Research and Development, 2011Co-Authors: Jessica Van Oosterwijck, Jo Nijs, Mira Meeus, Steven Truijen, Julie Craps, Nick Van Den Keybus, Lorna PaulAbstract:Chronic whiplash is a debilitating condition characterized by increased sensitivity to Painful stimuli, maladaptive illness beliefs, inappropriate attitudes, and movement dysfunctions. Previous work in people with chronic low back Pain and chronic fatigue syndrome indicates that Pain Neurophysiology education is able to improve illness beliefs and attitudes as well as movement performance. This single-case study (A-B-C design) with six patients with chronic whiplash associated disorders (WAD) was aimed at examining whether education about the Neurophysiology of Pain is accompanied by changes in symptoms, daily functioning, Pain beliefs, and behavior. Periods A and C represented assessment periods, while period B consisted of the intervention (Pain Neurophysiology education). Results showed a significant decrease in kinesiophobia (Tampa Scale for Kinesiophobia), the passive coping strategy of resting (Pain Coping Inventory), self-rated disability (Neck Disability Index), and photophobia (WAD Symptom List). At the same time, significantly increased Pain pressure thresholds and improved Pain-free movement performance (visual analog scale on Neck Extension Test and Brachial Plexus Provocation Test) were established. Although the current results need to be verified in a randomized, controlled trial, they suggest that education about the physiology of Pain is able to increase Pain thresholds and improve Pain behavior and Pain-free movement performance in patients with chronic WAD.
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Pain physiology education improves Pain beliefs in patients with chronic fatigue syndrome compared with pacing and self management education a double blind randomized controlled trial
Archives of Physical Medicine and Rehabilitation, 2010Co-Authors: Mira Meeus, Jo Nijs, Jessica Van Oosterwijck, Veerle Van Alsenoy, Steven TruijenAbstract:Abstract Meeus M, Nijs J, Van Oosterwijck J, Van Alsenoy V, Truijen S. Pain physiology education improves Pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Objective To examine whether Pain physiology education was capable of changing Pain cognitions and Pain thresholds in patients with chronic fatigue syndrome (CFS) and chronic widespread Pain. Design Double-blind randomized controlled trial. Setting Specialized chronic fatigue clinic in university hospital. Participants A random sample of patients (N=48) with CFS patients (8 men, 40 women) experiencing chronic Pain, randomly allocated to the control group (n=24) or experimental group (n=24). Two women in the experimental group did not complete the study because of practical issues (lack of time and restricted mobility). Interventions One individual Pain physiology education session (experimental) or 1 pacing and self-management education session (control). Main Outcome Measures Algometry, the Neurophysiology of Pain Test, and questionnaires evaluating Pain cognitions—the Pain Coping Inventory, the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia–version CFS—were completed immediately before and immediately after the intervention. Results After the intervention, the experimental group demonstrated a significantly better understanding of the Neurophysiology of Pain ( P P =.009) compared with controls. For these variables, moderate to large Cohen d effect sizes were revealed (.79–2.53). Conclusions A 30-minute educational session on Pain physiology imparts a better understanding of Pain and brings about less rumination in the short term. Pain physiology education can be an important therapeutic modality in the approach of patients with CFS and chronic Pain, given the clinical relevance of inappropriate Pain cognitions.