PhD ceremony Mr. J.M. Hallegraeff: Common musculoskeletal disorders in primary care physiotherapy: assessment and intervention. Acute low back pain and nocturnal leg cramps

PhD ceremony: Mr. J.M. Hallegraeff, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Common musculoskeletal disorders in primary care physiotherapy: assessment and intervention. Acute low back pain and nocturnal leg cramps

Promotor(s): prof. C.P. van der Schans

Faculty: Medical Sciences

There is tension between the needs of patients with acute nonspecific low back pain and guidelines that recommend to wait with treatment. Modifiable personal factors such as expectations and perceptions should be inventoried in the acute stage of low back pain to assess the risk for transition to chronic low back pain.

Patients with negative recovery expectations to recover from acute low back pain have a twice as high risk to develop chronic low back pain, compared to patients without such negative expectations. Pain perception importantly influences a patients’ coping style. A passive or inadequate coping style was also found to increase the risk for transition to chronic low back pain. The Illness Perception Questionnaire-Brief (IPQ-B) is frequently used to measure pain perception but the psychometric properties in the population with low back pain were not yet investigated. In a cross-sectional psychometric study we showed that the B-IPQ is a reliable and valid instrument for patients with acute low back pain. In another cross-sectional study we found that the Low Back Pain Perception Questionnaire (LBPPS) did not produce adequate and acceptable results for patients with acute low back pain. We advise to use this instrument with caution.

In a RCT we investigated the effect of manual therapy in the acute stage of patients with low back pain (<16 days) without appearance of pain distal to the knee. The results showed a stronger decrease in activity limitations than physiotherapy in this acute stage of low back pain. Finally, in another RCT we investigated the effect of stretching the hamstrings and calf muscles by older patients (> 55 years) with nocturnal leg cramps (NLC) before going to bed. In the six weeks trial a significant decrease in pain and frequency of NLC was demonstrated.