Week 8 Flashcards
Q1: What is the main goal of the current exercise approach in pain management?
To reinforce that movement ≠ damage or threat by using activities that promote appropriate movement and synaptic learning.
What are the three key aspects of this exercise approach?
- Reduce threatening input.
- Use graded activities to reconcile threat-tissue mismatch.
- Expose to threatening inputs to upgrade tolerance.
What is pacing?
A technique to manage activity intensity, duration, and frequency to avoid flare-ups and gradually increase physical function.
What are the 5 attributes of pacing?
Action – requires active participation.
Time – managed over time.
Balance – between activity and rest.
Learning – conscious skill acquisition.
Self-management – independently directed.
When is pacing appropriate?
When activity is disrupted by pain.
Boom/bust activity patterns.
Low pain self-management knowledge.
What’s the goal of pacing and graded activity?
To activate the pain neuromatrix without triggering pain, by upgrading tolerance through exposure in a safe, graded way.
What is the “Twin Peaks” model?
A visual model showing tissue tolerance and flare-up thresholds, used to guide safe activity within homeostasis.
In the Twin Peaks model, what do the acronyms stand for?
TT = Tissue Tolerance
PBP = Protect by Pain
NPBP = New Post-Injury Protection Line
BL = Baseline
FUL = Flare-Up Line
NTT = New Tissue Tolerance
What are the axes in the Homeostasis model?
Y-axis: Intensity/load
X-axis: Frequency/duration
Used to maintain activity within the envelope of function without flaring up.
How do you prescribe pacing? (Step 1)
Set a meaningful physical goal (e.g. walk the dog).
Break it into manageable tasks. small but lots
How do you prescribe pacing? (Step 2 – Set baseline)
Try the activity for 2 days, average it.
Reduce the average by 20% to find the baseline.
Stick to that level for 1 week.
What should be done during a flare-up?
Don’t panic.
Cut back activity (not stop).
Use positive self-talk.
Keep rest under 30 mins.
Monitor progress.
What is the goal during a flare-up?
To manage it calmly, continue some level of activity, and avoid full regression.
What tool helps identify what to pace?
The Patient-Specific Functional Scale (PSFS) – helps set goals and track meaningful progress.
Name 5 pain self-management strategies.
Activity pacing
Goal setting
Thought challenging
Desensitisation
Stretching exercises
What predicts better pain outcomes?
Consistently practicing 4/5 self-management strategies during treatment.
How effective is exercise for chronic conditions like OA?
Proven to be significantly beneficial; further studies deemed unnecessary as of 2002.
