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Article ; Online: People with painful knee osteoarthritis hold negative implicit attitudes towards activity.

Pulling, Brian W / Braithwaite, Felicity A / Mignone, Joanne / Butler, David S / Caneiro, J P / Lipp, Ottmar V / Stanton, Tasha R

Pain

2024

Abstract: Abstract: Negative attitudes/beliefs surrounding osteoarthritis, pain, and activity contribute to reduced physical activity in people with knee osteoarthritis (KOA). These attitudes/beliefs are assessed using self-report questionnaires, relying on ... ...

Abstract	Abstract: Negative attitudes/beliefs surrounding osteoarthritis, pain, and activity contribute to reduced physical activity in people with knee osteoarthritis (KOA). These attitudes/beliefs are assessed using self-report questionnaires, relying on information one is consciously aware of and willing to disclose. Automatic (ie, implicit) assessment of attitudes does not rely on conscious reflection and may identify features unique from self-report. We developed an implicit association test that explored associations between images of a person moving/twisting their knee (activity) or sitting/standing (rest), and perceived threat (safe vs dangerous). We hypothesised that people with KOA would have greater implicit threat-activity associations (vs pain-free and non-knee pain controls), with implicit attitudes only weakly correlating with self-reported measures (pain knowledge, osteoarthritis/pain/activity beliefs, fear of movement). Participants (n = 558) completed an online survey: 223 had painful KOA (n = 157 female, 64.5 ± 8.9 years); 207 were pain free (n = 157 female, 49.3 ± 15.3 years); and 99 had non-KOA lower limb pain (n = 74 female, 47.5 ± 15.04 years). An implicit association between "danger" and "activity" was present in those with and without limb pain (KOA: 0.36, 95% CI 0.28-0.44; pain free: 0.13, 95% CI 0.04-0.22; non-KOA lower limb pain 0.11, 95% CI -0.03 to 0.24) but was significantly greater in the KOA group than in the pain free (P < 0.001) and non-KOA lower limb pain (P = 0.004) groups. Correlations between implicit and self-reported measures were nonsignificant or weak (rho = -0.29 to 0.19, P < 0.001 to P = 0.767). People with painful KOA hold heightened implicit threat-activity associations, capturing information unique to that from self-report questionnaires. Evaluating links between implicit threat-activity associations and real-world behaviour, including physical activity levels, is warranted.
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	193153-2
ISSN	1872-6623 ; 0304-3959
ISSN (online)	1872-6623
ISSN	0304-3959
DOI	10.1097/j.pain.0000000000003210
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Zs.A 1158: Show issues

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Article ; Online: Item development and pre-testing of an Osteoarthritis Conceptualisation Questionnaire to assess knowledge and beliefs in people with knee pain.

Pulling, Brian W / Braithwaite, Felicity A / Butler, David S / Vogelzang, Anna R / Moseley, G Lorimer / Catley, Mark J / Murray, Carolyn M / Stanton, Tasha R

PloS one

2023 Volume 18, Issue 9, Page(s) e0286114

Abstract: Many people with osteoarthritis hold beliefs that physical activity is unhelpful or dangerous for their joints, despite high-level evidence suggesting otherwise. Recent advances in scientific understanding of osteoarthritis have led to new treatments ... ...

Abstract	Many people with osteoarthritis hold beliefs that physical activity is unhelpful or dangerous for their joints, despite high-level evidence suggesting otherwise. Recent advances in scientific understanding of osteoarthritis have led to new treatments that target an individual's understanding both of their condition and the importance of best-practice management strategies, such as physical activity. Conceptual change has been proposed as an important mechanism by which cognitive interventions, such as pain science education, may reduce pain and improve function. There are currently no specific assessments of osteoarthritis conceptualisation to determine the effectiveness of cognitive interventions in effecting conceptual change in people with knee osteoarthritis. Therefore, we aimed to develop an item bank, as the first phase of developing a questionnaire to assess people's conceptualisations about their knee osteoarthritis and the role of physical activity in managing their osteoarthritis. Using a guideline-informed mixed method design, a panel of experts identified domains relevant to conceptualisation about knee osteoarthritis and physical activity (knowledge, beliefs, understanding) based upon available evidence. The panel created 33 provisional items. Qualitative and quantitative pretesting were used to explore how people with knee osteoarthritis understood the provisional items. Eighteen people with knee osteoarthritis completed cognitive interviews about their comprehension of the wording/grammar of each provisional item. The provisional item bank was field tested with 100 people with knee osteoarthritis. Readability was adequate with a Flesch reading ease score of 57.7. Although 14.7% used the 'Strongly agree' response option, only 3.4% of responses used the 'Strongly disagree' option, suggesting possible response bias. Predictive quality testing identified relevant modifications to the questionnaire instructions. The panel of experts appraised the qualitative data to assess whether and how items should be modified to address the problems identified, resulting in a final item bank of 45 items that can be evaluated for psychometric properties in future research.
MeSH term(s)	Humans ; Osteoarthritis, Knee/psychology ; Concept Formation ; Pain ; Surveys and Questionnaires ; Exercise
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0286114
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Imprecise Visual Feedback About Hand Location Increases a Classically Conditioned Pain Expectancy Effect.

Chaves, Thais Cristina / Stanton, Tasha R / Grant, Ashley / Pulling, Brian W / Madden, Victoria J / Newport, Roger / Moseley, G Lorimer

The journal of pain

2021 Volume 22, Issue 6, Page(s) 748–761

Abstract: We tested the hypotheses that rendering sensory input about hand location imprecise increases a classically conditioned pain expectancy effect, increases generalization of the effect to novel locations and reduces extinction of the effect. Forty healthy ... ...

Abstract	We tested the hypotheses that rendering sensory input about hand location imprecise increases a classically conditioned pain expectancy effect, increases generalization of the effect to novel locations and reduces extinction of the effect. Forty healthy volunteers performed movements with their right hand along predefined paths. Each path passed through 2 locations that were defined as either i) the conditioned stimulus (CS+; paired with a painful unconditioned stimulus), or ii) unpaired (CS-). During acquisition phase, participants watched their hand as they moved it. Participants were randomly allocated to an Imprecise group, for whom visual feedback of the hand was offset 30 to 50 mm from its true location, or a Precise group, for whom vision was not disrupted. In the test phase, participants moved their hands to 5 locations-the CS+, CS-, and 3 locations that lay between the 2 ("generalization stimuli"). Our primary hypothesis was supported-pain expectancy was greater at the CS+ location in the Imprecise group than in the Precise group (6.9 [SD = 1.9] vs 5.4 [SD = 2.5], P= .02). Pain expectancies generalized to novel locations similarly in both groups and there was no difference in extinction between groups. Our primary hypothesis was supported but our subsequent hypotheses were not. PERSPECTIVE: We conditioned pain expectancy at a certain location of one hand, even though most participants were unaware of the contingency. Conditioned pain expectancy was greater when sensory information about location was less precise. This adds support to the possibility that associative learning may play a role in the progression of an acute pain episode to a more generalized pain disorder.
MeSH term(s)	Adult ; Anticipation, Psychological/physiology ; Association Learning/physiology ; Conditioning, Classical/physiology ; Feedback, Sensory/physiology ; Female ; Hand/physiology ; Humans ; Illusions/physiology ; Male ; Nociceptive Pain/physiopathology ; Space Perception/physiology ; Visual Perception/physiology ; Young Adult
Language	English
Publishing date	2021-01-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2018789-0
ISSN	1528-8447 ; 1526-5900
ISSN (online)	1528-8447
ISSN	1526-5900
DOI	10.1016/j.jpain.2021.01.004
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Article ; Online: The effect of knee resizing illusions on pain and swelling in symptomatic knee osteoarthritis: a case report.

MacIntyre, Erin / Sigerseth, Maja / Pulling, Brian W / Newport, Roger / Stanton, Tasha R

Pain reports

2019 Volume 4, Issue 6, Page(s) e795

Abstract: Introduction: Resizing illusions that manipulate perceived body size are analgesic in some chronic pain conditions. Little is known whether such illusions may also alter other physiological features, such as swelling.: Objectives: To determine the ... ...

Abstract	Introduction: Resizing illusions that manipulate perceived body size are analgesic in some chronic pain conditions. Little is known whether such illusions may also alter other physiological features, such as swelling. Objectives: To determine the effects of a knee resizing illusion on knee pain and swelling in symptomatic osteoarthritis. Methods: This case study was extracted from a larger study evaluating the analgesic effects of resizing illusions in people with knee osteoarthritis. A mediated reality system (alters real-time video) was used to provide resizing "stretch" and "shrink" illusions of the knee. Knee pain intensity (0-100 numerical rating scale) was measured before and after illusion and after sustained (3 minutes) and repeated (n = 10) illusions. In this case study, knee swelling (leg circumference below, at, and above the knee) was also measured. Results: The 55-year-old male participant reported a long history of episodic knee pain and swelling that was subsequently diagnosed as severe osteoarthritis in 2013. In the first testing session, the participant experienced an increase in pain with the shrink illusion and a decrease in pain with stretch illusion. A noticeable increase in knee swelling was also observed. Thus, in sessions 2/3, swelling was also assessed. The stretch illusion decreased pain to the largest extent, but resulted in increased knee swelling. Repeated and sustained stretch illusions had cumulative analgesic effects but resulted in cumulative increases in swelling. While the shrink illusion increased pain, sustained (∼10 minutes) visual minification of the entire knee and leg reduced both pain and swelling. Conclusion: Our case report suggests that both pain and swelling may be modifiable by altering body-relevant sensory input in symptomatic knee osteoarthritis.
Language	English
Publishing date	2019-11-21
Publishing country	United States
Document type	Case Reports
ISSN	2471-2531
ISSN (online)	2471-2531
DOI	10.1097/PR9.0000000000000795
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Suggestions in Hypnosis to Aid Pain Education (SHAPE) in People with Chronic Low-Back Pain: A Pilot Feasibility Randomized, Controlled Trial.

Pulling, Brian W / Braithwaite, Felicity A / Moseley, G Lorimer / Jensen, Mark P / Burke, Anne L J / Collins, Kathryn L / Hull, Melissa J / Jones, Hannah G / Cyna, Allan M / Ferencz, Nicki / Stanton, Tasha R

The International journal of clinical and experimental hypnosis

2022 Volume 70, Issue 3, Page(s) 251–276

Abstract: Chronic low back pain (CLBP) is a debilitating and burdensome condition, and new treatment strategies are needed. This study aimed to evaluate (1) the feasibility of undertaking a controlled clinical trial investigating a novel intervention for people ... ...

Abstract	Chronic low back pain (CLBP) is a debilitating and burdensome condition, and new treatment strategies are needed. This study aimed to evaluate (1) the feasibility of undertaking a controlled clinical trial investigating a novel intervention for people with CLBP: hypnotically reinforced pain science education, and (2) the acceptability of the intervention as rated by participants.
MeSH term(s)	Chronic Pain/therapy ; Feasibility Studies ; Humans ; Hypnosis ; Low Back Pain/therapy ; Suggestion
Language	English
Publishing date	2022-08-15
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	218267-1
ISSN	1744-5183 ; 0020-7144
ISSN (online)	1744-5183
ISSN	0020-7144
DOI	10.1080/00207144.2022.2105147
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Article ; Online: Erratum: An Extension Study Using Hypnotic Suggestion as an Adjunct to Intravenous Sedation.

Pulling, Brian W / Braithwaite, Felicity A / Jensen, Mark P / Moseley, G Lorimer / Mackey, Edward F / Stanton, Tasha R

The American journal of clinical hypnosis

2020 Volume 62, Issue 4, Page(s) 427–428

Language	English
Publishing date	2020-03-26
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	219387-5
ISSN	2160-0562 ; 0002-9157
ISSN (online)	2160-0562
ISSN	0002-9157
DOI	10.1080/00029157.2020.1713630
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Article ; Online: The EPIPHA-KNEE trial: Explaining Pain to target unhelpful pain beliefs to Increase PHysical Activity in KNEE osteoarthritis - a protocol for a multicentre, randomised controlled trial with clinical- and cost-effectiveness analysis.

Stanton, Tasha R / Braithwaite, Felicity A / Butler, David / Moseley, G Lorimer / Hill, Catherine / Milte, Rachel / Ratcliffe, Julie / Maher, Carol / Tomkins-Lane, Christy / Pulling, Brian W / MacIntyre, Erin / Esterman, Adrian / Stanford, Ty / Lee, Hopin / Fraysse, Francois / Metcalf, Ben / Mouatt, Brendan / Bennell, Kim

BMC musculoskeletal disorders

2021 Volume 22, Issue 1, Page(s) 738

Abstract: Background: Despite well-established benefits of physical activity for knee osteoarthritis (OA), nine of ten people with knee OA are inactive. People with knee OA who are inactive often believe that physical activity is dangerous, fearing that it will ... ...

Abstract	Background: Despite well-established benefits of physical activity for knee osteoarthritis (OA), nine of ten people with knee OA are inactive. People with knee OA who are inactive often believe that physical activity is dangerous, fearing that it will further damage their joint(s). Such unhelpful beliefs can negatively influence physical activity levels. We aim to evaluate the clinical- and cost-effectiveness of integrating physiotherapist-delivered pain science education (PSE), an evidence-based conceptual change intervention targeting unhelpful pain beliefs by increasing pain knowledge, with an individualised walking, strengthening, and general education program. Methods: Two-arm, parallel-design, multicentre randomised controlled trial involving 198 people aged ≥50 years with painful knee OA who do not meet physical activity guideline recommendations or walk regularly for exercise. Both groups receive an individualised physiotherapist-led walking, strengthening, and OA/activity education program via 4x weekly in-person treatment sessions, followed by 4 weeks of at-home activities (weekly check-in via telehealth), with follow-up sessions at 3 months (telehealth) and 5 and 9 months (in-person). The EPIPHA-KNEE group also receives contemporary PSE about OA/pain and activity, embedded into all aspects of the intervention. Outcomes are assessed at baseline, 12 weeks, 6 and 12 months. Primary outcomes are physical activity level (step count; wrist-based accelerometry) and self-reported knee symptoms (WOMAC Total score) at 12 months. Secondary outcomes are quality of life, pain intensity, global rating of change, self-efficacy, pain catastrophising, depression, anxiety, stress, fear of movement, knee awareness, OA/activity conceptualisation, and self-regulated learning ability. Additional measures include adherence, adverse events, blinding success, COVID-19 impact on activity, intention to exercise, treatment expectancy/perceived credibility, implicit movement/environmental bias, implicit motor imagery, two-point discrimination, and pain sensitivity to activity. Cost-utility analysis of the EPIPHA-KNEE intervention will be undertaken, in addition to evaluation of cost-effectiveness in the context of primary trial outcomes. Discussion: We will determine whether the integration of PSE into an individualised OA education, walking, and strengthening program is more effective than receiving the individualised program alone. Findings will inform the development and implementation of future delivery of PSE as part of best practice for people with knee OA. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12620001041943 (13/10/2020).
MeSH term(s)	Australia ; COVID-19 ; Cost-Benefit Analysis ; Exercise ; Exercise Therapy ; Humans ; Multicenter Studies as Topic ; Osteoarthritis, Knee/diagnosis ; Osteoarthritis, Knee/therapy ; Pain ; Quality of Life ; Randomized Controlled Trials as Topic ; SARS-CoV-2
Language	English
Publishing date	2021-08-28
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ISSN	1471-2474
ISSN (online)	1471-2474
DOI	10.1186/s12891-021-04561-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: People with painful knee osteoarthritis hold negative implicit attitudes towards activity.

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Article ; Online: Item development and pre-testing of an Osteoarthritis Conceptualisation Questionnaire to assess knowledge and beliefs in people with knee pain.

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Article ; Online: Imprecise Visual Feedback About Hand Location Increases a Classically Conditioned Pain Expectancy Effect.

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Article ; Online: The effect of knee resizing illusions on pain and swelling in symptomatic knee osteoarthritis: a case report.

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Article ; Online: Suggestions in Hypnosis to Aid Pain Education (SHAPE) in People with Chronic Low-Back Pain: A Pilot Feasibility Randomized, Controlled Trial.

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Article ; Online: Erratum: An Extension Study Using Hypnotic Suggestion as an Adjunct to Intravenous Sedation.

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Article ; Online: The EPIPHA-KNEE trial: Explaining Pain to target unhelpful pain beliefs to Increase PHysical Activity in KNEE osteoarthritis - a protocol for a multicentre, randomised controlled trial with clinical- and cost-effectiveness analysis.

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