Morten Hoegh - Academia.edu (original) (raw)

Papers by Morten Hoegh

Research paper thumbnail of ‘What scientific evidence supports this?’ how do physiotherapists in private practice use evidence-based practice and what are the main challenges? A convergent parallel mixed-methods study

European Journal of Physiotherapy

Research paper thumbnail of What is known and what is still unknown within chronic musculoskeletal pain? A systematic evidence and gap map

Research paper thumbnail of How do we explain painful chronic non-traumatic knee conditions to children and adolescents? A multiple-method study to develop credible explanations

INTRODUCTIONPerceived diagnostic uncertainty can leave adolescents confused about their condition... more INTRODUCTIONPerceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand“what’s wrong with me”. Our aim is to develop credible explanations (trustworthy and understandable explanation of the condition) for adolescents suffering from chronic non-traumatic knee pain.METHODSThis multiple-method study integrated findings from a systematic literature search of qualitative studies, an Argumentative Delphi with international experts (n=16) and think-aloud sessions with adolescents (n=7). Experts provided feedback with arguments on how to communicate credible explanations to meet adolescents’ needs. We analyzed feedback using thematic analysis before tailoring explanations to end-users.RESULTSWe screened 3.239 titles/abstracts and included 16 papers which explored diagnostic uncertainty from adolescents’ and parents’ perspectives. Five themes emerged: (1) Understanding causes and contributors to the pain experience, (2) Feeling...

Research paper thumbnail of Pain Science in Practice (Part 5): Central Sensitization II

Journal of Orthopaedic & Sports Physical Therapy

Research paper thumbnail of Musculoskeletal Pain: Current and Future Directions of Physical Therapy Practice

Archives of Rehabilitation Research and Clinical Translation

Research paper thumbnail of Pain Science in Practice (Part 4): Central Sensitization I

Journal of Orthopaedic & Sports Physical Therapy

Research paper thumbnail of Not being able to measure what is important, does not make things we can measure important

Research paper thumbnail of Paradoxical differences in pain ratings of the same stimulus intensity

Scandinavian Journal of Pain, 2017

Aims Stimulus intensity used for assessing temporal summation of pain (TSP) is commonly set at th... more Aims Stimulus intensity used for assessing temporal summation of pain (TSP) is commonly set at the participants’ pain tolerance. Yet pain ratings during TSP rarely reach that initial pain tolerance pain rating. This study aimed to explore the differences between baseline pain tolerance assessed by cuff algometry and subsequent pain ratings of the same stimulus intensity, and the reliability of these ratings over 2 sessions. Methods In two sessions, separated by one week, 24 healthy, pain-free males had their pressure pain detection (PDT) and tolerance threshold (PTT) recorded using a staircase inflation paradigm (5 kPa increments, 1sec-ON:4sec-OFF) with a cuff algometry system. The pain intensity was assessed during cuff stimulation using an electronic visual analogue scale (VAS, 0–10 cm). Three different inflation paradigms were then performed, using the PTT level as stimulation intensity, and a 1-s duration for each stimulus: PEAKS: 3 inflations at 0.17 Hz, SLOW: 10 inflations at ...

Research paper thumbnail of Pain Science in Practice (Part 3): Peripheral Sensitization

Journal of Orthopaedic & Sports Physical Therapy

Research paper thumbnail of Sex-specific Differences in Pain Intensity in Danish Physiotherapy Patients

IASP 2021 Virtual World Congress on Pain, Jun 9, 2021

Research paper thumbnail of The Effect of Unilateralt and Bilateral Painful Stimuli on Cognitive Function

Research paper thumbnail of Guía de buenas prácticas para el dolor y los trastornos musculoesqueléticos en empresas y trabajadores

Las acciones dirigidas a la mejora de la seguridad y de la salud laboral surgieron de la necesida... more Las acciones dirigidas a la mejora de la seguridad y de la salud laboral surgieron de la necesidad de proteger frente a los accidentes a los empleados que trabajaban en industrias europeas; como en centrales nucleares o en industrias químicas de gran escala. Actualmente, este campo ha evolucionado en multitud de direcciones, siendo la prevención y el manejo de los trastornos musculoesqueléticos (TME) una de sus principales líneas de actuación, debido a que son el principal motivo de baja laboral en los trabajadores. Concretamente, la prevalencia de los TME representa más de 1,3 mil millones de personas y una pérdida de más de 100 millones de años de vida por incapacidad; siendo una causa común de incapacidad y de bajas laborales. Históricamente, el abordaje de los TME desde el lugar de trabajo se ha focalizado en la adopción de medidas ergonómicas, lo que ha sido positivo en algunos casos. Sin embargo, a pesar de las ergonómicas y biomecánicas llevadas de manera generalizada en los ...

Research paper thumbnail of Linee guida di buona pratica per la gestione del dolore e i disturbi muscolo-scheletrici nei lavoratori e nelle aziende

Le azioni volte a migliorare la salute e la sicurezza sul lavoro sono nate dalla necessità di pro... more Le azioni volte a migliorare la salute e la sicurezza sul lavoro sono nate dalla necessità di proteggere dagli incidenti i dipendenti che lavorano nelle industrie europee, come le centrali nucleari o le grandi industrie chimiche. Oggi, questo campo si è evoluto in molte direzioni, e la prevenzione e la gestione dei disturbi muscoloscheletrici (DMS) è una delle sue principali linee d'azione, dato che sono la ragione principale per cui i lavoratori si assentano dal lavoro. In particolare, la prevalenza dei DMS rappresenta più di 1,3 miliardi di persone e una perdita di più di 100 milioni di anni di vita a causa della disabilità; sono una causa comune di inabilità e di assenza per malattia. Storicamente, l'approccio ai DMS sul posto di lavoro si è concentrato sull'adozione di misure ergonomiche, che in alcuni casi sono state positive. Tuttavia, nonostante le misure ergonomiche e biomeccaniche siano ampiamente implementate sul posto di lavoro, la crescente prevalenza dei DMS...

Research paper thumbnail of OUP accepted manuscript

Pain Medicine, 2019

OBJECTIVES Stress and pain have been interrelated in clinical widespread pain conditions. Studies... more OBJECTIVES Stress and pain have been interrelated in clinical widespread pain conditions. Studies indicate that acute experimental stress in healthy volunteers has a negative effect on the descending inhibitory pain control system and thus the ability to inhibit one painful stimulus with another (conditioned pain modulation [CPM]) although without effect on general pain sensitivity. CPM effects can be assessed immediately after the stress induction, whereas some physiological stress responses (e.g., cortisol release) are delayed and longer lasting. It is unclear whether CPM may relate to stress-induced increases in cortisol. DESIGN Twenty-five healthy men had CPM effects measured over a period of 10 minutes. Pain detection thresholds (PDTs) were assessed by repeated test stimuli with cuff algometry on one leg, with and without painful cuff pressure conditioning on the contralateral leg. CPM effects, assessed as the increase in PDT during conditioning stimulation compared with without, were measured before and after experimental stress and a control condition (Montreal Imaging Stress Task [MIST]). Saliva cortisol levels and self-perceived stress were collected. RESULTS Participants reported the MIST to be more stressful compared with the MIST control, but cortisol levels did not change significantly from baseline. In all sessions, PDT increased during conditioning (P = 0.001), although the MIST compared with the MIST control had no significant effect on PDT or CPM effects. A negative correlation between changes in cortisol and conditioned PDT was found when applying the MIST (P < 0.03). CONCLUSIONS No significant effect of stress was found on CPM compared with a matched control condition. Individual changes in experimental stress and in conditioned pain sensitivity may be linked with cortisol.

Research paper thumbnail of Pain Science in Practice: What Is Pain Neuroscience? Part 2

Journal of Orthopaedic & Sports Physical Therapy

SYNOPSIS Biomechanical explanations for musculoskeletal pain are abundant and have been used for ... more SYNOPSIS Biomechanical explanations for musculoskeletal pain are abundant and have been used for many years; however, researchers and clinicians are moving toward neuroscience-based explanations to study and explain them. This article discusses some specific mechanisms, commonly used in pain medicine, and their somewhat less specific but equally important role in nonpharmacological management of musculoskeletal pain. The article also explains the role of different receptors and how they relate to clinical conditions. J Orthop Sports Phys Ther 2022;52(4):166-168. doi:10.2519/jospt.2022.10994.

Research paper thumbnail of Reducing the Weight of Spinal Pain in Children and Adolescents

Children, 2021

Spinal pain in adults is a significant burden, from an individual and societal perspective. Accor... more Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-manageme...

Research paper thumbnail of Reducing the Weight of Spinal Pain in Children and Adolescents

Children, 2021

Spinal pain in adults is a significant burden, from an individual and societal perspective. Accor... more Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-manageme...

Research paper thumbnail of Pain Science in Practice: Linking Basic Pain Science to the Clinic and Quality Musculoskeletal Rehabilitation Care

Journal of Orthopaedic & Sports Physical Therapy, 2022

Research paper thumbnail of Good practice guidelines for pain and musculoskeletal disorders in workers and companies

Actions to improve occupational health and safety arose from the need to protect employees workin... more Actions to improve occupational health and safety arose from the need to protect employees working in European industries, such as nuclear power plants or large-scale chemical industries, from accidents. Today, the field has evolved in many directions, with the prevention and management of musculoskeletal disorders (MSDs) being one of its main lines of action. MSDs are the main reason for workers to take time off work. Specifically, the prevalence of MSDs represents more than 1.3 billion people and a loss of more than 100 million years of life due to disability; they are a common cause of disability and sick leave. Historically, the workplace approach to MSDs has focused on adopting ergonomic measures, which has been positive in some cases. However, despite ergonomic and biomechanical measures being widely implemented in the workplace, the increasing prevalence of MSDs globally indicates that they are not sufficient measures on their own. Therefore, new holistic approaches that take...

Research paper thumbnail of Participatory Research: A Priority Setting Partnership for Chronic Musculoskeletal Pain in Denmark

Background Patient and stakeholder engagements in research have increasingly gained attention in ... more Background Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to establish research priorities for chronic musculoskeletal (MSK) pain by engaging with humans living with chronic MSK pain, relatives to humans living with chronic MSK pain, healthcare professionals (HCP), and researchers working with chronic MSK pain. Methods This JLA-PSP included a nation-wide survey in Denmark, an interim prioritisation, and an online consensus building workshop. The information gained from this was the basis for developing the final list of specific research priorities within chronic MSK pain. Results In the initial survey, 1010 respondents (91% people living with chronic MSK pain/relatives, 9% HCPs/researchers) submitted 31...

Research paper thumbnail of ‘What scientific evidence supports this?’ how do physiotherapists in private practice use evidence-based practice and what are the main challenges? A convergent parallel mixed-methods study

European Journal of Physiotherapy

Research paper thumbnail of What is known and what is still unknown within chronic musculoskeletal pain? A systematic evidence and gap map

Research paper thumbnail of How do we explain painful chronic non-traumatic knee conditions to children and adolescents? A multiple-method study to develop credible explanations

INTRODUCTIONPerceived diagnostic uncertainty can leave adolescents confused about their condition... more INTRODUCTIONPerceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand“what’s wrong with me”. Our aim is to develop credible explanations (trustworthy and understandable explanation of the condition) for adolescents suffering from chronic non-traumatic knee pain.METHODSThis multiple-method study integrated findings from a systematic literature search of qualitative studies, an Argumentative Delphi with international experts (n=16) and think-aloud sessions with adolescents (n=7). Experts provided feedback with arguments on how to communicate credible explanations to meet adolescents’ needs. We analyzed feedback using thematic analysis before tailoring explanations to end-users.RESULTSWe screened 3.239 titles/abstracts and included 16 papers which explored diagnostic uncertainty from adolescents’ and parents’ perspectives. Five themes emerged: (1) Understanding causes and contributors to the pain experience, (2) Feeling...

Research paper thumbnail of Pain Science in Practice (Part 5): Central Sensitization II

Journal of Orthopaedic & Sports Physical Therapy

Research paper thumbnail of Musculoskeletal Pain: Current and Future Directions of Physical Therapy Practice

Archives of Rehabilitation Research and Clinical Translation

Research paper thumbnail of Pain Science in Practice (Part 4): Central Sensitization I

Journal of Orthopaedic & Sports Physical Therapy

Research paper thumbnail of Not being able to measure what is important, does not make things we can measure important

Research paper thumbnail of Paradoxical differences in pain ratings of the same stimulus intensity

Scandinavian Journal of Pain, 2017

Aims Stimulus intensity used for assessing temporal summation of pain (TSP) is commonly set at th... more Aims Stimulus intensity used for assessing temporal summation of pain (TSP) is commonly set at the participants’ pain tolerance. Yet pain ratings during TSP rarely reach that initial pain tolerance pain rating. This study aimed to explore the differences between baseline pain tolerance assessed by cuff algometry and subsequent pain ratings of the same stimulus intensity, and the reliability of these ratings over 2 sessions. Methods In two sessions, separated by one week, 24 healthy, pain-free males had their pressure pain detection (PDT) and tolerance threshold (PTT) recorded using a staircase inflation paradigm (5 kPa increments, 1sec-ON:4sec-OFF) with a cuff algometry system. The pain intensity was assessed during cuff stimulation using an electronic visual analogue scale (VAS, 0–10 cm). Three different inflation paradigms were then performed, using the PTT level as stimulation intensity, and a 1-s duration for each stimulus: PEAKS: 3 inflations at 0.17 Hz, SLOW: 10 inflations at ...

Research paper thumbnail of Pain Science in Practice (Part 3): Peripheral Sensitization

Journal of Orthopaedic & Sports Physical Therapy

Research paper thumbnail of Sex-specific Differences in Pain Intensity in Danish Physiotherapy Patients

IASP 2021 Virtual World Congress on Pain, Jun 9, 2021

Research paper thumbnail of The Effect of Unilateralt and Bilateral Painful Stimuli on Cognitive Function

Research paper thumbnail of Guía de buenas prácticas para el dolor y los trastornos musculoesqueléticos en empresas y trabajadores

Las acciones dirigidas a la mejora de la seguridad y de la salud laboral surgieron de la necesida... more Las acciones dirigidas a la mejora de la seguridad y de la salud laboral surgieron de la necesidad de proteger frente a los accidentes a los empleados que trabajaban en industrias europeas; como en centrales nucleares o en industrias químicas de gran escala. Actualmente, este campo ha evolucionado en multitud de direcciones, siendo la prevención y el manejo de los trastornos musculoesqueléticos (TME) una de sus principales líneas de actuación, debido a que son el principal motivo de baja laboral en los trabajadores. Concretamente, la prevalencia de los TME representa más de 1,3 mil millones de personas y una pérdida de más de 100 millones de años de vida por incapacidad; siendo una causa común de incapacidad y de bajas laborales. Históricamente, el abordaje de los TME desde el lugar de trabajo se ha focalizado en la adopción de medidas ergonómicas, lo que ha sido positivo en algunos casos. Sin embargo, a pesar de las ergonómicas y biomecánicas llevadas de manera generalizada en los ...

Research paper thumbnail of Linee guida di buona pratica per la gestione del dolore e i disturbi muscolo-scheletrici nei lavoratori e nelle aziende

Le azioni volte a migliorare la salute e la sicurezza sul lavoro sono nate dalla necessità di pro... more Le azioni volte a migliorare la salute e la sicurezza sul lavoro sono nate dalla necessità di proteggere dagli incidenti i dipendenti che lavorano nelle industrie europee, come le centrali nucleari o le grandi industrie chimiche. Oggi, questo campo si è evoluto in molte direzioni, e la prevenzione e la gestione dei disturbi muscoloscheletrici (DMS) è una delle sue principali linee d'azione, dato che sono la ragione principale per cui i lavoratori si assentano dal lavoro. In particolare, la prevalenza dei DMS rappresenta più di 1,3 miliardi di persone e una perdita di più di 100 milioni di anni di vita a causa della disabilità; sono una causa comune di inabilità e di assenza per malattia. Storicamente, l'approccio ai DMS sul posto di lavoro si è concentrato sull'adozione di misure ergonomiche, che in alcuni casi sono state positive. Tuttavia, nonostante le misure ergonomiche e biomeccaniche siano ampiamente implementate sul posto di lavoro, la crescente prevalenza dei DMS...

Research paper thumbnail of OUP accepted manuscript

Pain Medicine, 2019

OBJECTIVES Stress and pain have been interrelated in clinical widespread pain conditions. Studies... more OBJECTIVES Stress and pain have been interrelated in clinical widespread pain conditions. Studies indicate that acute experimental stress in healthy volunteers has a negative effect on the descending inhibitory pain control system and thus the ability to inhibit one painful stimulus with another (conditioned pain modulation [CPM]) although without effect on general pain sensitivity. CPM effects can be assessed immediately after the stress induction, whereas some physiological stress responses (e.g., cortisol release) are delayed and longer lasting. It is unclear whether CPM may relate to stress-induced increases in cortisol. DESIGN Twenty-five healthy men had CPM effects measured over a period of 10 minutes. Pain detection thresholds (PDTs) were assessed by repeated test stimuli with cuff algometry on one leg, with and without painful cuff pressure conditioning on the contralateral leg. CPM effects, assessed as the increase in PDT during conditioning stimulation compared with without, were measured before and after experimental stress and a control condition (Montreal Imaging Stress Task [MIST]). Saliva cortisol levels and self-perceived stress were collected. RESULTS Participants reported the MIST to be more stressful compared with the MIST control, but cortisol levels did not change significantly from baseline. In all sessions, PDT increased during conditioning (P = 0.001), although the MIST compared with the MIST control had no significant effect on PDT or CPM effects. A negative correlation between changes in cortisol and conditioned PDT was found when applying the MIST (P < 0.03). CONCLUSIONS No significant effect of stress was found on CPM compared with a matched control condition. Individual changes in experimental stress and in conditioned pain sensitivity may be linked with cortisol.

Research paper thumbnail of Pain Science in Practice: What Is Pain Neuroscience? Part 2

Journal of Orthopaedic & Sports Physical Therapy

SYNOPSIS Biomechanical explanations for musculoskeletal pain are abundant and have been used for ... more SYNOPSIS Biomechanical explanations for musculoskeletal pain are abundant and have been used for many years; however, researchers and clinicians are moving toward neuroscience-based explanations to study and explain them. This article discusses some specific mechanisms, commonly used in pain medicine, and their somewhat less specific but equally important role in nonpharmacological management of musculoskeletal pain. The article also explains the role of different receptors and how they relate to clinical conditions. J Orthop Sports Phys Ther 2022;52(4):166-168. doi:10.2519/jospt.2022.10994.

Research paper thumbnail of Reducing the Weight of Spinal Pain in Children and Adolescents

Children, 2021

Spinal pain in adults is a significant burden, from an individual and societal perspective. Accor... more Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-manageme...

Research paper thumbnail of Reducing the Weight of Spinal Pain in Children and Adolescents

Children, 2021

Spinal pain in adults is a significant burden, from an individual and societal perspective. Accor... more Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-manageme...

Research paper thumbnail of Pain Science in Practice: Linking Basic Pain Science to the Clinic and Quality Musculoskeletal Rehabilitation Care

Journal of Orthopaedic & Sports Physical Therapy, 2022

Research paper thumbnail of Good practice guidelines for pain and musculoskeletal disorders in workers and companies

Actions to improve occupational health and safety arose from the need to protect employees workin... more Actions to improve occupational health and safety arose from the need to protect employees working in European industries, such as nuclear power plants or large-scale chemical industries, from accidents. Today, the field has evolved in many directions, with the prevention and management of musculoskeletal disorders (MSDs) being one of its main lines of action. MSDs are the main reason for workers to take time off work. Specifically, the prevalence of MSDs represents more than 1.3 billion people and a loss of more than 100 million years of life due to disability; they are a common cause of disability and sick leave. Historically, the workplace approach to MSDs has focused on adopting ergonomic measures, which has been positive in some cases. However, despite ergonomic and biomechanical measures being widely implemented in the workplace, the increasing prevalence of MSDs globally indicates that they are not sufficient measures on their own. Therefore, new holistic approaches that take...

Research paper thumbnail of Participatory Research: A Priority Setting Partnership for Chronic Musculoskeletal Pain in Denmark

Background Patient and stakeholder engagements in research have increasingly gained attention in ... more Background Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to establish research priorities for chronic musculoskeletal (MSK) pain by engaging with humans living with chronic MSK pain, relatives to humans living with chronic MSK pain, healthcare professionals (HCP), and researchers working with chronic MSK pain. Methods This JLA-PSP included a nation-wide survey in Denmark, an interim prioritisation, and an online consensus building workshop. The information gained from this was the basis for developing the final list of specific research priorities within chronic MSK pain. Results In the initial survey, 1010 respondents (91% people living with chronic MSK pain/relatives, 9% HCPs/researchers) submitted 31...