Page 46 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Chapter 3
It has been suggested that changes in illness perceptions may predict subsequent physical function in conditions such as LBP, but relatively few intervention studies have been conducted. In a randomized controlled trial for LBP, Siemonsma et al53 concluded that there were improvements in patient-relevant physical activities at 18-week follow-up after cognitive treatment of illness perceptions. This study and others have shown that influencing perceptions can improve physical functioning42.
Evaluating and addressing illness perceptions may be an important component in the treatment of patients with musculoskeletal pain. However, to the authors’ knowledge, no systematic review has evaluated the relationship between illness perceptions and pain intensity and physical functioning in individuals with musculoskeletal pain.
Therefore, this review explores the relationship of illness perceptions with pain intensity and physical function in patients with musculoskeletal pain in both cross-sectional and longitudinal studies. This review specifically asked (1) what associations illness perceptions may have with pain intensity and physical function in patients with musculoskeletal pain and (2) whether illness perceptions may be prognostic for pain intensity and physical function in patients with musculoskeletal pain.
Methods
This systematic review was written in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines38 and the A MeaSurement Tool to Assess systematicReviewschecklist52.DetailsoftheprotocolforthisstudywereregisteredwithPROS- PERO. The following terms with their definitions were used in this review: musculoskeletal pain is pain felt within the context of the following musculoskeletal conditions, according to the European Musculoskeletal Conditions Surveillance and Information Network11:
1) joint conditions (ie, rheumatoid-, osteoarthritis), 2) bone conditions (ie, osteoporosis), 3) spinal disorders (ie, LBP), 4) regional and widespread pain disorders, 5) musculoskeletal injuries and 6) multisystem inflammatory diseases.
Illness perceptions are the organized representations patients have about their illness that belong to the core concepts of the CSM34. Illness perceptions can be assessed by 3 validated questionnaires: (1) the Illness Perception Questionnaire (IPQ)59, (2) the Illness Perception Questionnaire revised (IPQ-R)43, and (3) the Brief IPQ29. All 3 questionnaires have good psychometric properties36.
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