UNIT 3: Wk 2: Pain Interventions

Question 1

What are the two intervention approaches to help with pain?

Answer 1

• education
• graded exposure

Question 2

Top Down approach to intervention

Answer 2

Cognitive based interventions
- educate about pain neuroscience
- graded motor imagery
- cognitive behavioral therapy (CBT)
- mindfulness meditation

Question 3

Bottom Up approach to pain interventions

Answer 3

Physical interventions
- manual therapy
- motor learning
- peripheral discrimination training

Question 4

Biopsychosocial approach

Answer 4

Looks at whole person - pain happens between biological, psychological, and social
Recognize threat (fear, aging, etc )

Question 5

Cognitive behavioral therapy

Answer 5

Thoughts, emotional responses, psychological and behavioral responses interact and influence one another

• strategies to change patterns of thoughts and regulate emotions
• cope more effectively with pain and stressors

Question 6

CBT Phases

Answer 6

1. Assessment
2. Reconceptualization (largest portion)
3. Skill acquisition
4. Skill consolidating and application training
5. Generalization and maintenance
6. Post treatment assessment and follow up

Question 7

CBT influence in PT

Answer 7

• WE become more aware of our perceptions of how we view pt
• listening to understand— not to drop an answer
• teach breathing focus, relaxation, affirmations, distraction, self manage mood and pain

Question 8

Pain Neuroscience Education

Answer 8

Trying to eliminate the perception of danger that the patient is experiencing
- people want to learn about their pain — not anatomy and biomechanics
- actual pain science

Question 9

T or F: education is therapy

Answer 9

TRUE — don’t say “their pain is in their head”

Question 10

Advice for pts

Answer 10

• do aerobic activity (brisk 10 min walk) LOG ACTIVITIES
• sleep hygiene (8hrs)
• medicine - antidepressants ‘
• goals and packing- break tasks up into achievable chunks

Question 11

Mindfulness Meditation

Answer 11

• ## non elaborative, non judgmental awareness of thought, feelings, behaviors

Question 12

Focused attention mindfulness meditation

Answer 12

Usually focus on breathing

Question 13

Open monitoring mindfulness meditation

Answer 13

Non focused, open minded awareness
- letting mind go - just letting go

Question 14

Mechanisms of Mindfulness Meditation

Answer 14

• enhance cognitive and emotional control
• altered contextual evaluation
• change attention, emotional response, and acceptance and coping to pain

Question 15

T or F: you can tap into parasympathetic nervous system via breath control

Answer 15

True

Question 16

Graded motor imagery

Answer 16

• brain exercise that works at synaptic level to restore map of body in brain

It reorganizes body schema, self awareness, acceptance, self perception

Question 17

Progression of GMI

Answer 17

Low threat to high threat

Observation watching activities —> L/R judgements —> Imagining movements —> mirror —> physical movements/activities

Question 18

Laterality recognition

Answer 18

Ability to distinguish R from L (of the body part in pain)
- starts as low threat images in relaxed positions then goes to higher threat (more painful position)
- 2x/day

Requires metal and special recognition
*ppl can be slower recognizing and can have pain during this

Question 19

Motor Imagery

Answer 19

Asking the person to imagine themselves moving and feeling themselves moving
- 2x/day

Progression: low threat - posting position and still; high threat - painful position or movement/activity

Question 20

Mirror therapy

Answer 20

Trick the brain by replacing the injured part and seeing the body part moving without the pain
“Retraining the brain to experience”

Question 21

Bottom up intervention

Answer 21

Try to remap the cortex using input from body

Question 22

Sensory discrimination training & what type of pt

Answer 22

Aims to reverse cortical reorganization (neuroplasticity) - doesn’t require any movement

Sharp/dull; sensation testing

• for patients w high pain levels and decreased tactile acuity