RESUMO
Objective: The purpose of this research was to design and psychometrically validate a new instrument (the Biobehavioural Pain and Movement Questionnaire/BioPMovQ), which assesses the relationship between pain and various factors related to motor behaviour from a biobehavioural perspective. Methods: A mixed-method design combining a qualitative study with an observational and cross-sectional study was employed to develop (content validity) and psychometrically validate (construct validity, reliability and concurrent/discriminant validity) a new instrument. A total of 200 patients with chronic musculoskeletal pain were recruited. Results: According to the exploratory factor analysis, the final version of the BioPMovQ consists of 16 items distributed across 4 subscales (1, disability, 2, self-efficacy for physical activity; 3, movement avoidance behaviours; and 4, self-perceived functional ability), all with an eigen value greater than 1, explaining 55.79% of the variance. The BioPMovQ showed high internal consistency (Cronbach's α = 0.82; McDonald's ω = 0.83). The intraclass correlation coefficient was 0.86 (95% confidence interval 0.76 to 0.91), which was considered to demonstrate excellent test-retest reliability. The standard error of measurement and minimal detectable change were 3.43 and 8.04 points, respectively. No floor or ceiling effects were identified. There was a positive, significant and moderate magnitude correlation with the Graded Chronic Pain Scale (r = 0.54), kinesiophobia (r = 0.60), pain catastrophising (r = 0.44) and chronic pain self-efficacy (r = -0.31). Conclusion: The BioPMovQ showed good psychometric properties. Based on the findings of this study, the BioPMovQ can be used in research and clinical practice to assess patients with chronic musculoskeletal pain.
RESUMO
BACKGROUND: Manual therapy (MT) is a treatment recommended by clinical practice guidelines in the management of patients with neck pain. However, the mechanisms through which MT works remain unknown. The aim of the present study is to investigate if MT is mediated by mechanisms related to conditioned pain modulation (CPM), comparing the effects of painful with a pain-free MT treatment. METHODS: A two-arm, parallel, randomized controlled clinical trial with concealed allocation and blinding of the outcome assessor was conducted in university students with chronic or recurrent nonspecific neck pain (NSNP). Participants received either a painful or pain-free MT session. Psychophysical variables including pressure pain thresholds, CPM, temporal summation of pain and cold pain intensity were assessed before and immediately after treatment. In addition, changes in neck pain intensity over the following 7 days and self-perceived improvement immediately and 7 days after treatment were assessed. RESULTS: No significant differences were found between groups in any of the psychophysical variables or in patients' self-perceived improvement. Only a significantly greater decrease in neck pain intensity immediately after treatment was found in the pain-free MT group compared to the painful MT group. CONCLUSION: The results suggest that the immediate and short-term effects of MT on NSNP are not mediated by CPM-related mechanisms.
RESUMO
El presente estudio evalúa un modelo estructural de relaciones entre los recursos cognitivos de control percibido sobre la enfermedad (expectativas de autoeficacia y lugar de control interno de dolor), el estado de estrés-recuperación y el malestar afectivo en mujeres con fibromialgia (n= 130). Los resultados fueron consistentes con la propuesta de que el balance de estrés-recuperación media la relación entre los recursos cognitivos y el malestar afectivo. Asimismo, se observó la presencia de un efecto directo por parte de los recursos cognitivos sobre la limitación funcional, mientras que la intensidad de dolor y los otros síntomas de enfermedad fueron directamente predictores del malestar afectivo. Teniendo en cuenta estos resultados, se señala la posible interpretación de una buena parte de las técnicas cognitivo-conductuales utilizadas habitualmente para el tratamiento de la fibromialgia, como herramientas orientadas a la búsqueda del correcto equilibrio entre estrés y recuperación, resultando fundamental para ello la modificación de las creencias de autoeficacia y las expectativas de control (AU)
This study evaluates a structural equation model (SEM) of linkages among cognitive control resources (illness-specific efficacy beliefs and internal pain control expectancies),stress/recovery state, and affective discomfort in women with fibromyalgia (n= 130). Results were consistent with the proposal that stress/recovery balance mediates the relationship between cognitive resources and affective discomfort. In addition, direct effects of cognitive resources on function limitation were observed, and pain intensity and symptoms were direct predictors of the affective discomfort. Based on the results, the possible interpretation of several cognitive-behavioural techniques commonly employed in the treatment of fibromyalgia are indicated as strategies aimed at finding the correct equilibrium between stress and recovery, and the modification of self-efficacy beliefs and pain control expectancies are fundamental (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Estresse Psicológico/psicologia , Fibromialgia/complicações , Fibromialgia/psicologia , Cognição , Afeto , Modelos PsicológicosRESUMO
This study evaluates a structural equation model (SEM) of linkages among cognitive control resources (illness-specific efficacy beliefs and internal pain control expectancies), stress/recovery state, and affective discomfort in women with fibromyalgia (n=130). Results were consistent with the proposal that stress/recovery balance mediates the relationship between cognitive resources and affective discomfort. In addition, direct effects of cognitive resources on function limitation were observed, and pain intensity and symptoms were direct predictors of the affective discomfort. Based on the results, the possible interpretation of several cognitive-behavioural techniques commonly employed in the treatment of fibromyalgia are indicated as strategies aimed at finding the correct equilibrium between stress and recovery, and the modification of self-efficacy beliefs and pain control expectancies are fundamental.
