Page 61 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

studies overall, seems to be independent of the nature of the musculoskeletal condition. This finding aligns with another systematic review that focused on generic prognostic factors for musculoskeletal pain1. The authors found 15 possible relevant prognostic factors identified in studies of patients with at least 2 different pain sites. Regardless of the location of the musculoskeletal pain, generic factors such as pain intensity, widespread pain, high functional disability, somatization, and movement restriction were reported as prognostic factors for pain. The authors see the same pattern in the present study; regardless of the musculoskeletal pain condition, the direction of the relationship was consistent. As a result, this study provides supplementary information for understanding the role of illness perception in musculoskeletal pain.
The authors considered higher scores on the illness perception domains of Consequences, Timeline, Identity, Concern, and Emotional Response, and lower scores on the domains of Personal and Treatment Control and Coherence, to be dysfunctional, because they are positively associated with, or prognostic for, increased pain intensity and increased limitations in physical function. The consistency of these findings, independent of musculoskeletal pain condition, contributes to understanding the role of illness perception in musculoskeletal pain. For instance, baseline assessment of dysfunctional illness perceptions in patients with musculoskeletal pain provides some insight in how patients themselves think about their pain or physical function.
For clinicians, addressing patients’ illness perceptions may open new possibilities for management. In this review, the authors found 3 validated questionnaires for illness perception assessment. These findings show no real differences of strength of association between illness perceptions and pain or physical function among these questionnaires. The most used questionnaire was the IPQ-R, which consists of 71 items. The Brief IPQ has 9 items. The latter might have less patient burden and so may be preferred for use in daily practice.
Changing dysfunctional illness perceptions may have a positive influence on pain and physical function. The authors found 1 randomized controlled trial that addressed dysfunctional illness perceptions of patients with chronic LBP with a cognitive treatment protocol, which showed promising results in a better level of patient-specific physical function after 18 weeks14. The cognitive treatment targeted dysfunctional illness perceptions of patients about their back pain and aimed to alter these perceptions. In 10 to 14 one- hour treatment sessions, dysfunctional illness perceptions were assessed and challenged, and alternative illness perceptions were formulated. This was done by mapping the illness perceptions with the IPQ-R and further exploring these perceptions with a Socratic
A systematic literature review
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