TY - JOUR A1 - Wippert, Pia-Maria A1 - De Witt Huberts, Jessie A1 - Klipker, Kathrin A1 - Gantz, Simone A1 - Schiltenwolf, Marcus A1 - Mayer, Frank T1 - Development and content of the behavioral therapy module of the MiSpEx intervention. Randomized, controlled trial on chronic nonspecific low back pain JF - Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der Österreichischen Schmerzgesellschaft und der Deutschen Interdisziplinären Vereinigung für Schmerztherapie N2 - 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. KW - Chronic pain KW - Cognitive behavioral therapy KW - Psychoeducation KW - Combined modality therapy KW - Sensorimotor training Y1 - 2015 U6 - https://doi.org/10.1007/s00482-015-0044-y SN - 0932-433X SN - 1432-2129 VL - 29 IS - 6 SP - 658 EP - 663 PB - Springer CY - New York ER - TY - JOUR A1 - Wippert, Pia-Maria A1 - Wiebking, C. T1 - Adaptation to physical activity and mental stress in the context of pain. Psychobiological aspects JF - Der Schmerz : Organ der Deutschen Gesellschaft zum Studium des Schmerzes, der Österreichischen Schmerzgesellschaft und der Deutschen Interdisziplinären Vereinigung für Schmerztherapie N2 - The genesis of chronic pain is predominantly explained by a multidimensional pain model approach that is based on the dysfunctional influence of biological, psychological and social variables as key risk factors inducing aberrant long-term changes. Biological facets comprise adaptation processes on the neuronal, musculoskeletal and (psycho) biological level that can be influenced by physical training or psychosocial factors, such as stress. These factors can play a causative role in developing dysfunctional adaptation mechanisms, which in turn prepare the biological ground to facilitate negative long-term changes in the peripheral and central nervous systems. Hence, these processes can be assumed to be fundamentally involved in the transition from acute to chronic and persistent pain. The aim of this review article is to discuss hypotheses for the genesis of chronic pain and possible treatment strategies. Selected research results about maladaptive processes in chronic pain due to psychological stress and physical activity are presented in order to inspire discussions about the ideal dose-response relationship of physical activity and the combination of different therapeutic concepts. KW - Chronic pain KW - Neuronal plasticity KW - Pain management KW - Central nervous system KW - Peripheral nervous system Y1 - 2016 U6 - https://doi.org/10.1007/s00482-016-0147-0 SN - 0932-433X SN - 1432-2129 VL - 30 SP - 429 EP - 436 PB - Springer CY - New York ER -