Unhelpful beliefs and attitudes about low back pain in the general population: A cross-sectional survey

Christe, Guillaume; Pizzolato, Valentina; Meyer, Meghann; Nzamba, Jessica; Pichonnaz, Claude

doi:10.1016/j.msksp.2021.102342

Cited by 27 publications

(21 citation statements)

References 39 publications

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“…In contrast, very few participants implemented more active strategies, such as conducting a physical activity or using coping self-statements to cope with the pain. These findings are consistent with previous research indicating that individuals prefer the use of passive treatment and coping strategies even though they generally believe that exercise would also help them to cope with the pain [57]. This is worrisome as passive coping strategies (e.g., reliance on others for pain control, avoiding activities due to pain, praying, or catastrophizing) are related to increased disability, anxiety, and depressive symptoms, while active coping strategies (i.e., continue to function despite the pain, engage in activities, diverting attention or exercising) could help to reduce fatigue and depressive symptoms [23,58,59].…”

Section: Main Conclusion Derived From Our Studysupporting

confidence: 91%

“…Therefore, based on the high frequency of use of passive coping strategies in our sample, we encourage professionals who are in continuous contact with cancer patients to provide the patients with a more varied and adaptive repertoire of coping strategies to cope with their pain (e.g., staying active, using coping self-statements, doing exercise, or resting with the aim of participating in an activity once the BTcP decreases). All this helps them manage intense, unpleasant emotions and function despite the pain, as recommended in the literature [ 55 , 57 ]. The clinical professionals would provide the appropriate coping strategy for mental health for these patients.…”

Section: Discussionmentioning

confidence: 99%

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Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings

Villegas

Martínez-Borba

Suso‐Ribera

et al. 2021

IJERPH

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Background: mobile applications (apps) facilitate cancer pain ecological momentary assessment (EMA) and provide more reliable data than retrospective monitoring. The aims of this study are (a) to describe the status of persons with cancer pain when assessed ecologically, (b) to analyze the utility of clinical alarms integrated into the app, and (c) to test the feasibility of implementing an app for daily oncological pain monitoring. Methods: in this feasibility study, 21 patients (mean age = 56.95 years, SD = 10.53, 81.0% men) responded to an app-based evaluation of physical status (baseline and breakthrough cancer pain (BTcP)) and mental health variables (fatigue, mood, and coping) daily during 30 days. Results: cancer pain characterization with the app was similar to data from the literature using retrospective assessments in terms of BTcP duration and perceived medication effectiveness. However, BTcP was less frequent when evaluated ecologically. Pain, fatigue, and mood were comparable in the morning and evening. Passive coping strategies were the most employed daily. Clinical alarms appear to be useful to detect and address adverse events. App implementation was feasible and acceptable. Conclusion: apps reduce recall bias and facilitate a rapid response to adverse events in oncological care. Future efforts should be addressed to integrate EMA and ecological momentary interventions to facilitate pain self-management via apps.

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Section: Main Conclusion Derived From Our Studysupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings

Villegas

Martínez-Borba

Suso‐Ribera

et al. 2021

IJERPH

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“…These changes are notable as physiotherapists who hold these beliefs have been found to make less evidenced-based clinical decisions and provide more advice that movement should be avoided [24]. Thus, following the spinal pain management training module, students may be more prepared to deliver adequate messages concerning these unhelpful beliefs, which are very prevalent in people with and without LBP [4][5][6][7][8] and have been associated with important contributors to LBP disability, such as pain-related fear, catastrophizing and anxiety [9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…Unhelpful beliefs were relatively prevalent in first year students. These beliefs were more prevalent than amongst practising physiotherapists but less prevalent than in the general population from the same geographic area [ 8 , 24 ]. These beliefs improved to a small degree over the students’ first year of training (below the questionnaire MDC), suggesting that non-specific education has only a small effect on unhelpful beliefs about LBP and that specific training is needed.…”

Section: Discussionmentioning

confidence: 99%

“…Unhelpful attitudes and beliefs about back pain have been shown to be predictors of outcomes [3]. People commonly believe that the back is vulnerable to injury and needs protection [4][5][6][7][8] and these beliefs may contribute to pain-related fear, catastrophizing and anxiety [9][10][11][12]. These psychological factors are important predictors of unhelpful behaviours and elevated levels of disability [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Changes in physiotherapy students’ beliefs and attitudes about low back pain through pre-registration training

2021

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Background Implementation of best-practice care for patients with low back pain (LBP) is an important issue. Physiotherapists’ who hold unhelpful beliefs are less likely to adhere to guidelines and may negatively influence their patients’ beliefs. Pre-registration education is critical in moving towards a biopsychosocial model of care. This study aimed to investigate the changes in 2nd year physiotherapy students’ beliefs about LBP after a module on spinal pain management and determine whether these changes were maintained at the end of academic training. Methods During three consecutive calendar years, this longitudinal cohort study assessed physiotherapy students’ beliefs with the Back Pain Attitudes Questionnaires (Back-PAQ) in their 1st year, before and after their 2nd year spinal management learning module, and at the end of academic training (3rd year). Unpaired t-tests were conducted to explore changes in Back-PAQ score. Results The mean response rate after the spinal management module was 90% (128/143 students). The mean (± SD) Back-PAQ score was 87.73 (± 14.21) before and 60.79 (± 11.44) after the module, representing a mean difference of − 26.95 (95%CI − 30.09 to − 23.80, p < 0.001). Beliefs were further improved at the end of 3rd year (− 7.16, 95%CI − 10.50 to − 3.81, p < 0.001). Conclusions A spinal management learning module considerably improved physiotherapy students’ beliefs about back pain. Specifically, unhelpful beliefs about the back being vulnerable and in need of protection were substantially decreased after the module. Improvements were maintained at the end of academic training one-year later. Future research should investigate whether modifying students’ beliefs leads to improved clinical practice in their first years of practice.

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The relationships between spinal amplitude of movement, pain and disability in low back pain: A systematic review and meta‐analysis

Nzamba

Damme

Favre

et al. 2023

European Journal of Pain

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Background and ObjectivesThe role of spinal movement alterations in low back pain (LBP) remains unclear. This systematic review and meta‐analyses examined the relationships between spinal amplitude of movement, disability and pain intensity in patients with LBP.Databases and Data TreatmentWe searched PubMed, CINAHL, Embase, Pedro and Web of Science for relevant articles until 14th March 2023. Risk of bias was assessed with the Quality in Prognostic Studies Tool. We analysed the relationships between amplitude of movement, disability and pain intensity with standard correlational meta‐analyses and meta‐analytic structural equation modelling (MASEM) in cross‐sectional and longitudinal data.ResultsA total of 106 studies (9001 participants) were included. In cross‐sectional data, larger amplitude of movement was associated with lower disability (pooled coefficient: −0.25, 95% confidence interval: [−0.29 to −0.21]; 69/5899 studies/participants) and pain intensity (−0.13, [−0.17 to −0.09]; 74/5806). An increase in amplitude of movement was associated with a decrease in disability (−0.23, [−0.31 to −0.15]; 33/2437) and pain intensity (−0.25, [−0.33 to −0.17]; 38/2172) in longitudinal data. MASEM revealed similar results and, in addition, showed that amplitude of movement had a very small influence on the pain intensity–disability relationship.ConclusionsThese results showed a significant but small association between amplitude of movement and disability or pain intensity. Moreover, they demonstrated a direct association between an increase in amplitude of movement and a decrease in pain intensity or disability, supporting interventions aiming to reduce protective spinal movements in patients with LBP.SignificanceThe large meta‐analyses performed in this work revealed an association between reductions in spinal amplitude of movement and increased levels of disability and pain intensity in people with LBP. Moreover, it highlighted that LBP recovery is associated with a reduction in protective motor behaviour (increased amplitude of movement), supporting the inclusion of spinal movement in the biopsychosocial understanding and management of LBP.

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Unhelpful beliefs and attitudes about low back pain in the general population: A cross-sectional survey

Cited by 27 publications

References 39 publications

Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings

Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings

Changes in physiotherapy students’ beliefs and attitudes about low back pain through pre-registration training

The relationships between spinal amplitude of movement, pain and disability in low back pain: A systematic review and meta‐analysis

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