Search

The purpose of this paper was first to gain an in-depth understanding of the barriers and facilitators to implementing the BPS model and pain neuroscience education in the current Lebanese physical therapy health care approach and explore its acceptability. A qualitative semi-structured interview using purposive sampling was conducted with eight Lebanese physical therapists practising in different governorates. The transcribed text from the interviews was analyzed using inductive thematic analysis. Two topics were generated and constructed by the researchers: (1) "barriers to the implementation of pain neuroscience education, with subthemes including (a) "current health care approach," (b) "basic curriculum and continuing education," (c) "patients' barriers"; (2) "facilitators to the implementation of pain neuroscience education," with subthemes containing (a) "interest in the BPS model, (b) "therapeutic alliance," and (c) "motivation for future training on BPS approach." The analysis of the results showed that Lebanese physical therapists currently hold a strong biomedical view of chronic pain, assessment, and treatment. However, despite the presence of barriers and challenges, they are aware and open to consider the implementation and future training about the BPS model and pain neuroscience education in their approach. The exploration of potential barriers and facilitators to the bio-psychosocial model and pain neuroscience education implementation may provide an opportunity for better development and design of a culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists. The exploration of barriers and facilitators to the implementation of pain neuroscience education will help to improve pain education and ensure better clinical pain management. The most important barriers were the dominant characteristic of the Lebanese physical therapist's health approach, which is focused on a biomechanically oriented model, and their lack of knowledge to approach chronic pain from a biopsychosocial perspective. [ABSTRACT FROM AUTHOR]

Objective: This systematic review summarizes the relevant literature on the effectiveness of tailored interventions in non‐specific low back pain (NSLBP). Methods: The search strategy has been executed in December 2019 in the electronic databases PubMed, Web of Science and Embase. Study selection, data extraction and quality assessment were done independently by two authors. Results: A total six eligible studies were identified. Five out of six articles used a classification system to subgroup patients. All active patient tailored interventions had similar or better results than the non‐patient tailored interventions, most importantly on pain (short‐ and mid‐term, not for long term follow‐up). Two motor control interventions revealed sustained or increased effects at 12 months follow‐up for disability. For cost‐effectiveness, medication use and work absenteeism, results were inconclusive. Global rating of change evaluation confirmed significant between‐group results at 10 weeks to 4 months follow‐up, but results were not maintained at 12‐month evaluation. Discussion & conclusion: Our findings support the preliminary evidence for the use of patient tailored treatment for reductions in pain and disability. However, our results are of very low to moderate quality evidence and the observed effects strongly depend on the subgroups and the chosen interventions. More high‐quality RCT's with homogenous designs and larger sample sizes are needed. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThis paper aims to understand the distinctive biopsychosocial aspects and patient perspectives on chronic low back pain in Lebanon, an Arab country with a unique and rich cultural heritage.Qualitative, semi-structured interviews with 12 Lebanese patients purposefully sampled from various governorates. The interviews included participants from different geographic areas and religions. The data underwent analysis through an inductive thematic approach guided by a bounded relativist ontology, a subjectivist epistemology, and a descriptive phenomenological framework. The coding process was managed by computer-assisted qualitative data analysis software (QSR NVivo version 12.0).The researchers identified and constructed two themes: (1) Chronic low back pain: understanding the impact, coping strategies, and communication patterns in lived experiences within the Lebanese context. This theme sheds light on the complexities of pain management and societal influences in Lebanon. (2) Explanatory model of patients living with chronic low back pain in Lebanon. This theme allowed an exploration of the multifaceted narratives of chronic low back pain.This study found that Lebanese individuals attribute chronic low back pain to biomedical factors despite some recognizing psychosocial elements. It emphasizes the need to educate patients on the biopsychosocial model, facilitate better care, and dispel misconceptions.The exploration of patients’ pain perception may provide an opportunity to better develop and design culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists.The rehabilitation process should incorporate a balanced biopsychosocial approach, addressing both physical and psychosocial elements of pain, to provide more effective care and outcomes for Lebanese patients who predominantly attribute chronic low back pain to biomedical factors.Lebanese healthcare professionals need to improve communication with Lebanese patients regarding the nature of chronic low back pain, using clear communication to help dispel misconceptions and enhance rehabilitation outcomes.The exploration of patients’ pain perception may provide an opportunity to better develop and design culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists.The rehabilitation process should incorporate a balanced biopsychosocial approach, addressing both physical and psychosocial elements of pain, to provide more effective care and outcomes for Lebanese patients who predominantly attribute chronic low back pain to biomedical factors.Lebanese healthcare professionals need to improve communication with Lebanese patients regarding the nature of chronic low back pain, using clear communication to help dispel misconceptions and enhance rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Prayer is the most common therapy used in alternative medicine1. The objective of this study was to explore the effect of prayers on endogenous pain modulation, pain intensity, and sensitivity in healthy religious participants. Methods: Two hundred and eight healthy religious participants were enrolled in this study and randomly distributed into two groups, a prayer group (n = 156) and a poem reading or control group (n = 52). Participants from the prayer group were allocated to either an active prayer group (n = 94) receiving an active type of praying or to a passive prayer group (n = 62) receiving a passive type of praying. Pain assessments were performed prior to and following the prayer or poem reading interventions and included pressure pain threshold assessment, conditioned pain modulation, and a numerical pain rating scale for perceived pain intensity. Results: A significant group-by-time interaction for PPT (p = 0.014) indicated post-intervention increases in PPT in the prayer group but not in the poem reading control group. Also, a significant group-by-time interaction for PPT (p = 0.005) indicated that these effects were greater in the active prayer group than in the passive prayer group. Participants experienced a decrease in CPM efficacy (p = 0.030) and an increase in pain intensity (p < 0.001) following the interventions, independent of their group allocation. Discussion: The results showed that prayer, irrespective to type, can positively affect pain sensitivity and intensity, but does not influence endogenous pain inhibition. Process evaluation: Future research should focus on understanding the mechanism behind "prayer induced analgesia". [ABSTRACT FROM AUTHOR]

Introduction: The aim of this cross-sectional study is to provide reference values of a conditioned pain modulation (CPM) paradigm using thermal stimulation. Reference values would allow patient phenotyping according to their CPM functional status and can hopefully improve the ability to predict the efficacy of treatments. Methods: Healthy pain-free adults will be recruited. A CPM paradigm using heat thermodes will be applied. The intensity of the test stimulus (TS) will be determined individually based on a NRS score of 4/10. The conditioning stimulus (CS) will be 0.5°C higher than the TS temperature. The CPM effect will be reported both as absolute difference between the NRS scores during and before the CS, as well as the percent change from baseline (1). Influencing factors that will be considered are: age, gender, level of physical activity, chronic stress, intake of oral contraceptives, attentional focus, pain perception and phase of menstrual cycle (2). Results: We expect the average NRS score to decrease after the CS (= positive CPM effect). Discussion: To our knowledge, the present study will be the first one that specifically tries to determine reference values of CPM in pain-free adults using heat for both the TS and CS. However, it is important to note that the reliability and validity of the CPM paradigm used in this study has not been investigated yet. Process evaluation: Subject recruitment has just started and it is clear that successful recruitment will be the most difficult aspect of this study due to the strict inclusion criteria and the current Covid-19 situation. [ABSTRACT FROM AUTHOR]

Introduction: Although physical activity is considered a pillar in the treatment of chronic pain, being physically active poses a challenge for these patients. Patients with low back pain and cancer survivors are not equal in terms of diagnosis, received treatment or life experiences, but both populations are impacted by a high prevalence of persistent pain. With this commonality, it is of interest to compare determinants of physical activity in both populations. Methods: A cross-sectional design is used. Demographic data, condition-specific characteristics, physical activity levels, beliefs on illness and exercise and pain-related emotional factors are collected using questionnaires through an online survey. The aim is to present data on the associations between collected data and physical activity levels within each population and to compare these relationships between both populations. Results: We hypothesize that significant associations will be found between the collected psychosocial factors and self-reported physical activity levels. We hypothesize that the found associations will differ between these two populations. Discussion: The understanding and comparison of the relationship between researched factors and physical activity can lead to more optimal interventions to promote physical activity in these populations. Process evaluation: A difficulty was finding valid and reliable questionnaires on beliefs, barriers and facilitators of exercise which could be applied in both populations. Recruitment of the study will start in December of 2021. [ABSTRACT FROM AUTHOR]

Introduction: Characterizing somatosensory profiles or phenotypes in subgroups of patients may provide indirect insights into underlying pathophysiological mechanisms. The most common method for quantifying somatosensory function is quantitative sensory testing (QST). This paper describes a protocol for determining these somatosensory profiles in a breast cancer population. Methods: A standardized QST protocol is implemented including nine static and dynamic QST methods (mechanical detection-pain thresholds, pressure pain thresholds, thermal detection-pain thresholds for heat and cold, temporal summation and conditioned pain modulation) performed in the surgical area and more distant regions. After the QST assessment, distribution of the data is checked and data is transformed if necessary (raw or log-transformed data).1,2 Subsequently, QST data is z-transformed using the mean and standard deviation of a 15332500, 2022, S2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/papr.13128 by EBSCO SUBSCRIPTION SERVICES - Journal Digital Lic, Wiley Online Library on [19/10/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commonscontrol group as reference data. The algebraic sign of the resulting z score is adjusted appropriately for clarity of data presentation (increased-decreased sensitivity to the tested stimuli). Results: The z-scores acquired with this protocol can inform at a glance whether there is a loss or gain in somatosensory function. Findings can be visualized using a scatter or bar chart. Discussion: Although this protocol was used to determine somatosensory profiles in a breast cancer population, the methodology for determining these profiles can be applied to data from other populations as well. Process evaluation: To correctly interpret QST results, data from a reference population that matches in QST method and test site is required. The proactive development of normative databases for specific QST protocols will improve the efficiency of QST data processing in the future. [ABSTRACT FROM AUTHOR]