A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain

Abstract

A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain.Clinical Rehabilitation, 31(2): [186][187][188][189][190][191][192][193][194][195][196] https://doi.org/10.1177/0269215516639356Access to the published version may require subscription. N.B. When citing this work, cite the original published paper. Key wordsChronic pain, Behavioural medicine, Primary care, Physical exercise, Long-term compliance Funding sourcesThe study received financial support from the Swedish Rheumatism Association, Uppsala County Council, and Caring Sciences Funding at the Faculty of Medicine, Uppsala University. Conflicts of interestNone declared. The manuscript contains original unpublished work and is not being submitted for publication elsewhere. All authors meet the criteria for authorship, and all authors discussed the results and commented on the manuscript. The study was approved by the regional ethical review board in Uppsala. AbstractObjective: To study the long-term outcomes of two interventions targeting patients with subacute and persistent pain in a primary care physiotherapy setting.Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition).Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome (p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: 2.5-14.25), and the control group (median: 0, Q1-Q3: 5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercisebased physiotherapy group had more days of sickness-related absence three months before treatment (p= 0.02), and at the 10-year follow-up (p=0.03). Discussion:The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

The perceptions of older adults living with chronic musculoskeletal pain about participating in an intervention based on a behavioral medicine approach to physical therapy

“…BMPI are individualized intervention programs based on physical activity and exercise, which aim to enhance an individual's ability to perform everyday activities, and particularly in this study, to improve physical function and decrease pain-related disability and pain-related beliefs (Åsenlöf, 2005;. BMPI are beneficial for middle-aged adults living with chronic pain (Emilson et al, 2016); however, knowledge of the effects of BMPI among target populations, as well as how older people perceive and experience their participation in BMPI, is lacking (Cederbom, Denison, and Bergland, 2017). Therefore, it is of high scientific interest to achieve a deeper understanding of how participants perceive and experience taking part in home-based BMPIs.…”

The prevalence of fear avoidance and pain catastrophising amongst patients with chronic neck pain

“…Noteably, the challenge remains for clinicians to sustain improvements achieved by interventions as shown by a 10-year follow-up study where this was not the case (Emilson et al 2017).…”

Goal setting in physiotherapy‐led adult musculoskeletal care: A scoping review

“…1318 -GAYTON and MONGA Åsenlöf et al, 2004, 2005a, 2005b, 2009). Others referred to operant conditioning (Emilson et al, 2017;Linton et al, 1999;Ostelo et al, 2000;Pool et al, 2006), self-determination theory (Alexanders & Douglas, 2018;Gardner et al, 2018;Keogh et al, 2018) and goal setting theory (Alexanders, Chesterton, et al, 2021;Nicolson et al, 2018;Schoeb et al, 2014). Other…”

“…Not further defined Schoeb, 2009;Pashley et al, 2010;Schoeb et al, 2014;Schmidt, 2016;Alexanders et al, 2018;Wolf et al, 2019 Accessing treatment within primary care Åsenlof et al, 2004;Åsenlof et al, 2005a;Åsenlof et al, 2009;Sandborgh et al, 2010;Stevens et al, 2017 Non-specific LBP Linton et al, 1999;Soukup & Vøllestad, 2001;Schonstein et al, 2002;Åsenlof et al, 2005b;Mannion et al, 2010;Mullis & Hay, 2010;Coppack et al, 2012;Gardner et al, 2015;Gardner et al, 2016;Emilson et al, 2017;Gardner et al, 2018;Gardner et al, 2019 Non-specific neck pain T A B L E 2 Using goal setting to improve treatment outcomes.…”

“…Undefined Linton et al, 1999;Ostelo et al, 2000;Åsenlof et al, 2005a;Åsenlof et al, 2005b;Pool et al, 2006;Åsenlof et al, 2009;Mannion et al, 2010;Sandborgh et al, 2010;Mullis & Hay, 2010;Schoeb et al, 2014;Schmidt, 2016;Emilson et al, 2017;Christiansen et al, 2018;Gardner et al, 2019;Wolf et al, 2019;Witjes et al, 2019;Gustavsson and von Koch, 2022 Adherence to treatment programme Bassett & Petrie, 1999;Scherzer et al, 2001;Coppack et al, 2012;Nicolson et al, 2018 Behavioural change Keogh et al, 2018;Cederbom et al, 2020Motivational tool Åsenlof et al, 2004Schmidt, 2016;Alexanders, Chesterton, et al, 2021;Alexanders et al, 2021b Treatment targets Soukup & Vøllestad, 2001;Schonstein et al, 2002;Gardner et al, 2016 GAYTON and MONGA -1319…”