TY - JOUR A1 - Fliesser, Michael A1 - De Witt Huberts, Jessie A1 - Wippert, Pia-Maria T1 - The choice that matters: the relative influence of socioeconomic status indicators on chronic back pain- a longitudinal study JF - BMC health services research N2 - Background: In health research, indicators of socioeconomic status (SES) are often used interchangeably and often lack theoretical foundation. This makes it difficult to compare results from different studies and to explore the relationship between SES and health outcomes. To aid researchers in choosing appropriate indicators of SES, this article proposes and tests a theory-based selection of SES indicators using chronic back pain as a health outcome. Results: Chronic back pain intensity was best predicted by the multidimensional index (beta = 0.31, p < 0.05), followed by job position (beta = 0.29, p < 0.05) and education (beta = -0.29, p < 0.05); whereas, income exerted no significant influence. Back pain disability was predicted strongest by education (beta = -0.30, p < 0.05) and job position (beta = 0. 29, p < 0.05). Here, multidimensional index and income had no significant influence. Conclusions: The choice of SES indicators influences predictive power on both back pain dimensions, suggesting SES predictors cannot be used interchangeably. Therefore, researchers should carefully consider prior to each study which SES indicator to use. The introduced framework can be valuable in supporting this decision because it allows for a stable prediction of SES indicator influence and their hierarchy on a specific health outcomes. KW - socioeconomic status KW - Indicators of socioeconomic status KW - health inequality KW - education KW - job position KW - income KW - chronic back pain Y1 - 2017 U6 - https://doi.org/10.1186/s12913-017-2735-9 SN - 1472-6963 VL - 17 PB - BioMed Central CY - London ER - TY - JOUR A1 - Wiebking, Christine A1 - Lin, Chiao-I A1 - Wippert, Pia-Maria T1 - Training intervention effects on cognitive performance and neuronal plasticity — A pilot study JF - Frontiers in Neurology, section Neurorehabilitation N2 - Studies suggest that people suffering from chronic pain may have altered brain plasticity, along with altered functional connectivity between pain-processing brain regions. These may be related to decreased mood and cognitive performance. There is some debate as to whether physical activity combined with behavioral therapy (e.g. cognitive distraction, body scan) may counteract these changes. However, underlying neuronal mechanisms are unclear. The aim of the current pilot study with a 3-armed randomized controlled trial design was to examine the effects of sensorimotor training for nonspecific chronic low back pain on (1) cognitive performance; (2) fMRI activity co-fluctuations (functional connectivity) between pain-related brain regions; and (3) the relationship between functional connectivity and subjective variables (pain and depression). Six hundred and sixty two volunteers with non-specific chronic low back pain were randomly allocated to a unimodal (sensorimotor training), multidisciplinary (sensorimotor training and behavioral therapy) intervention, or to a control group within a multicenter study. A subsample of patients (n = 21) from one study center participated in the pilot study presented here. Measurements were at baseline, during (3 weeks, M2) and after intervention (12 weeks, M4 and 24 weeks, M5). Cognitive performance was measured by the Trail Making Test and functional connectivity by MRI. Pain perception and depression were assessed by the Von Korff questionnaire and the Hospital and Anxiety. Group differences were calculated by univariate and repeated ANOVA measures and Bayesian statistics; correlations by Pearson's r. Change and correlation of functional connection were analyzed within a pooled intervention group (uni-, multidisciplinary group). Results revealed that participants with increased pain intensity at baseline showed higher functional connectivity between pain-related brain areas used as ROIs in this study. Though small sample sizes limit generalization, cognitive performance increased in the multimodal group. Increased functional connectivity was observed in participants with increased pain ratings. Pain ratings and connectivity in pain-related brain regions decreased after the intervention. The results provide preliminary indication that intervention effects can potentially be achieved on the cognitive and neuronal level. The intervention may be suitable for therapy and prevention of non-specific chronic low back pain. KW - chronic back pain KW - sensorimotor training intervention KW - multimodal intervention KW - MRI KW - neuroplasticity Y1 - 2022 U6 - https://doi.org/10.3389/fneur.2022.773813 SN - 1664-2295 VL - 13 PB - Frontiers CY - Lausanne, Schweiz ER - TY - GEN A1 - Wiebking, Christine A1 - Lin, Chiao-I A1 - Wippert, Pia-Maria T1 - Training intervention effects on cognitive performance and neuronal plasticity — A pilot study T2 - Zweitveröffentlichungen der Universität Potsdam : Gesundheitswissenschaftliche Reihe N2 - Studies suggest that people suffering from chronic pain may have altered brain plasticity, along with altered functional connectivity between pain-processing brain regions. These may be related to decreased mood and cognitive performance. There is some debate as to whether physical activity combined with behavioral therapy (e.g. cognitive distraction, body scan) may counteract these changes. However, underlying neuronal mechanisms are unclear. The aim of the current pilot study with a 3-armed randomized controlled trial design was to examine the effects of sensorimotor training for nonspecific chronic low back pain on (1) cognitive performance; (2) fMRI activity co-fluctuations (functional connectivity) between pain-related brain regions; and (3) the relationship between functional connectivity and subjective variables (pain and depression). Six hundred and sixty two volunteers with non-specific chronic low back pain were randomly allocated to a unimodal (sensorimotor training), multidisciplinary (sensorimotor training and behavioral therapy) intervention, or to a control group within a multicenter study. A subsample of patients (n = 21) from one study center participated in the pilot study presented here. Measurements were at baseline, during (3 weeks, M2) and after intervention (12 weeks, M4 and 24 weeks, M5). Cognitive performance was measured by the Trail Making Test and functional connectivity by MRI. Pain perception and depression were assessed by the Von Korff questionnaire and the Hospital and Anxiety. Group differences were calculated by univariate and repeated ANOVA measures and Bayesian statistics; correlations by Pearson's r. Change and correlation of functional connection were analyzed within a pooled intervention group (uni-, multidisciplinary group). Results revealed that participants with increased pain intensity at baseline showed higher functional connectivity between pain-related brain areas used as ROIs in this study. Though small sample sizes limit generalization, cognitive performance increased in the multimodal group. Increased functional connectivity was observed in participants with increased pain ratings. Pain ratings and connectivity in pain-related brain regions decreased after the intervention. The results provide preliminary indication that intervention effects can potentially be achieved on the cognitive and neuronal level. The intervention may be suitable for therapy and prevention of non-specific chronic low back pain. T3 - Zweitveröffentlichungen der Universität Potsdam : Gesundheitswissenschaftliche Reihe - 4 KW - chronic back pain KW - sensorimotor training intervention KW - multimodal intervention KW - MRI KW - neuroplasticity Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-580284 IS - 4 ER -