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Objectives Physical activity is essential for long-term chronic pain management, yet individuals struggle to participate. Exercise professionals, including fitness instructors, and personal trainers, are preferred delivery agents for education and instruction on chronic pain, physical activity, and strategies to use adherence-promoting behavioral skills. However, exercise professionals receive no relevant training during certification or continuing education opportunities to effectively support their participants living with chronic pain. Based on the ORBIT model for early pre-efficacy phases of development and testing of new behavioral treatments, the present Phase IIa proof-of-concept study was conducted. The purpose was to examine the impacts of a newly developed chronic pain and physical activity training workshop on psychosocial outcomes among exercise professionals. Outcomes included knowledge and attitudes regarding chronic pain, attitudes and beliefs about the relationship between pain and impairment, and self-efficacy to educate and instruct participants with chronic pain. Methods Forty-eight exercise professionals (M age=44.4±11.0 years) participated in a three-hour, in-person workshop that was offered at one of four different locations. Participants completed pre- and post-workshop outcome assessment surveys. Results Mixed MANOVA results comparing time (pre- versus post-workshop) by workshop location (sites 1 to 4) illustrated a significant within-subjects time effect (pp′s Conclusions Findings offer early phase preliminary support for the effectiveness of the chronic pain and physical activity training workshop for exercise professionals. Based on ORBIT model recommendations, findings warrant future phased testing via a pilot randomized clinical trial as well as testing for impacts that trained professionals have on activity adherence among their clients living with chronic pain. Eventual workshop adoption by exercise professional certification organizations would ensure widespread and sustainable access to qualified exercise professionals to help individuals engage in physical activity. By increasing the capacity of available exercise professionals to deliver effective support, active individuals could better manage their chronic pain and live well.

Background Pain associated with bleeding disorders has been demonstrated to have an impact on patients’ and families’ quality of life. Both acute and chronic pain are common experiences and require attention by professionals working in haemophilia treatment centres (HTCs). The benefits of psychological pain management strategies such as cognitive behaviour therapy and self-management skills training are well documented; however, it is not well understood how Canadian social workers involved in haemophilia care perceive and provide pain management support to patients. Aims To explore the current understanding of pain management and practice as well as the education needs of members of Canadian Social Workers in Hemophilia Care (CSWHC). Method Twelve semi-structured qualitative interviews were conducted with members of CSWHC. Transcribed interviews were coded with NVivo software and thematically analysed. Results The four key themes reflecting the experiences of social workers are: 1) Limited comprehension of key issues related to pain; 2) Conditioning to push through pain; 3) Expanding pain knowledge to enhance practice; 4) How we practice social work and choose to step in. Conclusion The current practice of CSWHC members aligns with literature in three main areas including assessment, instrumental services, and counselling. Social workers support the development of pain education and practical resources for patients with haemophilia who experience pain. While formal education, advocacy, and policy development of pain assessment and management are recognised, these areas require further research and development.

Background Physical activity (PA) patterns in children with juvenile idiopathic arthritis (JIA) over time are not well described. The aim of this study was to describe associations of physical activity (PA) with disease activity, function, pain, and psychosocial stress in the 2 years following diagnosis in an inception cohort of children with juvenile idiopathic arthritis (JIA). Methods In 82 children with newly diagnosed JIA, PA levels, prospectively determined at enrollment, 12 and 24 months using the Physical Activity Questionnaire for Children (PAQ-C) and Adolescents (PAQ-A) raw scores, were evaluated in relation to disease activity as reflected by arthritis activity (Juvenile Arthritis Disease Activity Score (JADAS-71)), function, pain, and psychosocial stresses using a linear mixed model approach. Results in the JIA cohort were compared to normative Pediatric Bone Mineral Accrual Study data derived from healthy children using z-scores. Results At enrollment, PA z-score levels of study participants were lower than those in the normative population (median z-score − 0.356; p = 0.005). At enrollment, PA raw scores were negatively associated with the psychosocial domain of the Juvenile Arthritis Quality of Life Questionnaire (r = − 0.251; p = 0.023). There was a significant decline in PAQ-C/A raw scores from baseline (median and IQR: 2.6, 1.4–3.1) to 24 months (median and IQR: 2.1, 1.4–2.7; p = 0.003). The linear mixed-effect model showed that PAQ-C/A raw scores in children with JIA decreased as age, disease duration, and ESR increased. The PAQ-C/A raw scores of the participants was also negatively influenced by an increase in disease activity as measured by the JADAS-71 (p Conclusion Canadian children with newly diagnosed JIA have lower PA levels than healthy children. The decline in PA levels over time was associated with disease activity and higher disease-specific psychosocial stress.

Occupational therapists (OTs) and physical therapists (PTs) are rehabilitation therapists with distinct but complementary roles who contribute to pain assessment and management in young people either as solo providers, or as a critical component of the interdisciplinary treatment team. Pain in infants, children, and adolescents interferes with their ability to engage in essential interactions with caregivers, acquisition of developmental milestones, and with participation in activities related to self-care, leisure, play, school, and work. OTs and PTs use specific treatment strategies, such as positioning, splinting, adaptive equipment, exercise, manual therapy, electrophysical agents, education on energy conservation, joint protection strategies, and pain self-management training to facilitate participation in valued life activities and occupations. This chapter provides an overview of important theoretical frameworks for rehabilitation therapists, reviews evidence for OT and PT interventions, and describes a framework for planning procedural pain management for rehabilitation therapists when working with pediatric clients.

While social workers have the capacity and scope of practice to make a significant contribution to pain management, little is understood about how they enact these roles. The initial goal of this scoping review was to examine the role of social work in pain management specifically in bleeding disorder care. Due to lack of published data on this topic, the review goal was broadened to chronic disease. Two electronic databases were searched providing a total of 13 published articles meeting the inclusion and exclusion criteria. Instrumental services, clinical services, and assessments were identified as primary roles of social workers, while advocacy, policy development, education, and skill development require further exploration in the literature.