Page 163 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Practical implications
Based on these results, we cannot recommend assessing baseline IPs as predictors for poor recovery. Nonetheless, this does not rule out the value of assessing IPs in MSP. In our study, the treatment was according to the guidelines of the Royal Dutch Society of Physical therapy or, in their absence, according to the physiotherapy usual practice. Therefore, it is unlikely that specific interventions aimed at patients’ beliefs were part of the treatment. This could be of influence on the outcome of poor recovery. We recommend future research on the possible effectiveness of an IP based physical therapy intervention targeting the specific dys- functional IPs of individual patients with disabling MSP.
Overall, the conclusions that can be drawn from the second theme of this thesis are:
• IPs do have a limited to moderate association with pain and physical function.
• A higher score on IPs could be indicative for dysfunctional IPs.
• Further research into the mediating and moderating effect of a physiotherapy treatment
for dysfunctional IPs in people with MSP is recommended.
Theme 3
Treatment of Illness Perceptions
1. The process and outcome of a case report intervention study, hypothesizing that changing dysfunctional IPs would reduce limitations in daily life in chapter 6.
Research aim:
Describing the process and outcome of a case report intervention study, hypothesizing that changing dysfunctional IPs would reduce limitations in daily life.
Summary of main findings
After the patient attended seven treatment sessions within three months, six out of eight IPs items changed beyond the Smallest Detectable Change of 3 points between the first and the last treatment. The IP dimensions Treatment Control and Coherence showed a difference of 1 and 2 points. At baseline, the patient’s attribution to the cause of her illness was her medical condition (OA) and her previous injury (IP Causal). At last treatment session she changed Causal Perception to her own behaviour as attribution factor. Changes in health-related out- comes were also reported. All activity limitations scored with the Patient Specific Function Score changed beyond the Smallest Detectable Change, showing clinically relevant decreases in limitations in climbing stairs, cycling and walking. Knee pain decreased significantly.
General discussion
161
8