Jessica Van Oosterwijck - Academia.edu (original) (raw)

Papers by Jessica Van Oosterwijck

Physiotherapy, 2015

eS1091 personality, high levels of negative over positive affect, and a retroversed pelvis in hab... more eS1091 personality, high levels of negative over positive affect, and a retroversed pelvis in habitual standing. High levels of negative over positive affect, backward trunk lean in customary standing and depressed mood were significantly associated with a higher risk of NP.

Pain physician

Background: Exercise is an effective treatment for various chronic pain disorders, including fibr... more Background: Exercise is an effective treatment for various chronic pain disorders, including fibromyalgia, chronic neck pain, osteoarthritis, rheumatoid arthritis, and chronic low back pain. Although the clinical benefits of exercise therapy in these populations are well established (i.e. evidence based), it is currently unclear whether exercise has positive effects on the processes involved in chronic pain (e.g. central pain modulation).

Physiotherapy, 2015

of guidelines will facilitate physical therapists with the implementation of measurement instrume... more of guidelines will facilitate physical therapists with the implementation of measurement instruments in clinical practice.

Pain Practice, 2015

Conditioned pain modulation (CPM) is believed to play an important role in the development and ex... more Conditioned pain modulation (CPM) is believed to play an important role in the development and exacerbation of chronic pain, because dysfunction of CPM is associated with a shift in balance between pain facilitation and pain inhibition. In many patients with central sensitization, CPM is less efficacious. Besides that, efficacy of CPM is highly variable in healthy people. Consequently, it seems that several individual variables may influence CPM. A systematic review examining personal factors influencing CPM was conducted. This systematic review follows the PRISMA guidelines. "Pubmed" and "Web of Science" were searched using different synonyms of CPM. Full-text clinical reports addressing the influence of personal factors on CPM in healthy adults were included. Checklists for RCTs and case-control studies provided by the Dutch Institute for Healthcare Improvement (CBO) and the Dutch Cochrane Centre were utilized to assess methodological quality. Levels of evidence and strength of conclusion were assigned using the CBO guidelines. Forty-six articles were identified that reported the influence of personal factors on CPM. Quality assessment revealed 10 studies with a methodological quality less than 50% wherefore they were excluded (21.8%), resulting in a general total methodological quality score of 72.5%. Overall younger adult age, male gender, ovulatory phase, positive expectations, attention to the conditioning stimulus, and carrier of the 5-HTTLPR long allele result in better CPM. It is advised for future studies to take these factors into account. Further research regarding the influence of oral contraceptives, catastrophizing, information about conditioning stimulation, distraction, physical activity, and genetics on CPM magnitude is required.

Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology, Jan 30, 2015

Trunk extension exercises are used to train endurance and strength of the trunk extensor muscles.... more Trunk extension exercises are used to train endurance and strength of the trunk extensor muscles. Appropriate exercise dosage is crucial to achieve specific training effects, however literature describing the relation between the predetermined exercise intensity and the actual trunk extensors activity is scarce and inconclusive. To examine whether the actual activity of the thoracic and lumbar extensors during extensions exercises correspond with the predetermined intensity, electromyographic evaluation of the trunk extensors was performed during trunk extension exercises at various intensities expressed as percentages of 1-RM. The 1-RM was predetermined using 2 different methods: (1) through direct estimation by determining the maximum isometric force produced during semi-seated trunk extension on a Tergumed rehabilitation device, (2) through indirect estimation calculated based on the relation between the maximum number of repetitions of trunk extension from prone lying on a varia...

Pain physician

The awareness is growing that central sensitization is of prime importance for the assessment and... more The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists. Designing the first set of classification criteria for the classification of central sensitization pain. A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain. It is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differential classification of nociceptive versus central sensitization pain. For the former, the International Association for the Study of Pain diagnostic criteria are available for diagnosing or excluding neuropathic pain. For the latter, clinicians are advised to screen their patients for 3 major classification criteria, and use them to complete...

Pain physician

Until now, there is no firm evidence for conservative therapy in patients with chronic Whiplash A... more Until now, there is no firm evidence for conservative therapy in patients with chronic Whiplash Associated Disorders (WAD). While chronic WAD is a biopsychosocial problem, education may be an essential part in the treatment and the prevention of chronic WAD. However, it is still unclear which type of educative intervention has already been used in WAD patients and how effective such interventions are. This systematic literature study aimed at providing an overview of the literature regarding the currently existing educative treatments for patients with whiplash or WAD and their evidence. Systematic review of the literature. A systematic literature search was conducted in the following databases: Pubmed, Springerlink, and Web of Science using different keyword combinations. We included randomized controlled clinical trials (RCT) that encompass the effectiveness of education for patients with WAD. The included articles were evaluated on their methodological quality. Ten RCT's of m...

The Journal of Headache and Pain, 2013

Over the past decades, scientific understanding of unexplained chronic pain disorders has increas... more Over the past decades, scientific understanding of unexplained chronic pain disorders has increased substantially. Several chronic musculoskeletal pain disorders may be explained by alterations in central nervous system processing. More specifically, the responsiveness of central neurons to input from unimodal and polymodal receptors is augmented, resulting in a pathophysiological state corresponding to central sensitization, characterized by generalized or widespread hypersensitivity. Central sensitization encompasses altered sensory processing in the brain, impaired functioning of top-down anti-nociceptive mechanisms, and (over)activation of top-down and bottomup pain facilitatory pathways which augment nociceptive transmission. Importantly, a different 'pain signature' arises in the brain of those with chronic musculoskeletal pain and central sensitization.

Journal of rehabilitation research and development, 2011

Chronic whiplash is a debilitating condition characterized by increased sensitivity to painful st... more Chronic whiplash is a debilitating condition characterized by increased sensitivity to painful stimuli, maladaptive illness beliefs, inappropriate attitudes, and movement dysfunctions. Previous work in people with chronic low back pain and chronic fatigue syndrome indicates that pain neurophysiology education is able to improve illness beliefs and attitudes as well as movement performance. This single-case study (A-B-C design) with six patients with chronic whiplash associated disorders (WAD) was aimed at examining whether education about the neurophysiology of pain is accompanied by changes in symptoms, daily functioning, pain beliefs, and behavior. Periods A and C represented assessment periods, while period B consisted of the intervention (pain neurophysiology education). Results showed a significant decrease in kinesiophobia (Tampa Scale for Kinesiophobia), the passive coping strategy of resting (Pain Coping Inventory), self-rated disability (Neck Disability Index), and photopho...

Pain Practice, 2014

Pain facilitation as well as pain inhibition might be present in chronic pain patients. A decreas... more Pain facilitation as well as pain inhibition might be present in chronic pain patients. A decreased efficacy of pain inhibition can be measured by conditioned pain modulation (CPM). The use of the CPM paradigm in scientific research has boosted over the last few years and is recognized for its high clinical relevance in chronic pain patients. It is, however, unclear whether the presence of pain and possible modulations of pain influences the efficacy of endogenous pain inhibition, measured by CPM. This systematic literature study aimed to provide an overview of the effects of clinical pain and experimental pain induction or pain reduction on CPM in adults. A systematic literature search was conducted in the databases "Pubmed" and "Web of Science". Only full texts of original studies regarding the effect of clinical pain and experimentally induced pain and pain reduction on CPM in adults were included. The included articles were scored on methodological quality and through a CPM paradigm. Twelve articles of good to moderate quality were included in this review. Some pain inhibitory medication and oral contraceptives inhibit the CPM mechanism. Removing chronic pain by surgery results in an improved CPM response. This effect is not observed when removing acute pain. Analgesic medication and oral contraceptives might inhibit the CPM response, whereas there is limited evidence that pain-relieving surgery improves CPM in chronic pain patients. However, the results merely suggest that decreased CPM values (as in chronic pain patients) can improve after elimination of pain.

Scandinavian Journal of Medicine & Science in Sports, 2014

The present study examined the activity levels of the thoracic and lumbar extensor muscles during... more The present study examined the activity levels of the thoracic and lumbar extensor muscles during different extension exercise modalities in healthy individuals. Therefore, 14 subjects performed four different types of extension exercises in prone position: dynamic trunk extension, dynamic-static trunk extension, dynamic leg extension, and dynamic-static leg extension. Pre-and post-exercise muscle functional magnetic resonance imaging scans from the latissimus dorsi, the thoracic and lumbar parts of the longissimus, iliocostalis, and multifidus were performed. Differences in water relaxation values (T2-relaxation) before and after exercise were calculated (T2-shift) as a measure of muscle activity and compared between extension modalities. Linear mixed-model analysis revealed higher lumbar extensor activity during trunk extension compared with leg extension (T2shift of 5.01 ms and 3.55 ms, respectively) and during the dynamic-static exercise performance compared with the dynamic exercise performance (T2-shift of 4.77 ms and 3.55 ms, respectively). No significant differences in the thoracic extensor activity between the exercises could be demonstrated. During all extension exercises, the latissimus dorsi was the least activated compared with the paraspinal muscles. While all extension exercises are equivalent effective to train the thoracic muscles, trunk extension exercises performed in a dynamic-static way are the most appropriate to enhance lumbar muscle strength.

Neuroscience Letters, 2011

Methods: The brain signatures of CFS screened patients (n = 30) admitted to a U.K.-based clinic w... more Methods: The brain signatures of CFS screened patients (n = 30) admitted to a U.K.-based clinic were assessed using a full-head 19 channel Quantitative EEG (electroencephalography) during 5 min of eyes open/closed at rest, and while performing a 20 min Visual Continuous Performance Task (VCPT). Following spectral and topographical analysis the data was compared to the Russian Academy of Sciences Human Brain Institute (HBI) normative database for statistically significant differences. In addition, associations between the data and symptom severity scales were also investigated.

Manual Therapy, 2011

Central sensitization provides an evidence-based explanation for many cases of 'unexplained' chro... more Central sensitization provides an evidence-based explanation for many cases of 'unexplained' chronic musculoskeletal pain. Prior to commencing rehabilitation in such cases, it is crucial to change maladaptive illness perceptions, to alter maladaptive pain cognitions and to reconceptualise pain. This can be accomplished by patient education about central sensitization and its role in chronic pain, a strategy known as pain physiology education. Pain physiology education is indicated when: 1) the clinical picture is characterized and dominated by central sensitization; and 2) maladaptive illness perceptions are present. Both are prerequisites for commencing pain physiology education. Face-to-face sessions of pain physiology education, in conjunction with written educational material, are effective for changing pain cognitions and improving health status in patients with various chronic musculoskeletal pain disorders. These include patients with chronic low back pain, chronic whiplash, fibromyalgia and chronic fatigue syndrome. After biopsychosocial assessment pain physiology education comprises of a first face-to-face session explaining basic pain physiology and contrasting acute nociception versus chronic pain (Session 1). Written information about pain physiology should be provided as homework in between session 1 and 2. The second session can be used to correct misunderstandings, and to facilitate the transition from knowledge to adaptive pain coping during daily life. Pain physiology education is a continuous process initiated during the educational sessions and continued within both the active treatment and during the longer term rehabilitation program.

The Journal of Pain, 2012

A controlled experimental study was performed to examine the efficacy of the endogenous pain inhi... more A controlled experimental study was performed to examine the efficacy of the endogenous pain inhibitory systems and whether this (mal)functioning is associated with symptom increases following exercise in patients with chronic whiplash-associated disorders (WAD). In addition, 2 types of exercise were compared. Twenty-two women with chronic WAD and 22 healthy controls performed a submaximal and a self-paced, physiologically limited exercise test on a cycle ergometer with cardiorespiratory monitoring on 2 separate occasions. Pain pressure thresholds (PPT), health status, and activity levels were assessed in response to the 2 exercise bouts. In chronic WAD, PPT decreased following submaximal exercise, whereas they increased in healthy subjects. The same effect was established in response to the self-paced, physiologically limited exercise, with exception of the PPT at the calf which increased. A worsening of the chronic WAD symptom complex was reported post-exercise. Fewer symptoms were reported in response to the self-paced, physiologically limited exercise. These observations suggest abnormal central pain processing during exercise in patients with chronic WAD. Submaximal exercise triggers post-exertional malaise, while a self-paced and physiologically limited exercise will trigger less severe symptoms, and therefore seems more appropriate for chronic WAD patients.

Journal of Manipulative and Physiological Therapeutics, 2012

Objective: The purpose of this study was to investigate the effect of dry needling on the blood f... more Objective: The purpose of this study was to investigate the effect of dry needling on the blood flow and oxygen saturation of the trapezius muscle. Methods: Twenty healthy participants participated in this study. One single dry needling procedure was performed in the right upper trapezius, at a point located midway between the acromion edge and the seventh cervical vertebrae. Using the oxygen to see device, blood flow and oxygen saturation were evaluated at the treated point and 3 distant points (similar point in the left upper trapezius and 30 mm laterally from this midpoint). Measurements were taken at baseline and in the recovery period (0, 5, and 15 minutes posttreatment). Results: After removal of the needle, the blood flow and oxygen saturation increased significantly from the pretreatment level in the treated point (P ≤ .001), and these values remained high throughout the 15-minute recovery period. There were only minor changes in the distant points. Conclusions: These results suggest that dry needling enhances the blood flow in the stimulated region of the trapezius muscle but not in a distant region used in this study. (J Manipulative Physiol Ther 2012;35:685-691)

Journal of Internal Medicine, 2010

Van Oosterwijck J, Nijs J, Meeus M, Lefever I, Huybrechts L, Lambrecht L, Paul L (Vrije Universit... more Van Oosterwijck J, Nijs J, Meeus M, Lefever I, Huybrechts L, Lambrecht L, Paul L (Vrije Universiteit Brussel, Brussels; ). Pain inhibition and postexertional malaise in myalgic encephalomyelitis ⁄ chronic fatigue syndrome. J Intern Med 2010; 268: 265-278.

Physiotherapy, 2015

eS1091 personality, high levels of negative over positive affect, and a retroversed pelvis in hab... more eS1091 personality, high levels of negative over positive affect, and a retroversed pelvis in habitual standing. High levels of negative over positive affect, backward trunk lean in customary standing and depressed mood were significantly associated with a higher risk of NP.

Pain physician

Background: Exercise is an effective treatment for various chronic pain disorders, including fibr... more Background: Exercise is an effective treatment for various chronic pain disorders, including fibromyalgia, chronic neck pain, osteoarthritis, rheumatoid arthritis, and chronic low back pain. Although the clinical benefits of exercise therapy in these populations are well established (i.e. evidence based), it is currently unclear whether exercise has positive effects on the processes involved in chronic pain (e.g. central pain modulation).

Physiotherapy, 2015

of guidelines will facilitate physical therapists with the implementation of measurement instrume... more of guidelines will facilitate physical therapists with the implementation of measurement instruments in clinical practice.

Pain Practice, 2015

Conditioned pain modulation (CPM) is believed to play an important role in the development and ex... more Conditioned pain modulation (CPM) is believed to play an important role in the development and exacerbation of chronic pain, because dysfunction of CPM is associated with a shift in balance between pain facilitation and pain inhibition. In many patients with central sensitization, CPM is less efficacious. Besides that, efficacy of CPM is highly variable in healthy people. Consequently, it seems that several individual variables may influence CPM. A systematic review examining personal factors influencing CPM was conducted. This systematic review follows the PRISMA guidelines. "Pubmed" and "Web of Science" were searched using different synonyms of CPM. Full-text clinical reports addressing the influence of personal factors on CPM in healthy adults were included. Checklists for RCTs and case-control studies provided by the Dutch Institute for Healthcare Improvement (CBO) and the Dutch Cochrane Centre were utilized to assess methodological quality. Levels of evidence and strength of conclusion were assigned using the CBO guidelines. Forty-six articles were identified that reported the influence of personal factors on CPM. Quality assessment revealed 10 studies with a methodological quality less than 50% wherefore they were excluded (21.8%), resulting in a general total methodological quality score of 72.5%. Overall younger adult age, male gender, ovulatory phase, positive expectations, attention to the conditioning stimulus, and carrier of the 5-HTTLPR long allele result in better CPM. It is advised for future studies to take these factors into account. Further research regarding the influence of oral contraceptives, catastrophizing, information about conditioning stimulation, distraction, physical activity, and genetics on CPM magnitude is required.

Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology, Jan 30, 2015

Trunk extension exercises are used to train endurance and strength of the trunk extensor muscles.... more Trunk extension exercises are used to train endurance and strength of the trunk extensor muscles. Appropriate exercise dosage is crucial to achieve specific training effects, however literature describing the relation between the predetermined exercise intensity and the actual trunk extensors activity is scarce and inconclusive. To examine whether the actual activity of the thoracic and lumbar extensors during extensions exercises correspond with the predetermined intensity, electromyographic evaluation of the trunk extensors was performed during trunk extension exercises at various intensities expressed as percentages of 1-RM. The 1-RM was predetermined using 2 different methods: (1) through direct estimation by determining the maximum isometric force produced during semi-seated trunk extension on a Tergumed rehabilitation device, (2) through indirect estimation calculated based on the relation between the maximum number of repetitions of trunk extension from prone lying on a varia...

Pain physician

The awareness is growing that central sensitization is of prime importance for the assessment and... more The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists. Designing the first set of classification criteria for the classification of central sensitization pain. A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain. It is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differential classification of nociceptive versus central sensitization pain. For the former, the International Association for the Study of Pain diagnostic criteria are available for diagnosing or excluding neuropathic pain. For the latter, clinicians are advised to screen their patients for 3 major classification criteria, and use them to complete...

Pain physician

Until now, there is no firm evidence for conservative therapy in patients with chronic Whiplash A... more Until now, there is no firm evidence for conservative therapy in patients with chronic Whiplash Associated Disorders (WAD). While chronic WAD is a biopsychosocial problem, education may be an essential part in the treatment and the prevention of chronic WAD. However, it is still unclear which type of educative intervention has already been used in WAD patients and how effective such interventions are. This systematic literature study aimed at providing an overview of the literature regarding the currently existing educative treatments for patients with whiplash or WAD and their evidence. Systematic review of the literature. A systematic literature search was conducted in the following databases: Pubmed, Springerlink, and Web of Science using different keyword combinations. We included randomized controlled clinical trials (RCT) that encompass the effectiveness of education for patients with WAD. The included articles were evaluated on their methodological quality. Ten RCT's of m...

The Journal of Headache and Pain, 2013

Over the past decades, scientific understanding of unexplained chronic pain disorders has increas... more Over the past decades, scientific understanding of unexplained chronic pain disorders has increased substantially. Several chronic musculoskeletal pain disorders may be explained by alterations in central nervous system processing. More specifically, the responsiveness of central neurons to input from unimodal and polymodal receptors is augmented, resulting in a pathophysiological state corresponding to central sensitization, characterized by generalized or widespread hypersensitivity. Central sensitization encompasses altered sensory processing in the brain, impaired functioning of top-down anti-nociceptive mechanisms, and (over)activation of top-down and bottomup pain facilitatory pathways which augment nociceptive transmission. Importantly, a different 'pain signature' arises in the brain of those with chronic musculoskeletal pain and central sensitization.

Journal of rehabilitation research and development, 2011

Chronic whiplash is a debilitating condition characterized by increased sensitivity to painful st... more Chronic whiplash is a debilitating condition characterized by increased sensitivity to painful stimuli, maladaptive illness beliefs, inappropriate attitudes, and movement dysfunctions. Previous work in people with chronic low back pain and chronic fatigue syndrome indicates that pain neurophysiology education is able to improve illness beliefs and attitudes as well as movement performance. This single-case study (A-B-C design) with six patients with chronic whiplash associated disorders (WAD) was aimed at examining whether education about the neurophysiology of pain is accompanied by changes in symptoms, daily functioning, pain beliefs, and behavior. Periods A and C represented assessment periods, while period B consisted of the intervention (pain neurophysiology education). Results showed a significant decrease in kinesiophobia (Tampa Scale for Kinesiophobia), the passive coping strategy of resting (Pain Coping Inventory), self-rated disability (Neck Disability Index), and photopho...

Pain Practice, 2014

Pain facilitation as well as pain inhibition might be present in chronic pain patients. A decreas... more Pain facilitation as well as pain inhibition might be present in chronic pain patients. A decreased efficacy of pain inhibition can be measured by conditioned pain modulation (CPM). The use of the CPM paradigm in scientific research has boosted over the last few years and is recognized for its high clinical relevance in chronic pain patients. It is, however, unclear whether the presence of pain and possible modulations of pain influences the efficacy of endogenous pain inhibition, measured by CPM. This systematic literature study aimed to provide an overview of the effects of clinical pain and experimental pain induction or pain reduction on CPM in adults. A systematic literature search was conducted in the databases "Pubmed" and "Web of Science". Only full texts of original studies regarding the effect of clinical pain and experimentally induced pain and pain reduction on CPM in adults were included. The included articles were scored on methodological quality and through a CPM paradigm. Twelve articles of good to moderate quality were included in this review. Some pain inhibitory medication and oral contraceptives inhibit the CPM mechanism. Removing chronic pain by surgery results in an improved CPM response. This effect is not observed when removing acute pain. Analgesic medication and oral contraceptives might inhibit the CPM response, whereas there is limited evidence that pain-relieving surgery improves CPM in chronic pain patients. However, the results merely suggest that decreased CPM values (as in chronic pain patients) can improve after elimination of pain.

Scandinavian Journal of Medicine & Science in Sports, 2014

The present study examined the activity levels of the thoracic and lumbar extensor muscles during... more The present study examined the activity levels of the thoracic and lumbar extensor muscles during different extension exercise modalities in healthy individuals. Therefore, 14 subjects performed four different types of extension exercises in prone position: dynamic trunk extension, dynamic-static trunk extension, dynamic leg extension, and dynamic-static leg extension. Pre-and post-exercise muscle functional magnetic resonance imaging scans from the latissimus dorsi, the thoracic and lumbar parts of the longissimus, iliocostalis, and multifidus were performed. Differences in water relaxation values (T2-relaxation) before and after exercise were calculated (T2-shift) as a measure of muscle activity and compared between extension modalities. Linear mixed-model analysis revealed higher lumbar extensor activity during trunk extension compared with leg extension (T2shift of 5.01 ms and 3.55 ms, respectively) and during the dynamic-static exercise performance compared with the dynamic exercise performance (T2-shift of 4.77 ms and 3.55 ms, respectively). No significant differences in the thoracic extensor activity between the exercises could be demonstrated. During all extension exercises, the latissimus dorsi was the least activated compared with the paraspinal muscles. While all extension exercises are equivalent effective to train the thoracic muscles, trunk extension exercises performed in a dynamic-static way are the most appropriate to enhance lumbar muscle strength.

Neuroscience Letters, 2011

Methods: The brain signatures of CFS screened patients (n = 30) admitted to a U.K.-based clinic w... more Methods: The brain signatures of CFS screened patients (n = 30) admitted to a U.K.-based clinic were assessed using a full-head 19 channel Quantitative EEG (electroencephalography) during 5 min of eyes open/closed at rest, and while performing a 20 min Visual Continuous Performance Task (VCPT). Following spectral and topographical analysis the data was compared to the Russian Academy of Sciences Human Brain Institute (HBI) normative database for statistically significant differences. In addition, associations between the data and symptom severity scales were also investigated.

Manual Therapy, 2011

Central sensitization provides an evidence-based explanation for many cases of 'unexplained' chro... more Central sensitization provides an evidence-based explanation for many cases of 'unexplained' chronic musculoskeletal pain. Prior to commencing rehabilitation in such cases, it is crucial to change maladaptive illness perceptions, to alter maladaptive pain cognitions and to reconceptualise pain. This can be accomplished by patient education about central sensitization and its role in chronic pain, a strategy known as pain physiology education. Pain physiology education is indicated when: 1) the clinical picture is characterized and dominated by central sensitization; and 2) maladaptive illness perceptions are present. Both are prerequisites for commencing pain physiology education. Face-to-face sessions of pain physiology education, in conjunction with written educational material, are effective for changing pain cognitions and improving health status in patients with various chronic musculoskeletal pain disorders. These include patients with chronic low back pain, chronic whiplash, fibromyalgia and chronic fatigue syndrome. After biopsychosocial assessment pain physiology education comprises of a first face-to-face session explaining basic pain physiology and contrasting acute nociception versus chronic pain (Session 1). Written information about pain physiology should be provided as homework in between session 1 and 2. The second session can be used to correct misunderstandings, and to facilitate the transition from knowledge to adaptive pain coping during daily life. Pain physiology education is a continuous process initiated during the educational sessions and continued within both the active treatment and during the longer term rehabilitation program.

The Journal of Pain, 2012

A controlled experimental study was performed to examine the efficacy of the endogenous pain inhi... more A controlled experimental study was performed to examine the efficacy of the endogenous pain inhibitory systems and whether this (mal)functioning is associated with symptom increases following exercise in patients with chronic whiplash-associated disorders (WAD). In addition, 2 types of exercise were compared. Twenty-two women with chronic WAD and 22 healthy controls performed a submaximal and a self-paced, physiologically limited exercise test on a cycle ergometer with cardiorespiratory monitoring on 2 separate occasions. Pain pressure thresholds (PPT), health status, and activity levels were assessed in response to the 2 exercise bouts. In chronic WAD, PPT decreased following submaximal exercise, whereas they increased in healthy subjects. The same effect was established in response to the self-paced, physiologically limited exercise, with exception of the PPT at the calf which increased. A worsening of the chronic WAD symptom complex was reported post-exercise. Fewer symptoms were reported in response to the self-paced, physiologically limited exercise. These observations suggest abnormal central pain processing during exercise in patients with chronic WAD. Submaximal exercise triggers post-exertional malaise, while a self-paced and physiologically limited exercise will trigger less severe symptoms, and therefore seems more appropriate for chronic WAD patients.

Journal of Manipulative and Physiological Therapeutics, 2012

Objective: The purpose of this study was to investigate the effect of dry needling on the blood f... more Objective: The purpose of this study was to investigate the effect of dry needling on the blood flow and oxygen saturation of the trapezius muscle. Methods: Twenty healthy participants participated in this study. One single dry needling procedure was performed in the right upper trapezius, at a point located midway between the acromion edge and the seventh cervical vertebrae. Using the oxygen to see device, blood flow and oxygen saturation were evaluated at the treated point and 3 distant points (similar point in the left upper trapezius and 30 mm laterally from this midpoint). Measurements were taken at baseline and in the recovery period (0, 5, and 15 minutes posttreatment). Results: After removal of the needle, the blood flow and oxygen saturation increased significantly from the pretreatment level in the treated point (P ≤ .001), and these values remained high throughout the 15-minute recovery period. There were only minor changes in the distant points. Conclusions: These results suggest that dry needling enhances the blood flow in the stimulated region of the trapezius muscle but not in a distant region used in this study. (J Manipulative Physiol Ther 2012;35:685-691)

Journal of Internal Medicine, 2010

Van Oosterwijck J, Nijs J, Meeus M, Lefever I, Huybrechts L, Lambrecht L, Paul L (Vrije Universit... more Van Oosterwijck J, Nijs J, Meeus M, Lefever I, Huybrechts L, Lambrecht L, Paul L (Vrije Universiteit Brussel, Brussels; ). Pain inhibition and postexertional malaise in myalgic encephalomyelitis ⁄ chronic fatigue syndrome. J Intern Med 2010; 268: 265-278.