Exposure to physical movement in chronic back pain patients: no evidence for generalization across different movements
Abstract
This study investigated whether the effects of exposure to one movement generalize towards another dissimilar movement in patients with low back pain. Thirty-nine patients (11 male, 28 female; mean age=43.49 yrs) were requested to perform two movements twice, i.e. bending forward and straight leg raising. During each of the four trials, baseline pain, expected pain and experienced pain were recorded. Analyses revealed that patients initially overpredicted pain, but after exposure the overprediction was readily corrected. This exposure effect did not generalize towards another dissimilar movement. The above pattern of results was only characteristic for patients reporting a high frequency of catastrophic thinking about pain. Low pain catastrophizers did not overpredict pain. The results are discussed in terms of the view that exposure may be better conceived of as the learning of exceptions to a general rule.
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Pain catastrophising is associated with increased use of healthcare services and longer hospital stays.
“increased use of healthcare services and longer hospital stays [15,16]”
From Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: A randomised controlled trial (2011) · cites this paper as [15]
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“…somewhat limited generalizability from the treatment clinic to the home environment, as well as limited transfer of learning across discrete physical activities (Crombez et al., 2002; Goubert, Crombez, & Danneels, 2005; Goubert, Crombez, & Lysens, 2005; Goubert et al., 2002; Trost et al., 2008).”
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“Also in chronic low back pain patients attitude change is a dynamic and gradual process (Crombez et al., in press; Goubert et al., 2002).”
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Self-citationOptimizing Long-term Outcomes of Exposure for Chronic Primary Pain from the Lens of Learning Theory
Gatzounis, R., den Hollander, M., & Meulders, A. (2021) · Journal of Pain · doi:10.1016/j.jpain.2021.04.012 · Cited by 29 · see citing works
The psychology of chronic pain and its management
Vlaeyen, J. W. S., Crombez, G., & Goubert, L. (2007) · Physical Therapy Reviews · doi:10.1179/108331907x223001 · Cited by 27 · see citing works
Self-citationFinley, M. A., & Euiler, E. (2019) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2019.1565717 · Cited by 27 · see citing works
Learning about pain through observation: the role of pain-related fear
Trost, Z., France, C. R., Vervoort, T., Lange, J. M., & Goubert, L. (2012) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9483-4 · Cited by 23 · see citing works
Self-citationHuijnen, I. P. J., Verbunt, J., Peters, M. L., & Seelen, H. A. M. (2009) · European Journal of Pain · doi:10.1016/j.ejpain.2009.10.014 · Cited by 20 · see citing works
“It may be assumed that especially patients with high fear of movement are prone to overestimate the activity-related pain, although previous studies found only weak or contradictory evidence for this (McCracken et al., 1993; Crombez et al., 2002; Goubert et al., 2002, 2005).”
BackgroundResultParsons, T. D., & Trost, Z. (2014) · Intelligent systems reference library · doi:10.1007/978-3-642-54816-1_25 · Cited by 19 · see citing works
“Finally, GEXP is challenged by the generalizability of treatment gains from the treatment clinic to the home environment, as well across discrete physical activities [20, 44, 46, 132].”
MethodGeneralizability of harm and pain expectations after exposure in chronic low back pain patients
Riecke, J., Rief, W., Vlaeyen, J. W. S., & Glombiewski, J. A. (2020) · European Journal of Pain · doi:10.1002/ejp.1604 · Cited by 19 · see citing works
“In contrast, preceding experimental studies concluded that instead of generalizing their exposure experience back pain patients learned an exception of a rule (Crombez et al., 2002; Goubert et al., 2002).”
ResultDaily diaries reveal influence of pessimism and anxiety on pain prediction patterns
Finan, P., Zautra, A., & Tennen, H. (2008) · Psychology & Health · doi:10.1080/08870440802108892 · Cited by 18 · see citing works
“For example, Goubert, Francken, Crombez, Vansteenvegen, and Lysens ( 2002 ) reported that over predictions were easily corrected only among high catastrophisers and for a specific controlled bodily movement.”
BackgroundGeneralization of exposure in vivo in Complex Regional Pain Syndrome type I
den Hollander, M., de Jong, J. R., Onghena, P., & Vlaeyen, J. W. S. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.103511 · Cited by 18 · see citing works
“Four previous experimental studies have investigated whether exposure to di ff erent movements enhanced generalization of extinction of pain-related fear in chronic low back pain patients (Crombez et al., 2002; Goubert, Crombez, & Lysens, 2005; Goubert et al., 2002; Trost et al., 2008).”
BackgroundLiebenson, C. (2011) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2011.11.003 · Cited by 10 · see citing works
Pain, Chronicity, and Disability
Sullivan, M. J. L., Martel, M. O., & Trost, Z. (2013) · Springer eBooks · doi:10.1007/978-1-4614-6214-9_8 · Cited by 8 · see citing works
Beeckman, M., Hughes, S., Kissi, A., Simons, L. E., & Goubert, L. (2019) · Journal of Pain · doi:10.1016/j.jpain.2019.02.013 · Cited by 7 · see citing works
Self-citationFinley, M. A., Euiler, E., Baehr, L. A., Gracely, E. J., Brownsberger, M. G., Schmidt-Read, M., Frye, S. K., Kallins, M., Summers, A., York, H. S., et al. (2021) · Spinal Cord Series and Cases · doi:10.1038/s41394-021-00415-4 · Cited by 6 · see citing works
Golchin, N., Janbozorgi, M., Alipour, A., & Agahheris, M. (2011) · Cited by 6 · see citing works
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Fear reduction in subacute whiplash-associated disorders: The royal road to recovery?
Meulders, A., & Vlaeyen, J. W. S. (2013) · Pain · doi:10.1016/j.pain.2013.01.004 · Cited by 4 · see citing works
“Experimental evidence, in fact, suggests that fear reduction established during ET generalizes poorly to new activities/contexts outside the clinic [4,10,11] (except for [16]).”
BackgroundExpositionstherapie bei chronischen Rückenschmerzen: Nicht ohne Verhaltensexperimente
Schemer, L., Riecke, J., & Glombiewski, J. A. (2020) · Verhaltenstherapie · doi:10.1159/000510169 · Cited by 3 · see citing works
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Stress Distribution and Displacement Analysis to Design of Patient Lifting Equipment
Keangin, P., Sakunsongbunsiri, M., Auttiya, K., & Kuntaraporn, T. (2019) · IOP Conference Series Materials Science and Engineering · doi:10.1088/1757-899x/501/1/012045 · Cited by 2 · see citing works
Graded exposure in de praktijk: de behandeling bij volwassenen
den Hollander, M., Huijnen, I. P. J., & Smeets, R. (2016) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-1106-4_4 · Cited by 2 · see citing works
Pain Catastrophizing and Fear of Movement: Detection and Intervention
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Pain catastrophizing and fear of movement: detection and intervention
Paré, C., & Sullivan, M. J. L. (2022) · doi:10.1002/9781119701170.ch27 · Cited by 2 · see citing works
Casser, H., Graf, M., & Kaiser, U. (2019) · Springer Reference Medizin · doi:10.1007/978-3-662-57487-4_21 · Cited by 1 · see citing works
Syrett, J., Evans, D. W., & Liew, B. X. W. (2022) · Applied Sciences · doi:10.3390/app13010220 · Cited by 1 · see citing works
Thompson, S., Evans, E. M., & Yli-Piipari, S. R. (2020) · International Journal of Physical Education Fitness and Sports · doi:10.34256/ijpefs2041 · Cited by 1 · see citing works
“Researchers, such as Crombez et al. (1996) and Goubert et al. (2002), have discovered that exposure through repetition of specific movements associated with participants’ perceptions of pain significantly decreased the fear regarding those exercises and the expectation of high levels of pain with…”
BackgroundFear Reduction through Exposure in Vivo
de Jong, J. R., & Vlaeyen, J. W. S. (2006) · Springer eBooks · doi:10.1007/978-3-540-29805-2_1490 · Cited by 1 · see citing works
Chronic Pain, Types of (Cancer, Musculoskeletal, Pelvic), Management of
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Cognitief-gedragsmatige behandeling van chronische pijn: een associatief leerperspectief
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You’ll never know if you never try
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Towards an understanding of physical activity in people with chronic low back pain
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- Authors
- Goubert, L., Francken, G., Crombez, G., Vansteenwegen, D., & Lysens, R.
- Affiliations
- Ghent University (BE)
- KU Leuven (BE)
- Universitair Ziekenhuis Leuven (BE)
- Corresponding author
- Goubert, Liesbet
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 40
- Issue
- 4
- Pages
- 415-429
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2038810749
- Cited by
- 96
- References
- 49
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 6 · 2019: 7 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 5
- FWCI
- 4.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic low back pain, forward bending, straight leg raise, pain anticipation
- MeSH terms
- Adult, Belgium, Female, Generalization, Psychological, Humans, Male, Middle Aged, Pain Measurement, Sick Role, Exercise, Low Back Pain
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