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Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing followi

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Full title:
Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: Pooled results from 2 randomized controlled trials
A. Malfliet, J. Van Oosterwijck, M. Meeus, B. Cagnie, L. Danneels, M. Dolphens, R. Buyl, J. Nijs
Intergrating Research into practice

http://www.manualtherapyjournal.com/article/S1356-689X(16)30281-8/abstract

Background: Many patients with chronic fatigue syndrome (CFS) and/or fibromyalgia (FM) have no understanding of their condition, leading to maladaptive pain cognitions and coping strategies. These should be tackled during therapy, e.g. by providing pain neurophysiology education (PNE). Although the positive effects of PNE are well-established in chronic pain populations, it remains unclear why some patients benefit more than others. Identifying predictive factors for therapy would add great value to clinical pratice.

Other, [very] similar study by the same set out authors discussed here and here.

Can anyone locate full text?

-J
 

Effi

Senior Member
Messages
1,496
Location
Europe
@JaimeS Can't find the full text, but I did find some more info on what they call 'pain neurophysiology education'. (brace yourself)
Pain neuroscience has taught us that pain can be present without tissue damage, is often disproportionate to tissue damage, and that tissue damage (and nociception) does not necessarily result in the feeling of pain. Unfortunately patients are often not aware of these facts and stick more to a biomedical model in which they keep on searching for a structural cause of their pain and consequently the “magic bullet” to solve their problem. This may result in low self-efficacy, unrealistic or inappropriate therapy expectations and huge therapy barriers.

Pain neuroscience education intends to transfer knowledge to chronic pain patients, thus allowing them to understand their pain and create adaptive perceptions and improving their ability to cope with their pain. Pain neuroscience education implies teaching people about the underlying mechanisms of pain, including how the brain produces pain. Much attention is paid to the fact that pain is not always the consequence of damage and that, definitely in case of persistent pain, the pain is due to enhanced central pain processing rather than structural damage.

Understanding pain this way, decreases its threat value, leading to more effective pain coping strategies. We and others have shown that pain neuroscience education is effective in changing pain beliefs, improving health status and reducing health care expenditure in adult patients with various chronic pain disorders. Another amazing finding from a randomized controlled trial of our group is the observed effect of pain neuroscience education on endogenous analgesia (measured using the conditioned pain modulation paradigm). Just 2 sessions of pain neuroscience education resulted in improved endogenous pain inhibition in fibromyalgia patients. Even though the effect size on endogenous analgesia was rather small, the finding provides a powerful message to be delivered during pain neuroscience education to our patients: ‘Research has shown that understanding more about pain in itself results in pain suppression in your body’. This way we can alter the patients’ expectations for care, always an important thing to do when treating patients with chronic pain. Although “acceptance” can be an important part in the therapy as well, it seems that recovery expectations are important prognostic factors regarding therapy outcome. Additionally, providing education is a first step in restoring the balance between pain facilitation and pain inhibition and dampening the pain neuromatrix. Understanding pain is crucial for changing certain pain cognitions (eg. catastrophizing) and these pain cognitions are related to increased brain activity. Pain neuroscience education is a way to reduce the widespread brain activity and to calm down the pain neuromatrix. By retraining the brain we can prime patients for further steps in our treatment approach.
(my bolding)

I don't know how many times I can say the exact same thing about this group of so called researchers: drivel drivel drivel. So sick of this nonsense!

There's more, if you really feel like ingesting more drivel: http://www.paininmotion.be/blog/det...neuroscience-education-physiotherapy-practice
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
As far as kinesiophobia goes, I'm continually asking myself if I really couldn't do more. Do I really need to be spending so many hours lying down? And when I had to get out of my house to avoid the tree-lopping noise, spending the day in my car, at a movie, lying down at a park, and still arriving home too early, to 1/2 hour of chain saw noise: I was a wreck. I needed anti-inflammatories, and had a very disrupted sleep. Barely moving the next day.

I'm certain that the noise was at least as much to blame as my need to be away. I've been asking myself from the first moment, whether I can't really do more, whether it's not just become a habitual life style choice. I only wish it were so. These jerks just won't quit their bs.:devil:

I've managed to get on top of my most awful symptoms these last 4 years, I've learned to manage myself to have no crashes for about 2 years. Could I do more if I just weren't afraid? If I hadn't learned from the lessons of the many people here who've done permanent damage by over activity, I could easily be far more disabled than I am now.
 

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
I don't know how many times I can say the exact same thing about this group of so called researchers: drivel drivel drivel. So sick of this nonsense!

That bit you bolded:

Even though the effect size on endogenous analgesia was rather small, the finding provides a powerful message to be delivered during pain neuroscience education to our patients: ‘Research has shown that understanding more about pain in itself results in pain suppression in your body’.
I mean wow. Just wow.
 

Denise

Senior Member
Messages
1,095
Full title:
Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: Pooled results from 2 randomized controlled trials
A. Malfliet, J. Van Oosterwijck, M. Meeus, B. Cagnie, L. Danneels, M. Dolphens, R. Buyl, J. Nijs
Intergrating Research into practice

http://www.manualtherapyjournal.com/article/S1356-689X(16)30281-8/abstract



Other, [very] similar study by the same set out authors discussed here and here.

Can anyone locate full text?

-J

@JaimeS At the top of the page on this link it says the article comes out in Sept.
http://www.manualtherapyjournal.com/article/S1356-689X(16)30281-8/abstract
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Except we're all missing the best part:

They say it doesn't work.

In fact, the point of this paper appears to be to state that pain education did not help a particular group of patients.

Why? Because it's voodoo to presume that one's psychology has absolute control over one's body's responses?

Nope -- because the patients in question were too 'maladaptive'.

So, even worse than what we're saying here is their true message: "Pain can be banished by right-thinking. The patients were incapable of right-thinking. Therefore, they continue to have pain."

-J
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
I'll add that I'm actually really shocked to see some of the authors here. Meeus, Nijs, and Van Oosterwijck at least have done bona fide biomedical research:

Nijs, J., Meeus, M., & De Meirleir, K. (2006, August). Chronic musculoskeletal pain in chronic fatigue syndrome: Recent developments and therapeutic implications. Elsevier Manual Therapy, 11(3), 187-191. doi:10.1016/j.math.2006.03.008

Nijs, J., Nees, A., Paul, L., De Kooning, M., Ickmans, K., Meeus, M., & Van Oosterwijck, J. (2014). Altered immune response to exercise in patients with chronic fatigue syndrome/myalgic encephalomyelitis: A systematic literature review. Exerc Immunol Rev., 20, 94-116. Retrieved June 30, 2016, from http://www.medizin.uni-tuebingen.de/transfusionsmedizin/institut/eir/content/2014/94/article.pdf

KDM is probably having a heart attack as we speak.
 

Aurator

Senior Member
Messages
625
"reducing healthcare expenditure..."
Interesting that they place this last in a list of three benefits. It's a climactic list, you understand - the last being the most important. However bad it is, any "science" that promises to take the strain off government health budgets is a good thing - for those in charge of government health budgets, at any rate.
 

Effi

Senior Member
Messages
1,496
Location
Europe
What a shame! Must be pretty recent; one of those articles was 2014.
The article from 2014 is a literature review of biomed research, in which they reach the conclusion that the evidence for an altered immune response in ME/CFS is only moderate.
A systematic literature search was conducted in the PubMed and Web of science databases using different keyword combinations. We included 23 case control studies that examined whether CFS patients, compared to healthy sedentary controls, have a different immune response to exercise. The included articles were evaluated on their methodological quality. The literature review provides level B evidence for an altered immune response to exercise in patients with CFS.
Sounds like cherry picking in order to find the result they wanted: CFS has no biomed base. With every single study they have produced in latest years they are just trying to make a case for their own treatment, and a case for the governement to get them to force that treatment upon us.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Related study:

"Patients with rheumatoid arthritis showed decreased TS after exercise, both after paracetamol and placebo (P < 0.05). In patients with CFS/FM, results were less univocal. A nonsignificant decrease in TS was only observed after taking paracetamol. CPM responses to exercise are inconclusive, but seem to worsen after exercise."

Nijs et al. "Endogenous Pain Modulation in Response to Exercise in Patients with Rheumatoid Arthritis, Patients with Chronic Fatigue Syndrome and Comorbid Fibromyalgia, and Healthy Controls: A Double-Blind Randomized Controlled Trial"
http://onlinelibrary.wiley.com/doi/10.1111/papr.12181/abstract
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
I'm continually asking myself if I really couldn't do more. Do I really need to be spending so many hours lying down?

Me too, ahmo. I keep trying. I don't know when that will stop. Probably never.

The other day, I went on walks around my property (my family's is somewhat large). My goal was to walk for a half an hour, but in increments: 800 steps. The next time, 600 steps. The next time, 400 steps. The next time, 200 steps. You get the idea. Throughout the day. Because when I was in the Baltimore/Washington D.C. area, I walked many times in brief bursts and didn't crash. City walking, where you park and walk two blocks. It's really 5 minutes of mild exercise, so I figured I could artificially repeat that experience.

But apparently part of my issue is environmental. It wasn't the short bursts of walking that meant I wasn't done in -- it was where I did them.

The whole "patients are invested in their illness" narrative doesn't jive with me. It's not just that I want so badly to be well -- I want so badly to be active and well. I don't fear exercise, I keep sidling up to it like it's a wild animal that won't hurt me so long as I approach it quietly.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
The article from 2014 is a literature review of biomed research, in which they reach the conclusion that the evidence for an altered immune response in ME/CFS is only moderate.

Sounds like cherry picking in order to find the result they wanted: CFS has no biomed base. With every single study they have produced in latest years they are just trying to make a case for their own treatment, and a case for the governement to get them to force that treatment upon us.

I consider B-level evidence to actually be pretty good. I'll re-read this work with an eye for bias, however.
 

eastcoast12

Senior Member
Messages
136
Location
Long Island ny
That bit you bolded:


I mean wow. Just wow.
Lol. I just sent my paper for peer review. It should be published any day. This is my study.
Does survival fear prevent people from surviving from jumping off a bridge.
People-100
Died-98
Lived-2
Even though the study showed that results were small, there is a powerful message to take away from this. Research has shown that you in fact survive a jumping off of bridges.
 

eastcoast12

Senior Member
Messages
136
Location
Long Island ny
Except we're all missing the best part:

They say it doesn't work.

In fact, the point of this paper appears to be to state that pain education did not help a particular group of patients.

Why? Because it's voodoo to presume that one's psychology has absolute control over one's body's responses?

Nope -- because the patients in question were too 'maladaptive'.

So, even worse than what we're saying here is their true message: "Pain can be banished by right-thinking. The patients were incapable of right-thinking. Therefore, they continue to have pain."

-J
There's not a good enough face palm gif on the Internet to reply to this.
 
I'm sure everyone will be delighted to know that this has now been published, 11 months after being accepted by the journal and 16 months after having been sent to the journal. Behind a paywall but those who can access Sci-hub might be able to see all of this pyschobabble in it's full glory.

http://www.tandfonline.com/doi/full/10.1080/09593985.2017.1331481