Lecture 4 Flashcards
Limitations of self report questionnaires
Validity
Language fine, motor skills, concentration barriers
Time consuming
Affect rapport
Not a substitute for good clinical interview
Benefits of self report questionnaires
Efficient data collection
Normative values
Comprehensive
Patient feels supported
Assist with diagnosis
Screening tools
Confirms clinically significant change when used pre-post treatment
Define kinesiophobia
Fear of movement
Define self-efficacy
Refers to one’s confidence regarding one’s ability to function effectively while in pain
Own ability to achieve a desired outcome
What are the 5 stage of behaviour change?
Precontemplation (unaware of problem)
Contemplation (aware of problem and of desired behaviour change)
Preparation (intends to take action)
Action (practices the desired behaviour)
Maintenance (works to sustain the behaviour change)
What are the 3 forms of catastrophising?
Magnification
Rumination
Helplessness
What is the locus of control
Degree to which people believe that they have control over the outcome of events in their lives
What does strong internal locus of control mean?
Believe events in their life are primarily a result of their own actions
What does strong external locus of control mean?
Blame or praise external factors
Sympathetic nervous system and fight or flight response
SNS activates fight or flight during stress
- involves release of stress hormones (epinephrine and norepinephrine) which modulate pain perception by enhancing transmission of pain signals
Sympathetic nervous system and inflammation
SNS modulates inflammation
Can suppress or enhance inflammation depending on context and signalling pathways
HPA Axis in acute threat
- Acute threat activates autonomic nervous system
- elevate blood sugar levels and metabolism
- secretion of epinephrine and norepinephrine from adrenal gland signals start of HPA axis
- hypothalamus releases corticotropin releasing hormon (CRH)
- CRH acts on pituitary gland to release adrenocorticotrophic hormon (ACTH)
- ACTH signals adrenal cortex to release glucocorticoids (cortisol, etc)
- Cortisol produces and maintains high levels of glucose for rapid response after injury/threat
HPA Axis in chronic threat
- Prolonged HPA axis activation leads to cortisol imbalance
- to maintain high level of glucose it will break down protein in muscle and inhibit ongoing replacement of calcium in bone
- sustained cortisol release can produce myopathy, weakness, fatigue and decalcification of bone. As well as accelerate neural degeneration of hippocampus during aging and suppress immune system
Relationship between pain and disability
bidirectional and complex
What is the goal of cortisol release for acute threat
Reduce threat
get back to homeostasis
