Titel Deelnemers "Korte inhoud" "How do physiotherapists explain influencing factors to chronic low back pain? A qualitative study using a fictive case of chronic non-specific low back pain" "Rob Vanderstraeten, Antoine Fourré, Isaline Demeure, Christophe Demoulin, Jef Michielsen, Sibyl Anthierens, Hilde Bastiaens, Nathalie Roussel" "Background: While pain is influenced by multiple factors including psychosocial factors, previous research has shown that physiotherapists still favour a biomedical approach. Purpose: To evaluate: (1) how physiotherapists explain the patient’s chronic non-specific low back pain (LBP); (2) whether physiotherapists use one or multiple influencing factors, and (3) whether these factors are framed in a biopsychosocial or biomedical approach. Materials and methods: This exploratory qualitative study uses a vignette depicting chronic non-specific LBP and employs a flexible framework analysis. Physiotherapists were asked to mention contributing factors to the pain based on this vignette. Five themes were predefined (“Beliefs”, “Previous experiences”, “Emotions”, “Patients behaviour”, “Contextual factors”) and explored. Results: Physiotherapists use very brief explanations when reporting contributing factors to chronic pain (median 13 words). Out of 670 physiotherapists, only 40% mentioned more than two different themes and 2/3rds did not see any link between the patients’ misbeliefs and pain. Only a quarter of the participants mentioned the patient’s worries about pain and movement, which is considered to be an important influencing factor. Conclusion: The lack of a multifactorial approach and the persistent biomedical beliefs suggest that it remains a challenge for physiotherapists to fully integrate the biopsychosocial framework into their management of chronic LBP." "Do illness perceptions of people with chronic low back pain differ from people without chronic low back pain?" "Cornelis Paul Van Wilgen, Miriam W. van Ittersum, Ad A Kaptein" "OBJECTIVES: To determine why some people develop chronic low back pain, and whether illness perceptions are an important risk factor in the transition from acute to chronic low back pain.DESIGN: Cross-sectional study.PARTICIPANTS: Four hundred and two members of the general Dutch population, with and without chronic low back pain.MAIN OUTCOME MEASURES: Sociodemographics and the translated version of the illness perception questionnaire-revised, adapted for back pain.RESULTS: Of the sample, 115 (29%) individuals had chronic low back pain (>6 months) and 287 (71%) did not have chronic low back pain. Many of the participants with chronic low back pain believed that one 'wrong' movement can potentially lead to more severe problems, and that X-rays or computer tomography scans can determine the cause of the pain. Many of the participants with chronic low back pain did not perceive a relationship between psychosocial factors and low back pain.CONCLUSIONS: Illness perceptions differed between individuals with and without chronic low back pain. In the subacute phase, healthcare professionals could assess illness perceptions and, if necessary, incorporate them into the management of patients with low back pain." "Differences in pain processing between patients with chronic low back pain, recurrent low back pain and fibromyalgia" "Dorien Goubert, Thomas Graven-Nielsen, Filip Descheemaeker, Mira Meeus" "Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study" "Mira Meeus, Nathalie A Roussel, Steven Truijen, Jo Nijs" "Objective The aims of this study were to examine (i) base line pressure pain thresholds in patients with chronic fatigue syndrome and those with chronic low back pain compared with healthy subjects, (ii) the change in mean pain threshold in response to exercise, and (iii) associations with exercise induced increase in nitric oxide Participants Twenty six patients with chronic fatigue syndrome suffering of chronic pain, 21 patients with chronic low back pain and 31 healthy subjects Methods Participants underwent a submaximal aerobic exercise protocol on a bicycle ergometer, preceded and followed by venous blood sampling (nitric oxide) and algometry (hand arm calf low back) Results Patients with chronic fatigue syndrome presented overall lower pain thresholds compared with healthy sub jects and patients with chronic low back pain (p" "Reduced pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study" "Mira Meeus, Nathalie Roussel, Steven Truijen" "Objective. We aimed at examining 1) baseline pressure pain thresholds (PPTs) in Chronic Fatigue Syndrome (CFS) and Chronic Low Back Pain (CLBP) patients compared to healthy subjects, 2) the change in mean PPT in response to exercise, and 3) the possible association with exercise-induced increase in nitric oxide (NO). Design. Experimental case-control study. Participants. Twenty-six CFS-patients suffering from chronic pain, 21 CLBP-patients and 31 healthy subjects were recruited. Methods. Participants underwent a submaximal aerobic exercise protocol on a bicycle ergometer, preceded and followed by venous blood sampling (NO-analysis) and algometry (hand, arm, calf, low back). Results. At baseline, CFS-patients presented overall lower PPTs compared to healthy subjects and to CLBP-patients (p" "Culture-sensitive and standard pain neuroscience education improves pain, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain : a pilot randomized controlled trial" "Ceren Orhan, An Favoreel, Vesile Yildiz Kabak, Naziru Bashir Mukhtar, Mira Meeus" "Central sensitization and altered central pain processing in chronic low back pain: fact or myth?" "Nathalie A Roussel, Jo Nijs, Mira Meeus, Veit Mylius, Cécile Fayt, Rob Oostendorp" "Central sensitization and altered central pain processing in chronic low back pain: Fact or myth?" "R.a.b. Oostendorp" """Central sensitization and altered central pain processing in chronic low back pain: Fact or myth?"" Roussel N, Nijs J, Meeus M, Mylius V, Fayt C, Oostendorp RAB. Clinical Journal of Pain 2013; ;29(7):625-63. SCI=2.813" "Effects of high intensity training on pain, disability, exercise capacity and muscle strength in persons with nonspecific chronic low back pain: Preliminary RCT results" "Jonas VERBRUGGHE, Anouk AGTEN, Sjoerd STEVENS, Bert OP 'T EIJNDE, Frank VANDENABEELE, Annick TIMMERMANS" "Introduction/Background Nonspecific chronic low back pain (NSCLBP) is a musculoskeletal disorder affecting many people worldwide. Exercise therapy (ET) is an important component of NSCLBP management. However, effect sizes remain low. High Intensity Training (HIT) is an effective training method for improving physical fitness and health related parameters in healthy persons as well as for decreasing pain and disability in persons with chronic disorders. The value of HIT in NSCLBP rehabilitation is unclear. The aim of this study is (1) to compare HIT to conventional ET, and (2) to compare the effects of different modes of HIT, with regard to pain, disability, exercise capacity, and muscle strength, in persons with NSCLBP. Material and method A five-arm parallel RCT (n = 150) is carried out consisting of an ET program (24 sessions/12 weeks) organized at REVAL (Hasselt University, Belgium) in persons with NSCLBP. Participants are randomly assigned into one of four intervention groups performing various modes of HIT or a control group performing moderate intensity training resembling conventional care (Fig. 1). Participants are measured at baseline and after completing the program. Primary outcome measures are pain intensity (Visual Analogue Scale), functional disability (Oswestry Disability Index), exercise capacity (VO 2 max during exercise testing), and abdominal and back strength (Newton/kg during isometric strength testing). Results Forty-three persons with NSCLBP have completed the program (group average: n = 9). All outcomes showed time-related improvements in all groups (P > 0.001). No between group differences were noted in any outcomes. Conclusion Preliminary data of this RCT suggest that HIT has positive effects on pain intensity, functional disability, exercise capacity, and isometric abdominal/back muscle strength, in persons with NSCLBP. Patient recruitment is still ongoing to increase the power of this study and further analyse the differences between HIT groups with specific modalities and conventional therapy. Keywords Low back pain; Exercise therapy; High intensity training Disclosure of interest The authors have not supplied their declaration of competing interest. Fig. 1 Therapy protocols." """Being"" in pain: The role of self-discrepancies in the emotional experience and activity patterns of patients with chronic low back pain" "Johan Vlaeyen" "Chronic pain not only interferes with daily activities, it may also have a negative impact on the perceived integrity of one's self through self-discrepancies. Self-discrepancies are experienced distances between the actual self and self-guides that can exist from 2 perspectives (ie, own and other). Self-discrepancies are associated with negative mood states and incite self-regulatory behavior in order to reduce these discrepancies. The present study was aimed at replicating the emotional consequences of self-discrepancies in patients with chronic low back pain, and extending current knowledge of the behavioral consequences of self-discrepancies (ie, behavioral activity patterns such as avoidance and persistence). A cross-sectional design was employed with 83 patients who completed a number of self-report measures. We hypothesized that ideal and ought discrepancies, as well as feared congruencies were associated with depressed and anxious mood. On the behavioral level, a U-shaped relationship was hypothesized between ideal and ought self-discrepancies and persistence behavior, whereas feared self-discrepancies were hypothesized to be related to avoidance behavior. Results were partially in line with the hypotheses. With respect to the emotional consequences, feared (own and other) self-discrepancies were predictive of depressive and anxious mood. With regard to activity patterns, results showed a U-shaped relationship between ideal-other self-discrepancies and persistence behavior and a positive relationship between feared-own self-discrepancies and avoidance behavior. In contrast to expectations, none of the other self-discrepancies was related to activity patterns. Of interest was that avoidance, but not persistence behavior, was predictive of higher levels of disability and lower levels of quality of life. Support is provided for the role of self-discrepancies in the emotional well-being and behavioural patterns of patients with chronic low back pain."