ORCID Profile
0000-0002-5403-4826
Current Organisations
Leiden University
,
Federal Joint Committee
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Publisher: Wiley
Date: 30-03-2017
DOI: 10.1002/MSC.1191
Abstract: Chronic musculoskeletal pain (CMP) refers to ongoing pain felt in the bones, joints and tissues of the body that persists longer than 3 months. For these conditions, it is widely accepted that secondary pathologies or the consequences of persistent pain, including fear of movement, pain catastrophizing, anxiety and nervous system sensitization appear to be the main contributors to pain and disability. While exercise is a primary treatment modality for CMP, the intent is often to improve physical function with less attention to secondary pathologies. Exercise interventions for CMP which address secondary pathologies align with contemporary pain rehabilitation practices and have greater potential to improve patient outcomes above exercise alone. Biopsychosocial treatment which acknowledges and addresses the biological, psychological and social contributions to pain and disability is currently seen as the most efficacious approach to chronic pain. This clinical update discusses key aspects of a biopsychosocial approach concerning exercise prescription for CMP and considers both patient needs and clinician competencies. There is consensus for in idualized, supervised exercise based on patient presentation, goals and preference that is perceived as safe and non-threatening to avoid fostering unhelpful associations between physical activity and pain. The weight of evidence supporting exercise for CMP has been provided by aerobic and resistance exercise studies, although there is considerable uncertainty on how to best apply the findings to exercise prescription. In this clinical update, we also provide evidence-based guidance on exercise prescription for CMP through a synthesis of published work within the field of exercise and CMP rehabilitation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2013
DOI: 10.1016/J.PAIN.2013.05.031
Abstract: Sensitization of the nervous system can present as pain hypersensitivity that may contribute to clinical pain. In spinal pain, however, the relationship between sensory hypersensitivity and clinical pain remains unclear. This systematic review examined the relationship between pain sensitivity measured via quantitative sensory testing (QST) and self-reported pain or pain-related disability in people with spinal pain. Electronic databases and reference lists were searched. Correlation coefficients for the relationship between QST and pain intensity or disability were pooled using random effects models. Subgroup analyses and mixed effects meta-regression were used to assess whether the strength of the relationship was moderated by variables related to the QST method or pain condition. One hundred and forty-five effect sizes from 40 studies were included in the meta-analysis. Pooled estimates for the correlation between pain threshold and pain intensity were -0.15 (95% confidence interval [CI]: -0.18 to -0.11) and for disability -0.16 (95% CI: -0.22 to -0.10). Subgroup analyses and meta-regression did not provide evidence that these relationships were moderated by the QST testing site (primary pain/remote), pain condition (back/neck pain), pain type (acute/chronic), or type of pain induction stimulus (eg, mechanical/thermal). Fair correlations were found for the relationship between pain intensity and thermal temporal summation (0.26, 95% CI: 0.09 to 0.42) or pain tolerance (-0.30, 95% CI: -0.45 to -0.13), but only a few studies were available. Our study indicates either that pain threshold is a poor marker of central sensitization or that sensitization does not play a major role in patients' reporting of pain and disability. Future research prospects are discussed.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.BERH.2017.04.001
Abstract: In recent years, there has been increasing interest in studying causal mechanisms in the development and treatment of back pain. The aim of this article is to provide an overview of our current understanding of causal mechanisms in the field. In the first section, we introduce key concepts and terminology. In the second section, we provide a brief synopsis of systematic reviews of mechanism studies relevant to the clinical course and treatment of back pain. In the third section, we reflect on the findings of our review to explain how understanding causal mechanisms can inform clinical practice and the implementation of best practice. In the final sections, we introduce contemporary methodological advances, highlight the key assumptions of these methods, and discuss future directions to advance the quality of mechanism-related studies in the back pain field.
Publisher: Springer International Publishing
Date: 2019
Publisher: Wiley
Date: 14-06-2018
DOI: 10.1002/MSC.1247
Abstract: Pain sensitivity and psychosocial issues are prognostic of poor outcome in acute neck disorders. However, knowledge of associations between pain sensitivity and ongoing pain and disability in chronic neck pain are lacking. We aimed to investigate associations of pain sensitivity with pain and disability at the 12-month follow-up in people with chronic neck pain. The predictor variables were: clinical and quantitative sensory testing (cold, pressure) neural tissue sensitivity neuropathic symptoms comorbidities sleep psychological distress pain catastrophizing pain intensity (for the model explaining disability at 12 months only) and disability (for the model explaining pain at 12 months only). Data were analysed using uni- and multivariate regression models to assess associations with pain and disability at the 12-month follow-up (n = 64 at baseline, n = 51 at follow-up). Univariable associations between all predictor variables and pain and disability were evident (r > 0.3 p < 0.05), except for cold and pressure pain thresholds and cold sensitivity. For disability at the 12-month follow-up, 24.0% of the variance was explained by psychological distress and comorbidities. For pain at 12 months, 39.8% of the variance was explained primarily by baseline disability. Neither clinical nor quantitative measures of pain sensitivity were meaningfully associated with long-term patient-reported outcomes in people with chronic neck pain, limiting their clinical application in evaluating prognosis.
Publisher: Wiley
Date: 04-09-2020
DOI: 10.1111/SPOL.12650
Abstract: In common with many other societies with ageing populations, loneliness and social isolation have become a significant problem in contemporary Japan. The financial burden associated with an ageing population, together with ongoing fiscal austerity, has severely constrained the ability of local authorities to address the problem. As a result, policymakers have sought cost‐effective methods of tackling the problem, including local co‐production with community groups. In this article, we consider the impact of loneliness and social isolation on wellbeing and then examine two illustrative case studies of local co‐production programs aimed at tackling social isolation amongst older adults in Japan.
No related grants have been discovered for Kohei Suzuki.