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Individually tailored treatment targeting motor behavior, cognitions, and disability: Two experimental single case studies of patients with recurrent and persistent pain in primary health care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
2005 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 85, no 10, 1061-1077 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE:

This article introduces an individually tailored intervention targeting motor behavior, cognition, and disability in patients managed by physical therapists in primary health care. Effects on self-rated disability, pain intensity, and pain control are described.

SUBJECTS:

Two women with recurrent or persistent disabling musculoskeletal pain were selected.

METHODS:

Two experimental single-subject A(1)-B-C-A(2) studies with multiple baselines across situations were used. Principal outcome data were collected daily with patient-specific continuous measures for 3 weeks before intervention, continuously during intervention, and for 2 weeks during each of the 1-, 4-, 6-, and 12-month follow-up examinations.

RESULTS:

Disability and pain intensity decreased, and pain control increased in both subjects. The results were maintained at the follow-up examinations.

DISCUSSION AND CONCLUSION:

Positive outcomes of the intervention were reported from 2 subjects with recurrent and persistent disabling pain. Procedures for systematic tailoring of treatment to behavioral goals and individual patient characteristics are available as a result of the successful application. The results need to be replicated in future clinical controlled group studies.

Place, publisher, year, edition, pages
2005. Vol. 85, no 10, 1061-1077 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-93013PubMedID: 16180955OAI: oai:DiVA.org:uu-93013DiVA: diva2:166360
Available from: 2005-04-27 Created: 2005-04-27 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Individually Tailored Treatment in the Management of Musculoskeletal Pain: Development and Evaluation of a Behavioural Medicine Intervention in Primary Health Care
Open this publication in new window or tab >>Individually Tailored Treatment in the Management of Musculoskeletal Pain: Development and Evaluation of a Behavioural Medicine Intervention in Primary Health Care
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis deals with clinical pain intervention research from a behavioural medicine perspective. The general aim was to develop and evaluate an individually tailored treatment protocol focused on pain management in everyday life in people who experience persistent musculoskeletal pain. Another aim was to develop and incorporate an idiographic outcome measure for behavioural goal assessment in the formal evaluation of the clinical significance of treatment outcomes.

The studies were conducted in a primary health care setting demonstrating a contribution from physical therapists in the field of behavioural medicine. Two separate samples of patients with musculoskeletal pain with a duration exceeding one month, n = 197 (Study I, descriptive and correlational design), and n = 97/82 (Study III/IV, randomized group-study) were included. In addition, four women were recruited for a series of experimental single-case studies (Study II).

The treatment protocol that was individually tailored to each participant’s behavioural treatment goals and assumed determinants of pain-related disability was more effective in reducing pain-related disability, pain intensity, fear-avoidance, and in increasing pain control when compared to an intervention including physical exercises. The individually tailored treatment was generally more beneficial for resumption of everyday life activity, increasing satisfaction, fulfilling pre-treatment expectations, and in preparing individuals for self-management of pain. The Patient Goal Priority Questionnaire that was elaborated over the course of the project can be used to a) identify and assess behavioural treatment goals, b) elaborate individual functional behavioural analyses relevant for everyday life functioning, and c) determine the clinical significance of treatment outcomes – that is, whether interventions produce outcomes of relevance for each individual’s everyday life. The inclusion of idiographic outcome measures in clinical pain intervention research is necessary and improves the ecological validity of the evaluation of clinical significance.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2005. 94 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 35
Keyword
Caring sciences, behavioural medicine, goal assessment, tailored treatment, chronic pain, physical therapy, primary health care, Vårdvetenskap
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-5781 (URN)91-554-6240-5 (ISBN)
Public defence
2005-05-20, Sal X, Universitetshuset, Uppsala, 13:15
Opponent
Supervisors
Available from: 2005-04-27 Created: 2005-04-27Bibliographically approved

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Åsenlöf, PernillaLindberg, Per

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