@article{NairLinWippert2022, author = {Na{\"i}r, Alexandra and Lin, Chiao-I and Wippert, Pia-Maria}, title = {Translation and adaptation of the French version of the risk stratification index, a tool for stratified care in chronic low back pain}, series = {Medicina : monthly medical journal of Lithuanian Medical Association, Kaunas}, volume = {58}, journal = {Medicina : monthly medical journal of Lithuanian Medical Association, Kaunas}, number = {4}, publisher = {Kaunas Univ. of Medicine}, address = {Kaunas, Litauen}, issn = {1648-9144}, doi = {10.3390/medicina58040469}, pages = {1 -- 8}, year = {2022}, abstract = {Background and Objectives: Low back pain is a worldwide health problem. An early diagnosis is required to develop personalized treatment strategies. The Risk Stratification Index (RSI) was developed to serve the purpose. The aim of this pilot study is to cross-culturally translate the RSI to a French version (RSI-F) and evaluate the test-retest reliability of RSI-F using a French active population. Materials and Methods: The RSI was translated from German to French (RSI-F) based on the guidelines of cross-cultural adaptation of self-report measures. A total of 42 French recreational athletes (age 18-63 years) with non-specific low back pain were recruited and filled in the RSI-F twice. The test-retest reliability was examined using intraclass correlation coefficient (ICC1,2) and Pearson correlation coefficient. Results: Finally, 33 questionnaires were analyzed (14 males and 19 females, age 31 ± 10 years, 9.5 ± 3.2 h/week of training). The test-retest of RSI-F CPI and DISS were excellent (CPI: ICC1,2 = 0.989, p < 0.001; r = 0.989, p < 0.001; DISS: ICC1,2 = 0.991, p < 0.001; r = 0.991, p < 0.001), as well as Korff pain intensity (ICC1,2 = 0.995, p < 0.001; r = 0.995, p < 0.001) and disability (ICC1,2 = 0.998, p < 0.001; r = 0.998, p < 0.001). Conclusion: The RSI-F is linguistically accurate and reliable for use by a French-speaking active population with non-specific low back pain. The RSI-F is considered a tool to examine the evolution of psychosocial factors and therefore the risk of chronicity and the prognostic of pain. Further evaluations, such as internal, external validity, and responsiveness should be evaluated in a larger population.}, language = {en} } @article{WippertNiedererDriessleinetal.2020, author = {Wippert, Pia-Maria and Niederer, Daniel and Drießlein, David and Beck, Heidrun and Banzer, Winfried Eberhard and Schneider, Christian and Schiltenwolf, Marcus and Mayer, Frank}, title = {Psychosocial Moderators and Mediators of Sensorimotor Exercise in Low Back Pain: A Randomized Multicenter Controlled Trial}, series = {Frontiers in Psychiatry}, volume = {12}, journal = {Frontiers in Psychiatry}, publisher = {Frontiers Research Foundation}, address = {Lausanne, Schweiz}, issn = {1664-0640}, doi = {10.3389/fpsyt.2021.629474}, pages = {1 -- 16}, year = {2020}, abstract = {The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this study assessed psychosocial characteristics, which moderate and mediate the effects of sensorimotor exercise on LBP. A single-blind 3-arm multicenter randomized controlled trial was conducted for 12-weeks. Three exercise groups, sensorimotor exercise (SMT), sensorimotor and behavioral training (SMT-BT), and regular routines (CG) were randomly assigned to 662 volunteers. Primary outcomes (pain intensity and disability) and psychosocial characteristics were assessed at baseline (M1) and follow-up (3/6/12/24 weeks, M2-M5). Multiple regression models were used to analyze whether psychosocial characteristics are moderators of the relationship between exercise and pain, meaning that psychosocial factors and exercise interact. Causal mediation analysis were conducted to analyze, whether psychosocial characteristics mediate the exercise effect on pain. A total of 453 participants with intermittent pain (mean age = 39.5 ± 12.2 years, f = 62\%) completed the training. It was shown, that depressive symptomatology (at M4, M5), vital exhaustion (at M4), and perceived social support (at M5) are significant moderators of the relationship between exercise and the reduction of pain intensity. Further depressive mood (at M4), social-satisfaction (at M4), and anxiety (at M5 SMT) significantly moderate the exercise effect on pain disability. The amount of moderation was of clinical relevance. In contrast, there were no psychosocial variables which mediated exercise effects on pain. In conclusion it was shown, that psychosocial variables can be moderators in the relationship between sensorimotor exercise induced adaptation on CLBP which may explain conflicting results in the past regarding the merit of exercise interventions in CLBP. Results suggest further an early identification of psychosocial risk factors by diagnostic tools, which may essential support the planning of personalized exercise therapy. Level of Evidence: Level I. Clinical Trial Registration: DRKS00004977, LOE: I, MiSpEx: grant-number: 080102A/11-14. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML\&TRIAL_ID=DRKS00004977.}, language = {en} } @article{WippertArampatzisBanzeretal.2019, author = {Wippert, Pia-Maria and Arampatzis, Adamantios and Banzer, Winfried and Beck, Heidrun and Hasenbring, Monika Ilona and Schiltenwolf, Marcus and Schneider, Christian and Stengel, Dirk and Platen, Petra and Mayer, Frank}, title = {Psychosoziale Risikofaktoren in der Entstehung von chronisch unspezifischen R{\"u}ckenschmerzen}, series = {Zeitschrift f{\"u}r Sportpsychologie}, volume = {26}, journal = {Zeitschrift f{\"u}r Sportpsychologie}, number = {1}, publisher = {Hogrefe}, address = {G{\"o}ttingen}, issn = {1612-5010}, doi = {10.1026/1612-5010/a000245}, pages = {25 -- 35}, year = {2019}, abstract = {Chronisch unspezifische R{\"u}ckenschmerzen (CURS) geh{\"o}ren international zu den h{\"a}ufigsten Schmerzph{\"a}nomenen und k{\"o}nnen f{\"u}r Athletinnen und Athleten karrierelimitierend sein. Knapp ein Drittel der j{\"a}hrlichen Trainingsausfallzeiten werden auf CURS zur{\"u}ckgef{\"u}hrt. In der Entstehung von chronischen Schmerzen ist ein multifaktorielles {\"A}tiologiemodell mit einem signifikanten Einfluss psychosozialer Risikofaktoren evident. Obwohl dies in der Allgemeinbev{\"o}lkerung bereits gut erforscht ist, gibt es in der Sportwissenschaft vergleichsweise wenige Arbeiten dar{\"u}ber. Dieses Thema wird daher in drei Multicenterstudien und zahlreichen Teilstudien des MiSpEx-Netzwerks (Medicine in Spine-Exercise-Network, F{\"o}rderzeitraum 2011 - 2018) aufgegriffen. Entsprechend der Empfehlung einer fr{\"u}hzeitigen Diagnostik von Chronifizierungsfaktoren in der „Nationalen Versorgungsleitlinie Kreuzschmerz", besch{\"a}ftigt sich das Netzwerk u. a. mit der {\"U}berpr{\"u}fung, Entwicklung und Evaluation diagnostischer M{\"o}glichkeiten. Der vorliegende Beitrag beschreibt die Entwicklung einer Diagnostik von psychosozialen Risikofaktoren, die einerseits eine Einsch{\"a}tzung des Risikos der Entwicklung von CURS und andererseits eine individuelle Zuweisung zu (Trainings)Interventionen erlaubt. Es wird die Entwicklungsrationale beschrieben und dabei verschiedene methodische Herangehensweisen und Entscheidungssequenzen reflektiert.}, language = {de} } @article{WippertFliesserKrause2017, author = {Wippert, Pia-Maria and Fliesser, Michael and Krause, Matthias}, title = {Risk and protective factors in the clinical rehabilitation of chronic back pain}, series = {Journal of pain research}, volume = {10}, journal = {Journal of pain research}, publisher = {Dove Medical Press}, address = {Albany, Auckland}, issn = {1178-7090}, doi = {10.2147/JPR.S134976}, pages = {1569 -- 1579}, year = {2017}, abstract = {Objectives: Chronic back pain (CBP) can lead to disability and burden. In addition to its medical causes, its development is influenced by psychosocial risk factors, the so-called flag factors, which are categorized and integrated into many treatment guidelines. Currently, most studies investigate single flag factors, which limit the estimation of individual factor significance in the development of chronic pain. Furthermore, factors concerning patients' lifestyle, biography and treatment history are often neglected. Therefore, the objectives of the present study are to identify commonly neglected factors of CBP and integrate them into an analysis model comparing their significance with established flag factors. Methods: A total of 24 patients and therapists were cross-sectionally interviewed to identify commonly neglected factors of CBP. Subsequently, the impact of these factors was surveyed in a longitudinal study. In two rehabilitation clinics, CBP patients (n = 145) were examined before and 6 months after a 3-week inpatient rehabilitation. Outcome variables, chronification factor pain experience (CF-PE) and chronification factor disability (CF-D), were ascertained with confirmatory factor analysis (CFA) of standardized questionnaires. Predictors were evaluated using stepwise calculations of simple and multiple regression models. Results: Through interviews, medical history, iatrogenic factors, poor compliance, critical life events (LEs), social support (SS) type and effort-reward were identified as commonly neglected factors. However, only the final three held significance in comparison to established factors such as depression and pain-related cognitions. Longitudinally, lifestyle factors found to influence future pain were initial pain, physically demanding work, nicotine consumption, gender and rehabilitation clinic. LEs were unexpectedly found to be a strong predictor of future pain, as were the protective factors, reward at work and perceived SS. Discussion: These findings shed insight regarding often overlooked factors in the development of CBP, suggesting that more detailed operationalization and superordinate frameworks would be beneficial to further research. Conclusion: In particular, LEs should be taken into account in future research. Protective factors should be integrated in therapeutic settings.}, language = {en} }