@misc{HasenbringLevenigHallneretal.2018, author = {Hasenbring, Monika Ilona and Levenig, Claudia and Hallner, D. and Puschmann, Anne-Katrin and Weiffen, A. and Kleinert, Jens and Belz, J. and Schiltenwolf, Marcus and Pfeifer, A. -C. and Heidari, Jahan . and Kellmann, M. and Wippert, Pia-Maria}, title = {Psychosoziale Risikofaktoren f{\"u}r chronischen R{\"u}ckenschmerz in der Allgemeingesellschaft und im Leistungssport}, series = {Manuelle Medizin}, volume = {56}, journal = {Manuelle Medizin}, number = {5}, publisher = {Springer}, address = {Heidelberg}, issn = {0025-2514}, doi = {10.1007/s00337-018-0450-1}, pages = {359 -- 373}, year = {2018}, abstract = {Hintergrund Lumbale Ruckenschmerzen und ihre Neigung zur Chronifizierung stellen nicht nur in der Allgemeinbevolkerung, sondern auch im Leistungssport ein bedeutendes Gesundheitsproblem dar. Im Gegensatz zu Nichtathleten ist die Erforschung psychosozialer Risikofaktoren sowie von Screeningfragebogen, die moglichst fruhzeitig die Entwicklung chronischer Schmerzen erkennen und vorhersagen konnen, im Leistungssport noch in den Anfangen. Das vorliegende systematische Review gibt einen uberblick uber den Stand der Risikofaktorenforschung in beiden Feldern und untersucht die pradiktive Qualitat verschiedener Screeningfragebogen bei Nichtathleten. Methodik Die Literatursuche erfolgte zwischen Marz und Juni 2016 in den Datenbanken MEDLINE, PubMed und PsycINFO mit den Suchbegriffen psychosocial screening, low back pain, sciatica und prognosis, athletes. Eingeschlossen wurden prospektive Studien an Patienten mit lumbalen Ruckenschmerzen mit und ohne Ausstrahlung in das Bein, 18Jahre und mit einem Follow-up von mindestens 3-monatiger Dauer. Ergebnisse In das Review zu Screeninginstrumenten wurden 16Studien einbezogen. Alle waren an klinischen Stichproben der Allgemeingesellschaft durchgefuhrt worden. Zu den am haufigsten publizierten Screeningfragebogen gehoren der orebro Musculoskeletal Pain Screening Questionnaire (oMPSQ) mit einer zufriedenstellenden Fruherkennung der Wiederherstellung der Arbeitsfahigkeit sowie das STarT Back Screening Tool (SBT) mit guter Vorhersage schmerzbedingter Beeintrachtigung. Fur die Vorhersage kunftiger Schmerzen eignen sich die Risikoanalyse der Schmerzchronifizierung (RISC-R) und der Heidelberger Kurzfragebogen (HKF). Schlussfolgerungen Psychosoziale Risikofaktoren fur chronische Ruckenschmerzen, wie z.B. chronischer Stress, ungunstige Schmerzverarbeitung und depressive Stimmungslagen, werden zunehmend auch im Leistungssport erkannt. Screeninginstrumente, die sich in der Allgemeingesellschaft als hinreichend vorhersagestark erwiesen haben, werden aktuell im MiSpEx-Forschungsverbund auf ihre Eignung uberpruft.}, language = {de} } @misc{HasenbringLevenigHallneretal.2018, author = {Hasenbring, Monika Ilona and Levenig, Claudia and Hallner, D. and Puschmann, Anne-Katrin and Weiffen, A. and Kleinert, Jens and Belz, J. and Schiltenwolf, Marcus and Pfeifer, A. -C. and Heidari, Jahan and Kellmann, M. and Wippert, Pia-Maria}, title = {Psychosocial risk factors for chronic back pain in the general population and in competitive sports}, series = {Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der {\"O}sterreichischen Schmerzgesellschaft und der Deutschen Interdisziplin{\"a}ren Vereinigung f{\"u}r Schmerztherapie}, volume = {32}, journal = {Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der {\"O}sterreichischen Schmerzgesellschaft und der Deutschen Interdisziplin{\"a}ren Vereinigung f{\"u}r Schmerztherapie}, number = {4}, publisher = {Springer}, address = {Heidelberg}, issn = {0932-433X}, doi = {10.1007/s00482-018-0307-5}, pages = {259 -- 273}, year = {2018}, abstract = {Lumbar back pain and the high risk of chronic complaints is not only an important health concern in the general population but also in high performance athletes. In contrast to non-athletes, there is a lack of research into psychosocial risk factors in athletes. Moreover, the development of psychosocial screening questionnaires that would be qualified to detect athletes with a high risk of chronicity is in the early stages. The purpose of this review is to give an overview of research into psychosocial risk factors in both populations and to evaluate the performance of screening instruments in non-athletes. The databases MEDLINE, PubMed, and PsycINFO were searched from March to June 2016 using the keywords "psychosocial screening", "low back pain", "sciatica" and "prognosis", "athletes". We included prospective studies conducted in patients with low back pain with and without radiation to the legs, aged ae18 years and a follow-up of at least 3 months. We identified 16 eligible studies, all of them conducted in samples of non-athletes. Among the most frequently published screening questionnaires, the A-rebro Musculoskeletal Pain Screening Questionnaire (A-MPSQ) demonstrated a sufficient early prediction of return to work and the STarT Back Screening Tool (SBT) revealed acceptable performance predicting pain-related impairment. The prediction of future pain was sufficient with the Risk Analysis of Back Pain Chronification (RISC-BP) and the Heidelberg Short Questionnaire (HKF). Psychosocial risk factors of chronic back pain, such as chronic stress, depressive mood, and maladaptive pain processing are becoming increasingly more recognized in competitive sports. Screening instruments that have been shown to be predictive in the general population are currently being tested for suitability in the German MiSpEx research consortium.}, language = {en} } @misc{HasenbringLevenigHallneretal.2018, author = {Hasenbring, Monika Ilona and Levenig, Claudia and Hallner, D. and Puschmann, Anne-Katrin and Weiffen, A. and Kleinert, Jens and Belz, Johanna and Schiltenwolf, Marcus and Pfeifer, Ann-Christin and Heidari, Jahan and Kellmann, Michael and Wippert, Pia-Maria}, title = {Screeninginstrumente}, series = {Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der {\"O}sterreichischen Schmerzgesellschaft und der Deutschen Interdisziplin{\"a}ren Vereinigung f{\"u}r Schmerztherapie}, volume = {32}, journal = {Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der {\"O}sterreichischen Schmerzgesellschaft und der Deutschen Interdisziplin{\"a}ren Vereinigung f{\"u}r Schmerztherapie}, number = {6}, publisher = {Springer Medizin Verlag GmbH}, address = {Heidelberg}, issn = {0932-433X}, doi = {10.1007/s00482-018-0340-4}, pages = {479 -- 481}, year = {2018}, language = {de} } @article{WippertDeWittHubertsKlipkeretal.2015, author = {Wippert, Pia-Maria and De Witt Huberts, Jessie and Klipker, Kathrin and Gantz, Simone and Schiltenwolf, Marcus and Mayer, Frank}, title = {Development and content of the behavioral therapy module of the MiSpEx intervention. Randomized, controlled trial on chronic nonspecific low back pain}, series = {Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der {\"O}sterreichischen Schmerzgesellschaft und der Deutschen Interdisziplin{\"a}ren Vereinigung f{\"u}r Schmerztherapie}, volume = {29}, journal = {Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der {\"O}sterreichischen Schmerzgesellschaft und der Deutschen Interdisziplin{\"a}ren Vereinigung f{\"u}r Schmerztherapie}, number = {6}, publisher = {Springer}, address = {New York}, issn = {0932-433X}, doi = {10.1007/s00482-015-0044-y}, pages = {658 -- 663}, year = {2015}, abstract = {Back pain is a complex phenomenon that goes beyond a simple medical diagnosis. The aetiology and chronification of back pain can be best described as an interaction between biological, psychological, and social processes. However, to date, multimodal prevention and intervention programs for back pain that target all three aetiological factors have demonstrated limited effectiveness. This lack of supportive evidence for multimodal programmes in the treatment of back pain could be due to the fact that few programs are suitable for long-term and unsupervised use in everyday life. Moreover, in combining the elements from various therapies, little attention has been paid to the mechanisms underlying the synergistic effects of the separate components. In this contribution, we will describe the development of a new multimodal intervention for back pain that set out to address these limitations. To this end, the biological elements of neuromuscular adaptation is supplemented with cognitive behavioral and psychophysiological techniques in an intervention that can be followed at home as well as in clinics, and that is suitable for all grades of pain. The efficacy of this intervention will be tested in a multicentric randomized controlled longitudinal trial (n = 714) at five time points over a period of 6 months. Here we will describe the development and the content of this new intervention.}, language = {de} } @article{PuschmannDriessleinBecketal.2020, author = {Puschmann, Anne-Katrin and Drießlein, David and Beck, Heidrun and Arampatzis, Adamantios and Moreno Catal{\´a}, Maria and Schiltenwolf, Marcus and Mayer, Frank and Wippert, Pia-Maria}, title = {Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain}, series = {Journal of Pain Research}, volume = {13}, journal = {Journal of Pain Research}, publisher = {Dove Medical Press}, address = {Albany, Auckland}, issn = {1178-7090}, doi = {10.2147/JPR.S223893}, pages = {613 -- 621}, year = {2020}, abstract = {Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods: This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results: The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (± 13.4) years; baseline pain intensity: 27.8 (± 18.4); disability: 14.3 (± 17.9)). In the 1-year follow-up, the stress types "tendency to worry", "social isolation", "work discontent" as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types "tendency to worry", "social isolation", "social conflicts", and "perceived long-term stress" as potential risk factors for both pain intensity and disability. Furthermore, "self-efficacy" ("internality", "self-concept") and "social externality" play a role in reducing pain-related disability. Conclusion: Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches.}, language = {en} } @misc{WippertPuschmannSchiltenwolfetal.2016, author = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Schiltenwolf, Marcus and Wiebking, Christine and Mayer, Frank}, title = {BACK PAIN: THE STUDY OF MECHANISMS AND THE TRANSLATION IN INTERVENTIONS WITHIN THE MISPEX NETWORK}, series = {Psychosomatic medicine}, volume = {78}, journal = {Psychosomatic medicine}, publisher = {Elsevier}, address = {Philadelphia}, issn = {0033-3174}, pages = {A91 -- A91}, year = {2016}, language = {en} } @misc{PuschmannDriessleinBecketal.2020, author = {Puschmann, Anne-Katrin and Drießlein, David and Beck, Heidrun and Arampatzis, Adamantios and Moreno Catal{\´a}, Maria and Schiltenwolf, Marcus and Mayer, Frank and Wippert, Pia-Maria}, title = {Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, issn = {1866-8364}, doi = {10.25932/publishup-46013}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-460134}, pages = {613 -- 621}, year = {2020}, abstract = {Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods: This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results: The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (± 13.4) years; baseline pain intensity: 27.8 (± 18.4); disability: 14.3 (± 17.9)). In the 1-year follow-up, the stress types "tendency to worry", "social isolation", "work discontent" as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types "tendency to worry", "social isolation", "social conflicts", and "perceived long-term stress" as potential risk factors for both pain intensity and disability. Furthermore, "self-efficacy" ("internality", "self-concept") and "social externality" play a role in reducing pain-related disability. Conclusion: Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches.}, 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} } @misc{PuschmannBeckSchiltenwolfetal.2017, author = {Puschmann, Anne-Kathrin and Beck, Heidrun and Schiltenwolf, Marcus and Wippert, Pia-Maria and Mayer, Frank}, title = {Distress in a longitudinal study of a population with nonspecific low back pain}, series = {Psychosomatic medicine}, volume = {79}, journal = {Psychosomatic medicine}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0033-3174}, pages = {A20 -- A21}, year = {2017}, language = {en} } @misc{WippertNiedererDriessleinetal.2021, 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 = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, publisher = {Universit{\"a}tsverlag Potsdam}, address = {Potsdam}, issn = {1866-8364}, doi = {10.25932/publishup-54327}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-543277}, pages = {1 -- 16}, year = {2021}, 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} }