Page 126 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Chapter 7
Abstract
Introduction: Illness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiother- apy treatment is unknown.
Methods: Amultiplesingle-caseexperimentaldesign,usingamatchedcarephysiotherapy intervention, with three phases (phases A-B-A’) was used including a three month follow up (phase A’). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep.
Results: Ninepatientswereincludedbysixdifferentprimarycarephysiotherapists.Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at three month follow up.
Conclusion: Our study seems to suggest that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. At baseline, assessing Personal control could be a relevant moderator for the outcome prognosis of successful phys- iotherapy management of persistent low back pain in our study.
Keywords: Low back pain; Illness Perceptions; Mediation; Moderation; SCED-study; Physiotherapy
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