Research Report Abstracts - Gesundheit

eS1294
Research Report Poster Display
Number: RR-PO-309-2-Wed Wednesday 22 June 13:00
RAI: Exhibit Halls 2&3
CAN PAIN PHYSIOLOGY EDUCATION CHANGE
PAIN COGNITIONS AND DESCENDING
NOCICEPTIVE PROCESSING IN FIBROMYALGIA?
A RANDOMISED CONTROLLED TRIAL
Van Oosterwijck J. 1,2,3 , Nijs J. 1,2,3 , Meeus M. 1,2 ,De
Schryver M. 1 , Pascal A. 1 , Paul L. 4
1Vrije Universiteit Brussel, Faculty of Physical Education &
Physiotherapy, Department of Human Physiology, Brussels,
Belgium, 2Artesis University College Antwerp, Department
of Health Care Sciences, Division of Musculoskeletal Physiotherapy,
Antwerp, Belgium, 3University Hospital Brussels,
Department of Physical Medicine and Physiotherapy, Brussels,
Belgium, 4University of Glasgow, Faculty of Medicine,
Nursing and Health Care, Glasgow, United Kingdom
Purpose: To examine whether pain physiology education is
capable of changing pain cognitions and descending nociceptive
processing in Fibromyalgia [FM].
Relevance: Rehabilitation specialists can use a single education
session in combination with an information leaflet
to explain to chronic pain patients the neurophysiology
of chronic pain. Based on the current study and previous
research we have shown that these patients are able to understand
this complex material and that it is a valuable part of the
rehabilitation program, used to correct inappropriate beliefs
and behaviour, resulting in an improvement of the health
status and an increased therapy compliance.
Participants: Patients fulfilling the criteria of the American
College of Rheumatology on Fibromyalgia were recruited
from a private medical practise speacialised in the treatment
of chronic pain patients. Thirty FM-patients, 26 females and 4
males, participated in this study. The patients from the control
group were 45.9 ± 11.3 years old, and reported a symptom
duration of 116 ± 46 months. The mean age of the patients
from the intervention group was 45.8 ± 9.5 years, with a
symptom duration of 156 ± 96 months.
Methods: A double blind randomised controlled trial was
performed. FM-patients were randomly allocated to either
the experimental group (receiving pain physiology education)
or the control group (receiving education about pacing
self-management). Outcome measures included health status,
pain behaviour and pain cognitions, pressure pain thresholds
[PPT’s], and the efficacy of the diffuse noxious inhibitory
control mechanism [DNIC] evaluated by using a spatial summation
procedure [SSP] in which thermal nociceptive stimuli
were spatially accumulated by immersing the arm gradually
in hot (46 ◦ C) water. These assessments were performed at
baseline, 2 weeks and 3 months follow-up.
Analysis: Repeated measures ANOVAS were used to reveal
possible therapy effects.
Results: After the intervention the experimental group presented
a significant better knowledge on pain physiology
(p < .001), compared to the control group. The experimental
group presented a significant improvement in physical functioning
(p = .046), vitality (p = .047), and mental (p < .001)
and general health (p < .001) status. No significant effect
were found for pain cognitions, behaviour or for the PPT’s.
Although no significant effects were established for the efficacy
of DNIC when the three different measurements in
time were compared, a significant difference was found when
the intervention group was compared with the control group
at three months follow-up. The intervention group reported
lower pain scores during the spatial summation procedure
(p = .019).
Conclusions: These results suggest that FM-patients are able
to understand and remember the complex material about pain
physiology. They reported increased levels of vitality and
physical functioning, and an improvement of their mental
and general health. We could not establish any effects on
pain cognitions or pain behaviour. Although pain pressure
thresholds remained the same, a positive effect was found
on the descending nociceptive processing at three months
follow-up.
Implications: Pain education seems a useful component in
the treatment of FM-patients as it can be used to improve
health status, and could improve pain inhibition in the long
term, but additional research is warranted.
Keywords: Fibromyalgia; Pain physiology; Pain inhibition
Funding acknowledgements: Jessica Van Oosterwijck is
financially supported by grant no. OZR1596 from the
research council of the Vrije Universiteit Brussel, Brussels,
Belgium. Mira Meeus is a postdoctoral fellow of the Fund
for Scientific Research Flanders (FWO).
Ethics approval: The study was approved by the Ethics
Committee of the University Hospital Brussels/Vrije Universiteit
Brussel.
Research Report Platform Presentation
Number: RR-PL-1984 Thursday 23 June 09:45
RAI: Elicium D203-204
EFFECTS OF PHYSICAL THERAPY IN NURSING
HOME RESIDENTS—A SYSTEMATIC
LITERATURE REVIEW
van Ravensberg D., van den Heuvel S. 1 , Hobbelen H. 2 ,
Nijhuis-van der Sanden R. 3
1Dutch Institute of Allied Health Care, Documentation,
Amersfoort, Netherlands, 2Dutch Institute of Allied Health
Care, Research and Innovation, Amersfoort, Netherlands,
3IQ Healthcare UMC St Radboud, Research and Innovation,
Nijmegen, Netherlands
Purpose: To gather evidence from a systematic literature
review on the effects of physical therapy in nursing home
residents i.e. persons with multiple co-morbidity.