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Rehabilitation and chronic pain

Published 30.10.2009

A study conducted by Umeå University in collaboration with RCT shows that patient´s pretreatment belief about recovery influence the outcome of a pain rehabilitation programme.

The study concludes that a special five-week cognitive-behavioral interdisciplinary rehabilitation programme can influence the pain, life satisfaction and, to a small extent, activity limitations of the patients in the right direction. Surprisingly only patients with positive beliefs about recovery before rehabilitation showed a decrease in pain intensity at the one-year follow-up.

Among the findings increased working ability and higher quality of life seemed to be predicted by the patient's self efficacy beliefs. Self-efficacy influences the effort one puts forth to change perceived risk behaviors and the persistence to continue striving despite barriers and setbacks that may undermine motivation. In the study, fear of movement/reinjury was leading to a reduc tion in the patient´s sense of control of pain and increased pain, which in turn lead to increased avoidance of normal activities. On the other hand there is support that a multidisciplinary pain rehabilitation programme could increase patient self efficacy beliefs in control of their pain, increase their internal control over pain and at the same time reduce their perception of external control of pain.

That the patient´s belief about recovery plays such an important role is an interesting finding, because it highlights that, from the very beginning of the pain rehabilitation process, this factor should be taken into consideration when planning the rehabilitation programme.

Torture survivors are often seriously disabled by chronic pain causing a lower quality of life as well as psycho-social and mental health problems. Randomized controlled trials of torture survivor rehabilitation are costly, but urgently warranted. In the present study, the studied patient group consisted of a non-traumatized patient population. Nonetheless, the evidence has to be considered a valuable contribution to the knowledge we have about pain management and rehabilitation.

"Patients' pretreatment beliefs about recovery influence outcome of a pain rehabilitation program"

By: Merrick, D. and Sjölund, B. H.
In: European journal of physical and rehabilitation medicine  vol. 45, no. 3

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Written by Heidi K. Tokle

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