Physiotherapists implicitly evaluate bending and lifting with a round back as dangerous

Cañeiro, J P; O’Sullivan, Peter; Smith, Anne; Ovrebekk, Ingrid Rask; Tozer, Luke; Williams, Michael; Teng, Magdalene Li Wen; Lipp, Ottmar V.

doi:10.1016/j.msksp.2018.12.002

Cited by 21 publications

(15 citation statements)

References 49 publications

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“…Definitely, the role of verbal information provided by peers, family and health care practitioners may substantially impact fear learning in patients. It is well known that erroneous beliefs about pain are prevalent in lay persons (Goubert et al 2004), but also in health professionals (Caneiro et al 2019, Houben et al 2005. The use of medical terminology and certain expressions implying harm (e.g.…”

Section: Predicting Harm: Pavlovian Conditioningmentioning

confidence: 99%

Behavioral Conceptualization and Treatment of Chronic Pain

Vlaeyen

Crombez

2020

Annu. Rev. Clin. Psychol.

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Pain is considered a hardwired signal of bodily disturbance belonging to a basic motivational system that urges the individual to act and to restore the body's integrity, rather than just a sensory and emotional experience. Given its eminent survival value, pain is a strong motivator for learning. Response to repeated pain increases when harm risks are high (sensitization) and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is adaptive in the short term but paradoxically may have detrimental long-term effects. Pain and pain-related responses compete with other demands in the environment. Exposure-based treatments share the aim of facilitating or restoring the pursuit of individual valued life goals in the face of persistent pain, and further improvements in pain treatment may require a paradigm shift toward more personalized approaches.

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Section: Predicting Harm: Pavlovian Conditioningmentioning

confidence: 99%

Behavioral Conceptualization and Treatment of Chronic Pain

Vlaeyen

Crombez

2020

Annu. Rev. Clin. Psychol.

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“…There are strong beliefs in both occupational health and clinical settings regarding the importance of squat lifting and minimising lumbar flexion, both for the prevention and management of LBP [7][8][9]14,17,26,27]. This is commonly taught in the workplace and advocated in clinical and rehabilitation settings [6].…”

Section: Discussionmentioning

confidence: 99%

“…The only two studies investigating pain ramp during lifting, have explored relationships between nonbiomechanical factors (quantitative sensory testing and psychological factors) and pain ramp [24,25]. Manual handling advisors and others involved in healthcare, commonly advocate more squat-like lifting, even though there is no support from in-vivo research that the biomechanics of lifting and LBP intensity during lifting are associated [17,26,27].…”

Section: Introductionmentioning

confidence: 99%

Exploring lumbar and lower limb kinematics and kinetics for evidence that lifting technique is associated with LBP

Saraceni

Campbell

et al. 2021

PLoS ONE

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Purpose To investigate if lumbar and lower limb kinematics or kinetics are different between groups with and without a history of LBP during lifting. Secondly, to investigate relationships between biomechanical variables and pain ramp during repeated lifting. Methods 21 LBP and 20 noLBP participants completed a 100-lift task, where lumbar and lower limb kinematics and kinetics were measured during lifting, with a simultaneous report of LBP intensity every 10 lifts. Lifts were performed in a laboratory setting, limiting ecological validity. Results The LBP group used a different lifting technique to the noLBP group at the beginning of the task (slower and more squat-like). Kinetic differences at the beginning included less peak lumbar external anterior shear force and greater peak knee power demonstrated by the LBP group. However, at the end of the task, both groups lifted with a much more similar technique that could be classified as more stoop-like and faster. Peak knee power remained greater in the LBP group throughout and was the only kinetic difference between groups at the end of the lifting task. While both groups lifted using a more comparable technique at the end, the LBP group still demonstrated a tendency to perform a slower and more squat-like lift throughout the task. Only one of 21 variables (pelvic tilt at box lift-off), was associated with pain ramp in the LBP group. Conclusions: Workers with a history of LBP, lift with a style that is slower and more squat-like than workers without any history of LBP. Common assumptions that LBP is associated with lumbar kinematics or kinetics such as greater lumbar flexion or greater forces were not observed in this study, raising questions about the current paradigm around ‘safe lifting’.

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“…51,52 Thus, clinician's implicit bias may influence their advice to patients. 50,53,54 Qualitative studies investigating beliefs of people with common musculoskeletal pain conditions such as back pain, 26,31,43 knee osteoarthritis 32,55 and hip pain 56 have highlighted some of the key beliefs held by society about the body and pain (Table 2).…”

Section: Part 1 ---Beliefsmentioning

confidence: 99%

Beliefs about the body and pain: the critical role in musculoskeletal pain management

Cañeiro

Bunzli

O’Sullivan

2021

Brazilian Journal of Physical Therapy

Self Cite

137

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Background: Beliefs about the body and pain play a powerful role in behavioural and emotional responses to musculoskeletal pain. What a person believes and how they respond to their musculoskeletal pain can influence how disabled they will be by pain. Importantly, beliefs are modifiable and are therefore considered an important target for the treatment of painrelated disability. Clinical guidelines recommend addressing unhelpful beliefs as the first line of treatment in all patients presenting with musculoskeletal pain. However, many clinicians hold unhelpful beliefs themselves; while others feel ill-equipped to explore and target the beliefs driving unhelpful responses to pain. As a result, clinicians may reinforce unhelpful beliefs, behaviours and resultant disability among the patients they treat. Methods: To assist clinicians, in Part 1 of this paper we discuss what beliefs are; how they are formed; the impact they can have on a person's behaviour, emotional responses and outcomes of musculoskeletal pain. In Part 2, we discuss how we can address beliefs in clinical practice. A clinical case is used to illustrate the critical role that beliefs can have on a person's journey from pain and disability to recovery. Conclusions: We encourage clinicians to exercise self-reflection to explore their own beliefs and better understand their biases, which may influence their management of patients with musculoskeletal pain. We suggest actions that may benefit their practice, and we propose key principles to guide a process of behavioural change.

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Physiotherapists implicitly evaluate bending and lifting with a round back as dangerous

Cited by 21 publications

References 49 publications

Behavioral Conceptualization and Treatment of Chronic Pain

Behavioral Conceptualization and Treatment of Chronic Pain

Exploring lumbar and lower limb kinematics and kinetics for evidence that lifting technique is associated with LBP

Beliefs about the body and pain: the critical role in musculoskeletal pain management

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