OBJECTIVE: To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status.METHODS: A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was assessed with 10 questions addressing relevance (0-30) and reassurance (0-30). Illness perceptions, catastrophizing and health status were measured with the Revised Illness Perception Questionnaire (IPQ-R), the Pain Catastrophizing Scale (PCS) and the Fibromyalgia Impact Questionnaire (FIQ) at baseline (T0), after a 2-week control period (T1) and 6 weeks after the intervention (T2).RESULTS: Forty-one patients participated. Mean (SD) scores for relevance and reassurance were 21.6 (5.6) and 18.7 (5.7), respectively. Only illness coherence, emotional representations, pain and fatigue changed significantly between T0 and T2. Correlations between appreciation and changes in outcomes ranged between r=0.00 and r=0.34.CONCLUSIONS: Although a majority of subjects appreciated the written information, it did not have clinically relevant effects on illness perceptions, catastrophizing or impact of FM on daily life.PRACTICE IMPLICATIONS: Written education about pain neurophysiology is inadequate toward changing illness perceptions, catastrophizing or perceived health status of participants with FM; education should be incorporated into a broader multidisciplinary self-management program.
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Background: Healthcare practitioner beliefs influence patients’ beliefs and health outcomes in musculoskeletal (MSK) pain. A validated questionnaire based on modern pain neuroscience assessing Knowledge and Attitudes ofPain (KNAP) was unavailable.Objectives: The aim of this study was to develop and test measurement properties of KNAP.Design: Phase 1; Development of KNAP reflecting modern pain neuroscience and expert opinion. Phase 2; a crosssectional and longitudinal study among Dutch physiotherapy students.Method: In the cross-sectional study (n = 424), internal consistency, structural validity, hypotheses testing, and Rasch analysis were examined. Longitudinal designs were applied to analyse test-retest reliability (n = 156), responsiveness, and interpretability (n = 76).Results: A 30-item KNAP was developed in 4 stages. Test-retest reliability: ICC (2,1) 0.80. Internal consistency: Cronbach’s α 0.80. Smallest Detectable Difference 90%: 4.99 (4.31; 5.75). Structural validity: exploratory factor analysis showed 2 factors. Hypotheses testing: associations with the Pain Attitudes and Beliefs Scale for Physiotherapists biopsychosocial subscale r = 0.60, with biomedical subscale r = 0.58, with the Neurophysiology of Pain Questionnaire r = 0.52. Responsiveness: 93% improved on KNAP after studying pain education. MinimalImportant Change: 4.84 (95%CI: 2.77; 6.91).Conclusions: The KNAP has adequate measurement properties. This new questionnaire could be useful to evaluate physiotherapy students’ knowledge and attitudes of modern pain neuroscience that could help to create awareness and evaluate physiotherapy education programs, and ultimately provide better pain management.
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Background: Health care practitioners' knowledge and attitudes influence patients’ beliefs and health outcomes in musculoskeletal (MSK) pain. It is unclear to what extent physiotherapists undertaking a postgraduate master in manual therapy (MT students) possess the knowledge and attitudes toward pain neuroscience to be able to apply the biopsychosocial model in patients with MSK pain. Objectives: The aim of this study was to assess the knowledge and attitudes toward pain neuroscience in MT students. Design: A cross-sectional study. Method: Self-reported knowledge and attitudes were measured among students (n = 662) at baseline and in all years of the MT postgraduate programs in the Netherlands. The Knowledge and Attitudes of Pain questionnaire (KNAP) was used as a primary measure. Difference in KNAP-scores between baseline (0), year 1, year 2 and year 3 was tested using a one-way ANOVA (hypothesis: 0 < 1
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Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia. A double-blind, multicenter randomized controlled clinical trial with 6-month follow-up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated-measures analyses with last observation carried forward principle were performed. Cohen's d effect sizes (ES) were calculated for all within-group changes and between-group differences. The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions. Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM.
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Blessurepreventieve oefenprogramma’s zijn in de sport niet erg populair. Hun effectiviteit staat ter discussie en het feit dat ze doorgaans geen directe bijdrage leveren aan prestatieverbetering komt de motivatie van coaches en sporters niet ten goede. Het toepassen van motorische leerprincipes binnen de blessurepreventie lijkt echter beide doelen te kunnen dienen: minder blessures en betere prestaties.
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One major drawback of deception detection is its vulnerability to countermeasures, whereby participants wilfully modulate their physiological or neurophysiological response to critical guilt-determining stimuli. One reason for this vulnerability is that stimuli are usually presented slowly. This allows enough time to consciously apply countermeasures, once the role of stimuli is determined. However, by increasing presentation speed, stimuli can be placed on the fringe of awareness, rendering it hard to perceive those that have not been previously identified, hindering the possibility to employ countermeasures. We tested an identity deception detector by presenting first names in Rapid Serial Visual Presentation and instructing participants to lie about their own identity. We also instructed participants to apply a series of countermeasures. The method proved resilient, remaining effective at detecting deception under all countermeasures.
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The definition of ‘Assistive Technology’ (AT) includes both assistive products and the services or actions necessary for safe and effective provision of the assistive products to people who need them. International standards and product specifications exist for assistive products. Despite huge unmet need for effective AT provision, a variety of service delivery models across different countries, and a shortage of personnel trained in this field, nowidely useable and accepted AT service provision guidelines currently exist. Aligned with contemporary global initiatives to improve access to AT, a scoping review was commissioned to inform the development of globally useable provision guidance. The aim was to deliver a rapid scoping review of the literature regarding quality guidelines for AT service provision. Method: The rapid scoping review utilised a two-tiered approach to identifying relevant publications: 1) systematic search of academic databases; 2) consultation with assistive technology organisations. The review was conducted in March 2023 across four databases (Medline, CINAHL, SCOPUS and Google Scholar) with no date limitations. Systematic outreach to international and global AT networks was used to access expert informants. Non-English publications were included utilizing Google Translate and support from expert informants to verify content. Analysis was guided by the body of work on quality AT provision and service delivery processes in Europe, as well as the World Health Organization-GATE 5P framework for strengthening access to AT. Results: The search strategies yielded 41 publications from diverse countries, and directed at differing assistive products, personnel and provision contexts. Results are reported from the charted data through to the data extraction framework, including type of publication, study design, audience and reach. We report on the type of AT and the AT provision ecosystem elements discussed, and service delivery process or steps and quality criteria service delivery. Conclusion: This review did not find established guidelines or standards for service provision, but it did identify key service delivery steps which may form part of such guidelines, and many of the 3 publications included mentioned the need for practice guidelines. Despite different contexts such as type of assistive product, recipient of the guidance, language, location and authorship, core elements of AT provision including service delivery steps can be identified. Consideration regarding the nuances of vocabulary, of process, and of enabling flexible foci, is recommended in systematizing globally applicable guidance. This review offers a strong starting point for developing guidance for assistive technology provision to meet global need.
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In our world of VUCA (volatile, uncertain, complex and ambiguous), a capacity for change and adaption is vital. However, changing successfully has been a challenging task for both individuals and organizations. Taking into account the insights of neuroscience, this chapter introduces a framework of change management called STREAP-Be. The acronym represents 7 factors that could significantly influence the effect of change: safety; trigger; reward; emotion; alignment; people; and behavior.
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Background: Sexual deviance is regarded as an important risk factor for sexual offending. However, little is known about the development of deviant sexual interests. The transfer of arousal between emotions, i.e., excitation transfer, could attribute sexual salience to stimuli that would otherwise not be sexual in nature. As such, excitation transfer could contribute to the very beginning of unusual or deviant sexual interests. The current protocol proposes a study to investigate to what extent excitation transfer occurs, i.e., to what extent genital and subjective sexual arousal to sexual stimuli is higher in an emotional state than in a neutral state. Following a prior pilot study, several adjustments were made to the study protocol, including a stronger emotional manipulation by using 360-degree film clips and the inclusion of a larger and more sexually diverse sample. Methods: We will recruit 50 adult male volunteers with diverse sexual interests. We will induce sexual arousal in four different emotional states (aggression/dominance, endearment, fear, disgust) and a neutral state. Sexual arousal will be measured genitally using penile plethysmography and subjectively via self-report. Using paired samples t-tests, sexual arousal in the emotional states will be compared with sexual arousal in the neutral state. Discussion: We aim to show that arousal in response to emotional stimuli that are initially nonsexual in nature, can enhance sexual arousal. These findings have potentially important implications for the development of unusual and/or deviant sexual interests and possibly for the treatment of such sexual deviant interests in people who have committed sexual offenses.
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