Description: The Neck Pain and Disability Scale (NPDS or NPAD) is a questionnaire aiming to quantify neck pain and disability.1 It is a patient-reported outcome measure for patients with any type of neck pain, of any duration, with or without injury.1,2 It consists of 20 items: three related to pain intensity, four related to emotion and cognition, four related to mobility of the neck, eight related to activity limitations and participation restrictions and one on medication.1,3 Patients respond to each item on a 0 to 5 visual analogue scale of 10 cm. There is also a nine-item short version.4 Feasibility: The NPDS is published and available online (https://mountainphysiotherapy.com.au/wp-content/uploads/2016/08/Neck-Pain-and-Disability-Scale.pdf).1 The NPDS is an easy to use questionnaire that can be completed within 5 to 8 minutes.1,5 There is no training needed to administer the instrument but its validity is compromised if the questionnaire must be read to the patient.2 Higher scores indicate higher severity (0 for normal functioning to 5 for the worst possible situation ‘your’ pain problem has caused you).2 The total score is the sum of scores on the 20 items (0 to 100).1 The maximum acceptable number of missing answers is three (15%).4 Two studies found a minimum important change of 10 points (sensitivity 0.93; specificity 0.83) and 11.5 points (sensibility 0.74; specificity 0.70), respectively.6,7 The NPDS is available in English, Dutch, Finnish, French, German, Italian, Hindi, Iranian, Korean, Turkish, Japanese and Thai. Reliability and validity: Two systematic reviews have evaluated the clinimetric properties of 11 of the translated versions.5,8 The Finnish, German and Italian translations were particularly recommended for use in clinical practice. Face validity was established and content validity was confirmed by an adequate reflection of all aspects of neck pain and disability.1,8 Regarding structural validity, the NPDS is a multidimensional scale, with moderate evidence that the NPDS has a three-factor structure (with explained variance ranging from 63 to 78%): neck dysfunction related to general activities; neck pain and neck-specific function; and cognitive-emotional-behavioural functioning. 4,5,9 A recent overview of four systematic reviews found moderate-quality evidence of high internal consistency (Cronbach’s alphas ranging from 0.86 to 0.93 for the various factors).10 Excellent test-retest reliability was found (ICC of 0.97); however, the studies were considered to be of low quality.3,10 Construct validity (hypotheses-testing) seems adequate when the NPDS is compared with the Neck Disability Index and the Global Assessment of Change with moderate to strong correlations (r = 0.52 to 0.86), based on limited moderate-quality studies.3,11,12 One systematic review reported good responsiveness to change in patients (r = 0.59).12
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Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Methods Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Results Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. Conclusion This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.
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AIM: To understand the steps in the decision-making process regarding pain assessment and management for people living with dementia from the perspectives and experiences of people with dementia, formal and informal carers.METHODS: A systematic review was conducted. Seven English databases were searched, including PubMed, Psychological Information Database, Cochrane Library, Scopus, Cumulative Index of Nursing and Allied Health Literature, Web of Science, and ProQuest, using synonyms and derivatives for "dementia", "cognitive impairment", "pain", "pain assessment", "pain management", "decision", "decision support", and "decision-making".RESULTS: Twenty-eight studies fulfilled the eligibility criteria. Pain assessment and management in dementia are complex, successive, and collaborative processes carried out by different individuals over a period based on one's understanding of the person with dementia but with high uncertainty. Pain assessment involves a certain degree of guesswork, while pain management is a trial-and-error process.CONCLUSION: More pragmatic approaches are needed to overcome challenges, including uncertainty and decisional conflicts.
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Even though considerable amounts of valuable wood are collected at waste collection sites, most of it remains unused and is burned: it is too labor-intensive to sort, process and upcycle useable parts. Valuable wood thus becomes worthless waste, against circular economy principles. In MoBot-Wood, waste collection organizations HVC and the municipality of Amsterdam, together with Rolan Robotics, Metabolic and AUAS investigate how waste wood can be sorted and processed at waste collection sites, using an easy-to-deploy robotic solution. In various preceding and on-going projects, AUAS and partners are exploring circular wood intake, sorting and processing using industrial robots, including processes like machine vision, 3D scanning, sawing, and milling. These projects show that harvesting waste wood is a challenging matter. Generally, the wood is only partially useable due to the presence of metal, excessive paint, deterioration by fungi and water, or other contamination and damages. To harvest useable wood thus requires intensive sorting and processing. The solution of transporting all the waste wood from collection sites to a central processing station might be too expensive and have a negative environmental impact. Considering that much of collected wood will need to be discarded, often no wood is harvested at all, due to the costs for collection and shipping. Speaking with several partners in related projects, the idea emerged to develop a mobile robotic station, which can be (temporarily) deployed at waste collection sites, to intake, sort and process wood for upcycling. In MoBot-Wood, research entails the design of such station, its deployment conditions, and a general assessment of its potential impact. The project investigates robotic sorting and processing on location as a new approach to increase the amount of valuable, useable wood harvested at waste collection sites, by avoiding material transport and reducing the volume of remaining waste.
Niet specifieke nekpijn (NSNP) vormt een groot probleem binnen de volwassen westerse bevolking. Deze aandoening is complex, invaliderend en kent een heterogene presentatie, waardoor NSNP moeilijk te behandelen is. Een brede beoordeling van de (complexe) klacht waarbij medische en psychosociale prognostische factoren een centrale rol spelen is essentieel om te kunnen beoordelen welke zorg het meest passend is. Dit verhoogd de doelmatigheid van zorg en verminderd de kans op onnodige zorg. Meer inzicht in heterogene patiëntengroepen door het bepalen van verschillende fenotypen kan nuttig zijn bij het ontwikkelen van gerichte interventies om het behandelresultaat te verbeteren. Psychologische en sociale factoren spelen een belangrijke rol bij het in standhouden van de ervaren pijn. De nieuwste wetenschappelijke inzichten en praktijkrichtlijnen adviseren dan ook met nadruk een biopsychosociale benadering bij patiënten met NSNP. Hoewel fysiotherapeuten hierin geschoold worden, ervaren zij nog wel regelmatig ongemak en uitdagingen bij het integreren van psychologische en sociale factoren in de diagnostiek en behandeling van deze patiëntengroep. Daarom rijst de vraag uit het werkveld: Hoe kunnen fysiotherapeuten in de eerstelijn beter in staat gesteld worden om bij mensen met nekpijn de complexiteit van de klachten in te schatten en behandelingen op maat aan te bieden en waar nodig samen te werken met een gespecialiseerde fysiotherapeut? Of is een andere discipline in de eerstelijnszorg noodzakelijk om multidisciplinair mee samen te werken? Om deze vraag te beantwoorden hebben wij een breed consortium samengesteld uit eerdere en nieuwe (MKB) partners. Het doel van dit onderzoek is om fysiotherapeuten handvatten te bieden voor het op maat (gepersonaliseerd) behandelen van patiënten met NSNP. Het onderzoek bestaat uit drie delen; (1)het fenotyperen op het gebied van psychosociale factoren in patiënten met (sub)acute NSNP, (2)het maken van een screeningstool om de fenotypen te identificeren en (3)het evalueren van een passende behandeling bij de verschillende fenotypen.
