Page 180 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Appendix
this patient eligible for assessment of changes in IPs, pain intensity and limitations in physical functioning during the physiotherapy treatment.
The hypothesis was that changing dysfunctional IPs into more functional ones would reduce pain intensity and limitations in physical functioning.
After the patient had attended seven treatment sessions within three months, changes to more functional perceptions were found on all IP dimensions. Although the dimension Coherence could not be evaluated as dysfunctional (score 9 on 0-10 scale) before treatment started, the dimension did change (with this patient) during the treatment. Initially, she had the perception that the symptoms were caused by a degenerated knee due to her age. Her perception changed after the explanation that the medical classification of the condition of her knee did not necessarily imply persistent symptoms like pain and limitations in physical functioning.
Based on this case study, no conclusions can be drawn on whether changes in perception had a causal association with changes in pain intensity and limitations in physical functioning. Neither can a direction be given for a possible causal association. Do the perceptions change pain intensity and physical functioning or do pain intensity and physical functioning change the perceptions?
Further and more extensive research on the role, mediation and/or moderation, of perceptions on changes of pain intensity and physical functioning is recommended.
Chapter 7
In this study, a multiple baseline single-case experimental design (SCED) was used to evaluate the effects of changed IPs on pain intensity and limitations in physical functioning. The IPs’ moderating and/or mediating effects in a “matched-care” physiotherapy on pain intensity and physical functioning were evaluated. Nine patients with persistent back pain were included in the study.
First of all, physiotherapy treatment showed a significant decrease in pain intensity and limitations in physical functioning after treatment, which continued three months post- treatment. Each matched-care intervention was specifically adjusted, prior to a physiotherapy intervention, for the dysfunctional IPs at that moment.
This research showed that dysfunctional IPs mediated the effect of the treatment. In particular, changes in the IP dimensions Consequences, Personal Control, Identity, Concern and Emotional Response explained a significant part of the outcome, during treatment as well
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