Brazil and Belgium combining forces to improve exercise prescription for patients with chronic pain? Delphi-study to be launched!   January 30th, 2019

​Chronic musculoskeletal pain is one of the conditions responsible for the increase in the number of years lived with disability, absenteeism and health care costs in the world (Andrew et al. 2014G. B. D 2017). The causes of musculoskeletal chronic pain are wide, ranging from arthritis to chronic pain syndromes such as fibromyalgia and neck pain (Ossipov 2006). Although there are many differences in clinical manifestation and pain mechanisms between different kinds of chronic pain, physical exercise is recommended as main component of the multimodal treatment for the most of chronic conditions reported (Bussières et al. 2016Macfarlane et al. 2016Geneen et al. 2017Häuser et al. 2017).

The literature recommends therapeutic exercise as an effective intervention for chronic pain (Bussières et al. 2016Macfarlane et al. 2016Geneen et al. 2017Häuser et al. 2017)but is still scarce as to the best recommendations for the prescription of the exercise, considering type, dose, frequency, supervision, intensity and progression. This absenteeism of recommendations for exercise makes it difficult to prescribe exercise in clinical practice, as now therapists prescribe exercise based only on their experience, which can generate problems such as: strenuous exercises for certain patients, or so mild that they do not generate the expected clinical effect. Since this patient population still has a resistance to performing physical exercises as a treatment this is a problem. Thus, it is extremely important to know how experts on musculoskeletal chronic pain think exercise therapy should be prescribed for these patients and if this is in line with the few existing evidence.

Therefore, Katherinne Ferro Moura Franco (Brazilian physical therapist and PhD student at Universidade Cidade de São Paulo) is visiting Ghent University (Belgium) with a research internship. The aim of her research is to get a world consensus about how musculoskeletal chronic pain experts in the world prescribe exercises for some chronic pain conditions, by means of a modified Delphi study.

So, if you are a clinical expert working as a physiotherapist with patients with fibromyalgia, chronic whiplash associated disorders, chronic idiopathic neck pain and central sensitization, help us perform this study. The contact information will soon be available. 

Thanks in advance!

Katherinne Ferro Moura Franco

Mira Meeus

2018 Pain in Motion

References and further reading

Andrew, R., S. Derry, R. S. Taylor, S. Straube and C. J. Phillips (2014). "The Costs and Consequences of Adequately Managed Chronic Non‐Cancer Pain and Chronic Neuropathic Pain." Pain Practice 14(1): 79-94.

Bussières, A. E., G. Stewart, F. Al-Zoubi, P. Decina, M. Descarreaux, J. Hayden, B. Hendrickson, C. Hincapié, I. Pagé and S. Passmore (2016). "The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline." Journal of Manipulative & Physiological Therapeutics 39(8): 523-564. e527.

G. B. D. Disease and Injury Incidence and Prevalence Collaborators (2017). "Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016." Lancet 390(10100): 1211-1259.

Geneen, L. J., A. Moore, C. Clarke, D. Martin, L. A. Colvin and B. H. Smith (2017). "Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews." The Cochrane database of systematic reviews.

Häuser, W., J. Ablin, S. Perrot and M. A. Fitzcharles (2017). "Management of fibromyalgia: key messages from recent evidence-based guidelines." Polish Arch Int Med 2017: 127.

Macfarlane, G., C. Kronisch, L. Dean, F. Atzeni, W. Häuser, E. Fluß, E. Choy, E. Kosek, K. Amris and J. Branco (2016). "EULAR revised recommendations for the management of fibromyalgia." Annals of the rheumatic diseases: annrheumdis-2016-209724.

Ossipov, M. H. and F. Porreca (2006). "Chronic pain: multiple manifestations, multiple mechanisms." Drug Discovery Today: Disease Mechanisms 3(3): 301-303.