Page 18 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij
P. 18

Chapter 1
 In Chapter 4, this thesis focuses on the “additional association”, of IPs over and above well-known independent risk factors for poor prognosis, such as number of pain sites, pain duration, somatization, distress, anxiety, and depression. Patients from primary physiotherapy care with MSP are included in the study. The outcomes are pain intensity and limitations in physical functioning.
In Chapter 5, the thesis investigates the predictive value of baseline IPs for poor recovery after three months of physiotherapy treatment, in a longitudinal cohort study. The primary outcomes are pain intensity, physical functioning and global perceived effect (GPE). We will look at the extra predictive effect of IPs on top of the well-known independent risk factors for poor outcome listed above. In addition, we will compare the predictive values of the Brief IPQ-DLV and the Four-Dimensional Symptom Questionnaire (4DSQ)57.
We aim to answer the following three research questions:
1. Do baseline IPs in MSP patients have added predictive value for poor recovery in terms of
pain intensity, physical functioning and patient General Perceived Effect after 3 months?
2. Is there an association between the 4DSQ and the Brief IPQ-DLV?
3. Is there a difference in the predictive value for poor recovery between the 4DSQ and the
Brief IPQ-DLV?
Treatment
We will set-up two intervention studies in primary care physiotherapy on the association of IPs and changes in pain intensity, physical functioning and GPE.
In Chapter 6, a case study is described in which the process and outcome of an intervention study is outlined. Dysfunctional IPs will be targeted, and we hypothesize that changing dysfunctional IPs could reduce pain intensity and limitations in physical functioning.
In Chapter 7, a multiple baseline Single-Case Experimental Design is used to investigate the possible modifying or mediating effect of dysfunctional IPs on pain intensity and limitations in physical functioning. A matched care physiotherapy treatment targets the dysfunctional IPs in order to convert them into more functional ones.
The research questions are:
1. Do pain intensity, physical functioning and pain interference change significantly during
and after matched-care physiotherapy treatment?
2. Do IPs mediate the effect of matched-care physiotherapy on pain intensity, physical func-
tioning and pain interference?
3. Do baseline IPs modify the effect of matched-care physiotherapy on pain intensity, phys-
ical functioning and pain interference?
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