Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 1, 2011
   Pages 43 — 58

Abstract —  Pain neurophysiology education improves cognitions, pain thresholds, and movement performance in people with chronic whiplash: A pilot study

Jessica Van Oosterwijck, MS;1-3 Jo Nijs, PhD;1-3* Mira Meeus, PhD;1-2 Steven Truijen, PhD, MSc;2 Julie Craps, MS;2 Nick Van den Keybus, MS;2 Lorna Paul, PhD4

1Department of Human Physiology, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; 2Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College of Antwerp, Antwerp, Belgium; 3Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; 4Nursing and Health Care, Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom

Abstract — Chronic whiplash is a debilitating condition characterized by increased sensitivity to painful stimuli, maladaptive illness beliefs, inappropriate attitudes, and movement dysfunctions. Previous work in people with chronic low back pain and chronic fatigue syndrome indicates that pain neurophysiology education is able to improve illness beliefs and attitudes as well as movement performance. This single-case study (A-B-C design) with six patients with chronic whiplash associated disorders (WAD) was aimed at examining whether education about the neurophysiology of pain is accompanied by changes in symptoms, daily functioning, pain beliefs, and behavior. Periods A and C represented assessment periods, while period B consisted of the intervention (pain neurophysiology education). Results showed a significant decrease in kinesiophobia (Tampa Scale for Kinesiophobia), the passive coping strategy of resting (Pain Coping Inventory), self-rated disability (Neck Disability Index), and photophobia (WAD Symptom List). At the same time, significantly increased pain pressure thresholds and improved pain-free movement performance (visual analog scale on Neck Extension Test and Brachial Plexus Provocation Test) were established. Although the current results need to be verified in a randomized, controlled trial, they suggest that education about the physiology of pain is able to increase pain thresholds and improve pain behavior and pain-free movement performance in patients with chronic WAD.

Key words: chronic pain, chronic whiplash, cognitions, education, movement performance, pain behavior, pain neurophysiology, pain thresholds, rehabilitation, whiplash associated disorders.

View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 1
This article and any supplementary material should be cited as follows:
Van Oosterwijck J, Nijs J, Meeus M, Truijen S, Craps J, Van den Keybus N, Paul L. Pain neurophysiology education improves cognitions, pain thresholds, and movement performance in people with chronic whiplash: A pilot study. J Rehabil Res Dev. 2011;48(1):43-58.

Last Reviewed or Updated  Thursday, January 13, 2011 2:53 PM

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