Page 57 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Strong evidence Moderate evidence Limited evidence Conflicting evidence No evidence
Abbreviations: PF, physical function; T1, time interval of less than 6 months; T2, time interval of 6 to 12 months; T3, time interval of greater than 12 months. *From Hayden et al; +, possitive associated; -, negative associated
Association of illness perceptions with pain or physical function
Pain Intensity There is moderate evidence in 9 cross-sectional studies for a positive association (ie, dysfunctional illness perceptions are associated with higher levels of pain), based on univariate regression, of all illness perception dimensions with pain intensity
( Table 5 ). This positive direction of the associations of all illness perceptions with pain intensity
A systematic literature review
Synthesis of results
The authors considered methodological heterogeneity based on the I2 test of more than 50% on all associations and prognostic outcome scores of the included studies24. Clinical heterogeneity differed among studies due to the diversity of study characteristics, such as number of patients, age, musculoskeletal condition, and duration of symptoms. The measurement instruments of illness perceptions, pain intensity, and physical function were also diverse across studies. Three different versions of the IPQ were used: the IPQ,59 the IPQ-R43,and the Brief IPQ6 .For the outcome measures of pain intensity, 8 different instruments were used, and for limitations in physical function, 8 instruments were employed (Table 3). Due to heterogeneity, the authors could not perform a meta-analysis; the data were summarized qualitatively.
Table 5 shows the level of evidence, according to Hayden et al21, for illness perception dimensions associated to pain intensity or physical function in musculoskeletal pain.
Table 5: Evidence for illness perception dimensions associated to pain or physical function in musculoskeletal pain*
Cross-sectional
Longitudinal: Pain
Longitudinal: PF
Dimension
Pain
PF
T1
T2
T3
T1
T2
T3
Consequences
+
+
+
+
+
+
Timeline-chronic
+
+
+
+
+
Timeline-cyclical
+
+
+
Personal Control
+
+
+
+
+
Treatment Control
+
+
+
+
Identity
+
+
+
+
+
+
Concern
+
+
+
+
Coherence
+
+
–
+
Emotional Response
+
+
+
+
+
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