Page 161 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Practical implications
Dysfunctional beliefs about MSP may contribute to pain intensity and limitations in physical functioning. Higher IP scores on Consequences, Identity and Coherence were associated with higher pain intensity. Higher IP scores on Consequences, Treatment Control, Identity and Con- cern were associated with greater limitations in physical functioning. Due to the cross-sec- tional design of our study, a Causal inference cannot be drawn, but this Causal interference has already been shown in cohorts of patients with persistent pain from repetitive strain injury35 and low back pain3. This highlights the therapeutic potential of targeting higher IP scores and trying to alter dysfunctional IPs to more favourable, functional, ones. Changing IPs is not only relevant for alleviating the burden of MSP, but also for reducing dependence on physiotherapy treatment. Higher scores on IPs are associated with more frequent use of physiotherapy30. Finally, our study calls for a study in which the IPs are explored longitudinally for their predictive value on pain intensity and physical functioning.
3. The added predictive value of baseline Illness Perceptions for short-term poor recovery in musculoskeletal pain in chapter 5.
Research questions:
Do Illness Perceptions add predictive value for short-term poor recovery in musculoskeletal pain? This question was split into three sub-questions:
• Do baseline IPs in MSP patients have added predictive value for poor recovery in pain
intensity, physical functioning and patient global perceived effect after 3 months?
• Is there an association between the Four-Dimensional Symptom Questionnaire and the
Brief IPQ-DLV?
• Is there a difference in added predictive value of poor recovery between the Four-Di-
mensional Symptom Questionnaire (4DSQ) and the Brief IPQ-DLV?
Summary of main findings
In addition to generic prognostic factors, the IP dimensions Treatment Control and Timeline have a small added predictive value for poor recovery from MSP in pain intensity, physical functioning and the global perceived effect. The clinical implication is limited and therefore we find assessing baseline IPs as predictors for poor recovery is not supported by the results of this study. Furthermore, the Brief IPQ-DLV showed a weak correlation with the 4DSQ for all IPs dimensions. The highest correlations (.32- .40) were found for the IP dimensions Con- sequences and Emotional Response. There was no difference between the predictive value for the psychological factors between these two questionnaires on poor recovery on pain
General discussion
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