Objectives: In a substantial portion of patients with axial spondyloarthritis (axSpA), disease activity scores remain high despite anti-inflammatory treatment. This is possibly due to factors beyond active inflammation including different pain mechanisms and psychosocial factors. Therefore, our aim was to build a biopsychosocial model to explore the interrelationships of Axial Spondyloarthritis Disease Activity Score (ASDAS) with central sensitization (CS), psychological and lifestyle factors in patients with axSpA.
View Article and Find Full Text PDFObjective: Sjögren's disease (SjD) can have a major impact on sexual functioning, but this topic has received limited attention in research and clinical practice. This qualitative study investigated how SjD affects sexual experience and functioning in both women and men.
Method: Reflexive thematic analysis was performed based on in-depth interviews with patients with SjD.
Background: The internet is increasingly used as a primary source of information for patients with musculoskeletal pain. Private physiotherapy practices provide informative content on low back pain (LBP) and neck pain (NP) on their websites, but the extent to which this information is biopsychosocial, guidelines-consistent, and fear-inducing is unknown. The aim of this study was to analyse the information on websites of private physiotherapy practices in the Netherlands about LBP and NP regarding consistency with the guidelines and the biopsychosocial model and to explore the use of fear-inducing language.
View Article and Find Full Text PDFBackground: In many patients with axial spondyloarthritis (axSpA), pain persists despite anti-inflammatory medication. Quantitative sensory testing (QST) indirectly assesses altered somatosensory function, though its clinical practicality is limited. The Central Sensitisation Inventory (CSI) could be an alternative in the initial assessment of central sensitisation (CS).
View Article and Find Full Text PDFBackground: The modified Short QUestionnaire to ASsess Health-enhancing physical activity (mSQUASH) was originally developed and validated in Dutch patients with axial spondyloarthritis (axSpA). To support world-wide distribution, applicability and comparability of measuring physical activity, our aim was to perform translation and cross-cultural adaptation of the mSQUASH into English, field testing in other rheumatic diseases and clinical validation in patients with axSpA.
Methods: The Dutch mSQUASH was translated into English according to forward-backward Beaton protocol.
Purpose: This study aims to explore the meaningful contributions of rehabilitation for participants living with persistent pain.
Materials And Methods: A phenomenological methodology was used. Thirteen purposefully selected participants, who self-identified as substantially improved from persistent pain due to rehabilitation, were interviewed in-depth.
Objective: To evaluate daily physical activity (PA) in relation to psychosocial factors, such as anxiety, depression and different types of coping strategies, as well as patient- and disease-related factors in patients with axial spondyloarthritis (axSpA).
Methods: Consecutive outpatients from the Groningen Leeuwarden AxSpA (GLAS) cohort completed the modified Short Questionnaire to assess health-enhancing PA (mSQUASH), Hospital Anxiety and Depression Scale (HADS) and Coping with Rheumatic Stressors (CORS) questionnaires, as well as standardized patient- and disease-related assessments. Univariable and multivariable linear regression analyses and comparison of lowest and highest PA tertiles were performed to explore associations between the HADS, CORS, patient- and disease-related factors and PA.
Objective: The objective of this study was to explore to what extent patients with axial spondyloarthritis (axSpA) link experienced pain in the neck, back, and hips to inflammation and/or structural damage.
Methods: Patients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort visiting the outpatient clinic between 2016 and 2019 filled out two additional questions in relation to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) question 2: (1) "To what extent do you think the pain you experience in your neck, back, and hips is related to inflammation caused by axSpA?" and (2) "To what extent do you think the pain you experience in your neck, back, and hips is related to damage of the spine and joints caused by axSpA?" Answers had to be depicted on a numeric rating scale from 0 (none) to 10 (very much); a difference of ≥2 points between the scores of these questions was considered clinically relevant in favor of the highest scoring question.
Results: A total of 688 patients with axSpA (24% with nonradiographic axSpA [nr-axSpA]) were included (62% male, mean ± SD age 48 ± 14 years, and mean ± SD Ankylosing Spondylitis Disease Activity Score [ASDAS] 2.
Introduction: Within the EULAR recommendations, patient education (PE) is stated as the basis of the management of axial spondyloarthritis (axSpA). However, educational needs are scarcely qualitatively studied in axSpA. Therefore, we aimed to explore experiences and needs of PE in patients with axSpA.
View Article and Find Full Text PDFUnlabelled: Measurement properties of the Working Alliance Inventory (WAI) and its various translations and adaptations for specific target groups have been investigated for over 30 years. No systematic review analyzing studies on measurement properties of the WAI has been conducted to date. COnsensus-based Standards for the selection of health Measurements INstruments (COSMIN) were developed for conducting high-quality systematic reviews on measurement properties in a transparent and standardized way.
View Article and Find Full Text PDFObjective: Since decades, supervised group exercise (SGE) is recommended for people with axial spondyloarthritis (axSpA). This study examines if weekly SGE contributes to fulfillment of exercise recommendations in axSpA patients.
Methods: Cross-sectional data from three studies with axSpA patients in The Netherlands, including two with outpatient populations (n = 196 and n = 153) and one with SGE participants (n = 128), were analysed.
Introduction: Persistent pain has large potential impact on quality of life (QoL). During the course of the disease, many patients with axial spondyloarthritis (axSpA) report persistent pain. Central sensitization (CS) may explain part of this chronic pain.
View Article and Find Full Text PDFAim: Adaptation of the Short QUestionnaire to Assess Health-enhancing physical activity (SQUASH) in order to improve measurement properties in axSpA patients.
Methods: The original SQUASH was adapted using a qualitative stepwise approach with in-depth interviews including healthcare professionals and patients. Content validity was explored by comparing modified-SQUASH (mSQUASH) and original SQUASH.
Purpose: This study aimed to explore factors that influence participants' perceptions of the therapeutic alliance with healthcare professionals; their participation in the alliance; and their commitment to treatment in a multidisciplinary pain rehabilitation setting.
Materials And Methods: A qualitative research-design was used and 26 participants in a multidisciplinary pain rehabilitation program were interviewed in-depth.
Results: Initially, participants reported to be satisfied with their healthcare professionals.
The mean age of lung transplant recipients has significantly increased in recent decades. Elderly recipients have a higher risk of developing herpes zoster (HZ), and they have in general a worse response to vaccination than younger persons do. We investigated the relationship between the humoral and cellular immune response to a live-attenuated HZ vaccine (Zostavax, Merck Sharp and Dohme) and the frequencies of T and B cell subsets, especially aged cell subsets (CD28-T cells and age associated B cells, ABCs).
View Article and Find Full Text PDFObjectives: Many patients with axial spondyloarthritis (axSpA) report persistent pain even when treated with anti-inflammatory agents. Our aim was to explore the presence of central sensitization (CS) and different types of illness perceptions in patients with axSpA, and to assess their associations with disease activity assessments.
Methods: Consecutive outpatients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort were included.
Background: Immune checkpoints are crucial molecules in maintaining a proper immune balance. Even though age and sex are known to have effects on the immune system, the interplay between age, sex and immune checkpoint expression by T cells is not known. The aim of this study was to determine whether age and sex affect immune checkpoint expression by T cells and if age and sex affect the kinetics of immune checkpoint expression following ex vivo stimulation.
View Article and Find Full Text PDFBackground: Herpes zoster (HZ) is caused by the reactivation of varicella-zoster virus (VZV). Patients with lung transplants are at high risk for HZ owing to their immunocompromised status and the need for lifelong immunosuppression. In this study, patients on the waiting list for lung transplantation were vaccinated by a live-attenuated HZ vaccine (Zostavax, Merck Sharp & Dohme), and the safety and immunogenicity of this vaccine were studied.
View Article and Find Full Text PDFBackground: Healthcare practitioner beliefs influence patients' beliefs and health outcomes in musculoskeletal (MSK) pain. A validated questionnaire based on modern pain neuroscience assessing Knowledge and Attitudes of Pain (KNAP) was unavailable.
Objectives: The aim of this study was to develop and test measurement properties of KNAP.
Objectives: Ultrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical factors in GCA.
Methods: This is a prospective study including 89 patients suspected of having GCA, of whom 58 had a confirmed clinical diagnosis of GCA after 6 months follow-up.
To explore perceptions and preferences of children, parents, and physical therapists regarding the therapeutic alliance in pediatric physical therapy in a rehabilitation setting. Qualitative phenomenological analysis of interviews with children ( = 10), their parents ( = 10), and physical therapists ( = 10). Three themes were identified: importance of trust in the physical therapist, transparency in sharing information, and negotiation concerning goals and tasks of treatment.
View Article and Find Full Text PDFTo reduce ceiling effects on domain scores (Task, Goal, and Bond) of the Working Alliance Inventory (WAI)-Rehabilitation Dutch Version by changing response scales and using Visual Analogue Scales (VASs). Clients, who had at least three treatment sessions prior, randomly received one of the three versions of the WAI-Rehabilitation Dutch Version, using items with a balanced Likert scale, Positive-Packed Likert scale or VAS. Primary outcome was percentage of ceiling effects in total- and domain scores, secondary outcomes were construct validity and internal consistency of the three versions.
View Article and Find Full Text PDFPhysiother Theory Pract
December 2019
: In rehabilitation, therapeutic alliance is associated with improvements in clinical outcomes. The Working Alliance Inventory (WAI) measures therapeutic alliance and is frequently used in rehabilitation research; however, it has not been validated for rehabilitation. : To determine content validity, internal consistency and construct validity of the Working Alliance Inventory Rehabilitation Dutch Version (WAI-ReD).
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