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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS26–eS426
Ethics approval: This project was approved to the Ethics Committee in Research of the Federal University of Juiz de Fora. http://dx.doi.org/10.1016/j.physio.2015.03.500 Research Report Poster Presentation Number: RR-PO-10-19-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 ABNORMAL PAIN RESPONSE TO VISUAL FEEDBACK IN CHRONIC WHIPLASH: AN EXPERIMENTAL STUDY M. De Kooning 1,2 , L. Daenen 1 , N. Roussel 3 , K. Ickmans 1 , P. Cras 2 , J. Nijs 1 1 Vrije
Universiteit Brussel, Departments of Human Physiology and Physiotherapy, Brussel, Belgium; 2 Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, Belgium; 3 Antwerp University, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium Background: Whiplash associated disorders (WAD) are a debilitating and costly condition. Previous research demonstrated that sensorimotor incongruence exacerbates symptoms in chronic WAD. Sensorimotor incongruence occurs when somatosensory input and predicted motor output are in conflict. This can be interpreted by the brain as threatening and hence, trigger pain. On the other hand, there is evidence that visual feedback can decrease pain in certain chronic pain conditions. Purpose: The aim of this study was to examine the effect of visual feedback and sensorimotor incongruence on pain thresholds in patients with chronic WAD. Methods: Thirty-four healthy controls and 30 patients with chronic WAD were subjected to six experimental conditions in a random order. Participants watched a monitor with correct real-time or modified visual feedback of the neck or hand (without movement as well as during repetitive neck lateroflexion). Sensorimotor incongruence was induced by manipulating visual feedback. Pressure pain thresholds were measured at baseline and during each condition at the trapezius and quadriceps muscles. Results: Visual feedback of the neck – correct or modified – did not influence pain thresholds in patients with chronic WAD. In contrast, healthy controls had significantly higher pain thresholds when provided with correct or modified visual feedback. When a movement of the neck was added during visual feedback, patients with chronic WAD showed no significant difference in pain thresholds, while an increase in pain thresholds was found in the healthy control group. Conclusion(s): In sharp contrast with the healthy controls, visual feedback and sensorimotor incongruence did not
alter pain thresholds in chronic WAD patients. These findings suggest an abnormal pain response to visual feedback and somatosensory incongruence as well as failing mechanisms of pain inhibition in patients with chronic WAD. Implications: Therapy results from visual feedback in chronic pain patients should not be extrapolated to the population of chronic whiplash patients. Keywords: Whiplash; Visual feedback; Pain thresholds Funding acknowledgements: No external funds were obtained for this study. Ethics approval: Study protocol, information leaflet and informed consent were approved by the Human Research Ethics Committee of the Antwerp University Hospital. http://dx.doi.org/10.1016/j.physio.2015.03.501 Research Report Platform Rapid 5 Presentation Number: RR-PLR5-1139 Monday 4 May 2015 13:45 Room 324–326 EFFECTS OF KINESIO-TAPING IN PAIN AND QUALITY OF LIFE IN THE ELDERLY WITH KNEE OSTEOARTHRITIS—A RANDOMIZED CONTROLLED TRIAL B. Wageck 1 , M. de Noronha 1,2 , G.S. Nunes 3 , N. Bohen 1 , G.M. Santos 1 1 Universidade
do Estado de Santa Catarina, Fisioterapia, Florianopolis, Brazil; 2 La Trobe University – Rural Health School, Allied Health, Bendigo, Australia; 3 Universidade Federal de São Carlos, Fisioterapia, São Carlos, Brazil Background: Knee osteoarthritis (OA) is one of the most prevalent injuries in elderly people. This injury causes pain, edema, and issues with life quality. There are many possible treatments for knee OA, one that is becoming popular is the application of Kinesio Taping (KT). This technique appears to improve muscle strength, reduce pain and edema. Purpose: To verify the effect of the KT technique on pain and quality of life in elderly with knee OA. Methods: 76 participants with knee OA were first assessed for quality of life via the WOMAC questionnaire and pain via pressure algometry that measured the pressure pain threshold in 6 different areas of the knee (superior patellar extremity, inferior patellar extremity, lateral patellar extremity, medial patellar extremity, lateral knee region and medial knee region). After the baseline evaluation, the subjects were randomly divided into two groups, intervention and placebo. The intervention group (IG) had 38 participants with mean age of 69.6 years (SD 6.9), BMI of 30.0 kg/m2 (SD 4.9) and female/male rate of 35:3; the Placebo group (PG) had 38 participants with mean age of 68.6 years (SD 6.3), BMI of 31.3 kg/m2 (SD 4.1) and female/male rate of 31:7. IG group received KT on the quadriceps muscle, following the Y technique from origin to insertion, also received KT for lymphatic
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS26–eS426
correction and space correction. The GP received elastic tapes without any therapeutic indication. All participants kept the tapes on for 4 days. Post-application evaluations were carried out at day 4 (post-treatment) and 19 (follow-up) after the start of the treatment. Results: Prior to treatment the IG group had mean pain thresholds that varied from 2.3 kgf (SD 1.0) to 4.8 kgf (SD 2.1) while for the PG it varied from 2.1 kgf (0.8 SD) to 4.6 kgf (SD 1.6). For the IG, after treatment, the mean pain threshold varied from 2.4 kgf (SD 1.1) to 4.9 kgf (SD 1.6) at day 4, and from 2.6 kgf (SD 0.9) to 5.1 kgf (SD 5.1) at day 15. For the PG the mean pain threshold varied from 2.2 kgf (SD 0.8) to 4.7 kgf (SD 1.6) at day 4 and from 2.5 kgf (SD 0.5) to 4.7 kgf (SD 1.0) at day 15. For quality of life, the IG had a mean score of 48.3 (SD 14.5) in the WOMAC questionnaire while the PG had a mean score of 48.6 (SD 18.5) prior to treatment. After treatment the IG had a mean WOMAC score of 36.7 (SD 15.6) at day 4 and 39.9 (SD 15.8) at day 15 while the PG had a mean score of 39.2 (SD 18.9) at day 4 and 42.8 (SD 16.9) at day 15. There were no between group differences for any of the variables investigated at any assessment time. Conclusion(s): KT technique provided no beneficial effects on pain and quality of life in elderly with knee OA. Implications: There seems to be trend toward the use of KT for various musculoskeletal problems however the results seem here do not support the use of the technique given the lack of positive effect and costs associated to this technique. Keywords: Kinesio-Taping; Knee osteoarthritis; Pain Funding acknowledgements: This study was funded by CNPq – National Council for Scientific and Technological Development – Brazilian Government. Ethics approval: Human Research Ethics Committee of Universidade do Estado de Santa Catarina (CAAE: 08132212.2.0000.0118). Also, Brazilian Clinical Trials Registry (RBR-36r3t5). http://dx.doi.org/10.1016/j.physio.2015.03.502
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Research Report Platform Presentation Number: RR-PL-2683 Monday 4 May 2015 17:02 Room 303–304 REGISTRATION PROJECT—PATIENT PROFILE. A DESCRIPTIVE STUDY OF THE PATIENT PROFILE IN PATIENTS REFERRED TO PHYSIOTHERAPY IN PRIMARY CARE N.-B. de Vos Andersen 1 , I. Qvist 1 , F. Pedersen 2 , M. Kongsgaard 3 , J. Ottosen 4 , C. Ib 4 , D. Hoyrup Christiansen 5 1 Region
Midtjylland, Quality and Medication, Viborg, Denmark; 2 Region Syddanmark, Primary Care, Vejle, Denmark; 3 Region Northjylland, Primary Care, Aalborg, Denmark; 4 Region Copenhagen, Primary Care, Copenhagen, Denmark; 5 Danish Rammazinicenter, Occupaional Medicine, Herning, Denmark Background: There are currently no Danish studies describing the patient profile of physiotherapy patients in primary care concerning diagnosis, pain, pain duration, fear avoidance, coping, functioning, labor market attachment, psychological well-being and quality of life. Purpose: Describe characteristics of patients referred to physiotherapy because of Musculoskeletal disorders. Methods: All patients referred to physiotherapy by general practitioner because of musculoskeletal disorders in the period January 2012 to May 2012 were invited to participate in the study. A total of 201 physical therapist in 30 clinics collected clinical and questionnaire. Patients completed a web-based questionnaire prior to first consultation. The questionnaire included validated scales from The Standard Evaluation Questionnaire, the Örebro Musculoskeletal Pain Screening Questionnaire, EQ-5D-5 and the Mental Health Scale Five. Clinical data were collected using standardized assessment form, and symptoms and diagnosis related to the musculoskeletal system was registered according to the Danish version of the International Classification of Primary Care 2nd Edition (ICPC-2 DK) in an already existing clinical database (FysDB). Results: 4885 patients were invited to participate in the study, 3281 (67%) accepted. Complete questionnaire and clinical data was obtained in 2773 (57%) of the patients. 66% were women and 34% men, average age was 48 years (SD 15), 53% were employed and 9% reported being sick listed. The most frequently recorded ICPC diagnosis was L01 neck (21%) and L03 lumbar spine (26%). In 48% the pain duration exceeded three month and 45% had troublesome pain in 2 regions or more. 40% took pain medicine on a daily basis and 46% reported sleep disturbances because of their musculoskeletal symptoms. The Average pain level was (0–10) was 6.6 (SD 2.2), the mean score for functional limitations due to pain (0–100) and fear avoidance (0–30) was 32.7. (SD 20.7), and 15.9 (SD 8.3), respectively. Medium or Low abil-
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS26–eS426
Ethics approval: This project was approved to the Ethics Committee in Research of the Federal University of Juiz de Fora. http://dx.doi.org/10.1016/j.physio.2015.03.500 Research Report Poster Presentation Number: RR-PO-10-19-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 ABNORMAL PAIN RESPONSE TO VISUAL FEEDBACK IN CHRONIC WHIPLASH: AN EXPERIMENTAL STUDY M. De Kooning 1,2 , L. Daenen 1 , N. Roussel 3 , K. Ickmans 1 , P. Cras 2 , J. Nijs 1 1 Vrije
Universiteit Brussel, Departments of Human Physiology and Physiotherapy, Brussel, Belgium; 2 Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, Belgium; 3 Antwerp University, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium Background: Whiplash associated disorders (WAD) are a debilitating and costly condition. Previous research demonstrated that sensorimotor incongruence exacerbates symptoms in chronic WAD. Sensorimotor incongruence occurs when somatosensory input and predicted motor output are in conflict. This can be interpreted by the brain as threatening and hence, trigger pain. On the other hand, there is evidence that visual feedback can decrease pain in certain chronic pain conditions. Purpose: The aim of this study was to examine the effect of visual feedback and sensorimotor incongruence on pain thresholds in patients with chronic WAD. Methods: Thirty-four healthy controls and 30 patients with chronic WAD were subjected to six experimental conditions in a random order. Participants watched a monitor with correct real-time or modified visual feedback of the neck or hand (without movement as well as during repetitive neck lateroflexion). Sensorimotor incongruence was induced by manipulating visual feedback. Pressure pain thresholds were measured at baseline and during each condition at the trapezius and quadriceps muscles. Results: Visual feedback of the neck – correct or modified – did not influence pain thresholds in patients with chronic WAD. In contrast, healthy controls had significantly higher pain thresholds when provided with correct or modified visual feedback. When a movement of the neck was added during visual feedback, patients with chronic WAD showed no significant difference in pain thresholds, while an increase in pain thresholds was found in the healthy control group. Conclusion(s): In sharp contrast with the healthy controls, visual feedback and sensorimotor incongruence did not
alter pain thresholds in chronic WAD patients. These findings suggest an abnormal pain response to visual feedback and somatosensory incongruence as well as failing mechanisms of pain inhibition in patients with chronic WAD. Implications: Therapy results from visual feedback in chronic pain patients should not be extrapolated to the population of chronic whiplash patients. Keywords: Whiplash; Visual feedback; Pain thresholds Funding acknowledgements: No external funds were obtained for this study. Ethics approval: Study protocol, information leaflet and informed consent were approved by the Human Research Ethics Committee of the Antwerp University Hospital. http://dx.doi.org/10.1016/j.physio.2015.03.501 Research Report Platform Rapid 5 Presentation Number: RR-PLR5-1139 Monday 4 May 2015 13:45 Room 324–326 EFFECTS OF KINESIO-TAPING IN PAIN AND QUALITY OF LIFE IN THE ELDERLY WITH KNEE OSTEOARTHRITIS—A RANDOMIZED CONTROLLED TRIAL B. Wageck 1 , M. de Noronha 1,2 , G.S. Nunes 3 , N. Bohen 1 , G.M. Santos 1 1 Universidade
do Estado de Santa Catarina, Fisioterapia, Florianopolis, Brazil; 2 La Trobe University – Rural Health School, Allied Health, Bendigo, Australia; 3 Universidade Federal de São Carlos, Fisioterapia, São Carlos, Brazil Background: Knee osteoarthritis (OA) is one of the most prevalent injuries in elderly people. This injury causes pain, edema, and issues with life quality. There are many possible treatments for knee OA, one that is becoming popular is the application of Kinesio Taping (KT). This technique appears to improve muscle strength, reduce pain and edema. Purpose: To verify the effect of the KT technique on pain and quality of life in elderly with knee OA. Methods: 76 participants with knee OA were first assessed for quality of life via the WOMAC questionnaire and pain via pressure algometry that measured the pressure pain threshold in 6 different areas of the knee (superior patellar extremity, inferior patellar extremity, lateral patellar extremity, medial patellar extremity, lateral knee region and medial knee region). After the baseline evaluation, the subjects were randomly divided into two groups, intervention and placebo. The intervention group (IG) had 38 participants with mean age of 69.6 years (SD 6.9), BMI of 30.0 kg/m2 (SD 4.9) and female/male rate of 35:3; the Placebo group (PG) had 38 participants with mean age of 68.6 years (SD 6.3), BMI of 31.3 kg/m2 (SD 4.1) and female/male rate of 31:7. IG group received KT on the quadriceps muscle, following the Y technique from origin to insertion, also received KT for lymphatic
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS26–eS426
correction and space correction. The GP received elastic tapes without any therapeutic indication. All participants kept the tapes on for 4 days. Post-application evaluations were carried out at day 4 (post-treatment) and 19 (follow-up) after the start of the treatment. Results: Prior to treatment the IG group had mean pain thresholds that varied from 2.3 kgf (SD 1.0) to 4.8 kgf (SD 2.1) while for the PG it varied from 2.1 kgf (0.8 SD) to 4.6 kgf (SD 1.6). For the IG, after treatment, the mean pain threshold varied from 2.4 kgf (SD 1.1) to 4.9 kgf (SD 1.6) at day 4, and from 2.6 kgf (SD 0.9) to 5.1 kgf (SD 5.1) at day 15. For the PG the mean pain threshold varied from 2.2 kgf (SD 0.8) to 4.7 kgf (SD 1.6) at day 4 and from 2.5 kgf (SD 0.5) to 4.7 kgf (SD 1.0) at day 15. For quality of life, the IG had a mean score of 48.3 (SD 14.5) in the WOMAC questionnaire while the PG had a mean score of 48.6 (SD 18.5) prior to treatment. After treatment the IG had a mean WOMAC score of 36.7 (SD 15.6) at day 4 and 39.9 (SD 15.8) at day 15 while the PG had a mean score of 39.2 (SD 18.9) at day 4 and 42.8 (SD 16.9) at day 15. There were no between group differences for any of the variables investigated at any assessment time. Conclusion(s): KT technique provided no beneficial effects on pain and quality of life in elderly with knee OA. Implications: There seems to be trend toward the use of KT for various musculoskeletal problems however the results seem here do not support the use of the technique given the lack of positive effect and costs associated to this technique. Keywords: Kinesio-Taping; Knee osteoarthritis; Pain Funding acknowledgements: This study was funded by CNPq – National Council for Scientific and Technological Development – Brazilian Government. Ethics approval: Human Research Ethics Committee of Universidade do Estado de Santa Catarina (CAAE: 08132212.2.0000.0118). Also, Brazilian Clinical Trials Registry (RBR-36r3t5). http://dx.doi.org/10.1016/j.physio.2015.03.502
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Research Report Platform Presentation Number: RR-PL-2683 Monday 4 May 2015 17:02 Room 303–304 REGISTRATION PROJECT—PATIENT PROFILE. A DESCRIPTIVE STUDY OF THE PATIENT PROFILE IN PATIENTS REFERRED TO PHYSIOTHERAPY IN PRIMARY CARE N.-B. de Vos Andersen 1 , I. Qvist 1 , F. Pedersen 2 , M. Kongsgaard 3 , J. Ottosen 4 , C. Ib 4 , D. Hoyrup Christiansen 5 1 Region
Midtjylland, Quality and Medication, Viborg, Denmark; 2 Region Syddanmark, Primary Care, Vejle, Denmark; 3 Region Northjylland, Primary Care, Aalborg, Denmark; 4 Region Copenhagen, Primary Care, Copenhagen, Denmark; 5 Danish Rammazinicenter, Occupaional Medicine, Herning, Denmark Background: There are currently no Danish studies describing the patient profile of physiotherapy patients in primary care concerning diagnosis, pain, pain duration, fear avoidance, coping, functioning, labor market attachment, psychological well-being and quality of life. Purpose: Describe characteristics of patients referred to physiotherapy because of Musculoskeletal disorders. Methods: All patients referred to physiotherapy by general practitioner because of musculoskeletal disorders in the period January 2012 to May 2012 were invited to participate in the study. A total of 201 physical therapist in 30 clinics collected clinical and questionnaire. Patients completed a web-based questionnaire prior to first consultation. The questionnaire included validated scales from The Standard Evaluation Questionnaire, the Örebro Musculoskeletal Pain Screening Questionnaire, EQ-5D-5 and the Mental Health Scale Five. Clinical data were collected using standardized assessment form, and symptoms and diagnosis related to the musculoskeletal system was registered according to the Danish version of the International Classification of Primary Care 2nd Edition (ICPC-2 DK) in an already existing clinical database (FysDB). Results: 4885 patients were invited to participate in the study, 3281 (67%) accepted. Complete questionnaire and clinical data was obtained in 2773 (57%) of the patients. 66% were women and 34% men, average age was 48 years (SD 15), 53% were employed and 9% reported being sick listed. The most frequently recorded ICPC diagnosis was L01 neck (21%) and L03 lumbar spine (26%). In 48% the pain duration exceeded three month and 45% had troublesome pain in 2 regions or more. 40% took pain medicine on a daily basis and 46% reported sleep disturbances because of their musculoskeletal symptoms. The Average pain level was (0–10) was 6.6 (SD 2.2), the mean score for functional limitations due to pain (0–100) and fear avoidance (0–30) was 32.7. (SD 20.7), and 15.9 (SD 8.3), respectively. Medium or Low abil-
