Papers by Astrid Woodhouse
Oxford Medicine Online, 2018
Norway is a member of the European Pain Federation (EFIC). The national pain society works to sup... more Norway is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.
European Journal of Pain, 2018
The development and recovery of chronic pain is highly dependent on previous pain. The prognosis ... more The development and recovery of chronic pain is highly dependent on previous pain. The prognosis of chronic pain may be predicted well when considering its duration in combination with other clinical, social and psychological factors. Targeting modifiable prognostic factors may be particularly important for newly developed chronic pain. Development and course of chronic pain 2
Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, Jan 27, 2017
To examine if elevated symptoms of insomnia affects neuropsychological functioning in patients wi... more To examine if elevated symptoms of insomnia affects neuropsychological functioning in patients with concurrent symptoms of pain, fatigue, and mood disorders. A total of seventy-six subjects participated in this (cross-sectional) study. Based on the cut-off score guidelines from The Insomnia Severity Index subjects were assigned to either a clinical insomnia group (N = 35) or a comparison group (N = 41). Factors such as age, general cognitive functioning, and symptoms of pain, fatigue, depression, and anxiety did not differ between the groups. Both groups completed a questionnaire which assessed subjective memory functioning. In addition they completed a set of neuropsychological tests measuring general cognitive functioning, spatial and verbal working memory, and inhibitory control. Although the subjects with clinical insomnia did not report more memory problems than the comparison group, they presented significant deficiencies on the tests assessing spatial and verbal working memor...
Journal of occupational rehabilitation, Jan 9, 2017
Purpose Transfer from on-site rehabilitation to the participant's daily environment is consid... more Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were me...
Frontiers in psychology, 2016
Introduction: The current study examined if adaptive working memory training (Cogmed QM) has the ... more Introduction: The current study examined if adaptive working memory training (Cogmed QM) has the potential to improve inhibitory control, working memory capacity, and perceptions of memory functioning in a group of patients currently on sick leave due to symptoms of pain, insomnia, fatigue, depression and anxiety. Participants who were referred to a vocational rehabilitation center volunteered to take part in the study. Methods: Participants were randomly assigned to either a training condition (N = 25) or a control condition (N = 29). Participants in the training condition received working memory training in addition to the clinical intervention offered as part of the rehabilitation program, while participants in the control condition received treatment as usual i.e., the rehabilitation program only. Inhibitory control was measured by The Stop Signal Task, working memory was assessed by the Spatial Working Memory Test, while perceptions of memory functioning were assessed by The Ev...
BMC Health Services Research, 2016
Background: Low back and neck pain are commonly reported in the general population and represent ... more Background: Low back and neck pain are commonly reported in the general population and represent frequent causes for health care consultations. The main aim of this study was to describe the determinants of health care contact during a 1-year period in a general population with recent onset spinal pain. Methods: From 9056 participants in a general health survey in Norway we identified 219 persons reporting a recent onset (<1 month) of low back or neck pain. Questionnaires were given at 1 (baseline), 2, 3, 6 and 12 months after pain debut. The main outcome was self-reported health care contact due to spinal pain. Associations between health care contact and pain-related factors, other somatic and mental health factors, pain-related work limitations, physical activity and sociodemographic factors were explored. Results: Conventional health care was sought by 93 persons (43 %) at least once throughout the year following the onset of pain. 18 persons (8 %) sought alternative health care only and 108 persons (49 %) sought no kind of health care. Baseline reports of coexisting low back and neck pain of equal intensity, poor self-reported health, symptoms of anxiety or depression, obesity and smoking were all associated with an increased tendency to seek conventional health care. Pain intensity and pain-related work limitations at each occasion were strongly associated with concurrent health care contact throughout the year. Higher education was associated with a reduced tendency to contact health care and no association was found for physical activity. Conclusion: The main finding in this study was that people from the general population who seek health-care for a new incident of neck or low back pain report more symptoms of mental distress, poorer self-reported health and more intense pain with stronger work limitations compared to those who do not. The findings suggest that identification of complementary symptoms is highly relevant in the examination of spinal pain patients, even for those with recent onset of symptoms.
Manual Therapy, 2016
First of all, I would like to thank my main supervisor, Ottar Vasseljen, for scientific guidance,... more First of all, I would like to thank my main supervisor, Ottar Vasseljen, for scientific guidance, always being available for questions, thorough reviews of manuscripts, and interesting ideas throughout the whole process. Your entusiasm for research has inspired me to carry on with research. I am grateful to my supervisors, Astrid Woodhouse, Ann-Katrin Stensdotter, and Øyvind Stavdahl, which together with Ottar have been the best supervisor team I could have wished for. Thanks to Astrid, my office colleague, for answering big and and small questions regarding pain and motor control and for sharing your clinical experience and thoughts. Thanks to Anki for discussions, ideas and sharing your expertise in the field of motor control. Thanks to Øyvind who has contributed with technical advice and helped me to understand the technical parts of this project. All of you are helpful and wonderful persons, and have complemented each other as supervisors. Thanks to all the physiotherapists working in private practice in Trondheim who contributed with inclusion of patients. A special thanks to Anita Bones, Ellinor Alstad, Elisabeth Eklo, Lise Brauten and Bjørg Vada for your help with inclusion of patients. In addition, thanks to the Neck and Back Pain Clinic at St.Olavs Hospital for helping with inclusion of patients. Several persons have contributed significantly to this project. I want to thank Knut andre Vestergren for invaluable help at the lab and development of the software program. Thanks to Håvard Lorås and Morten Dinhoff Pedersen for vital help with data analysis during the start and the end of the project, respectively. Thank to Hege Andresen for your help and experience in the lab during the first months of this project. Thanks to Marit Thielemann and Nina Vøllestad for discussions and sharing your knowledge in movement analysis. And lastly, Monica Unsgaard Tøndel for sharing office during the first part of the project and always answering questions. Thanks to all colleagues at 5th floor, ISM, for nice and supportive working environment and "salatlunsjer og kakefredager". Your kindness and helpfullness is of great value for a doctoral student! Thanks to my parents, Ragna and Ivar, for learning me hard work and always to do my best, and for showing me the most important in life. Finally, I owe my deepest gratitude to my wife, Kristine, love of my life, and our wonderful son Ebbe, making me smile each day I come home. This thesis would not have been possible without your support and taking care of Ebbe at night and day. I dedicate this thesis to you!
PLoS ONE, 2014
Objective: This study aimed to (1) See whether increased or decreased variation relate to subject... more Objective: This study aimed to (1) See whether increased or decreased variation relate to subjective reports of common somatic and psychological symptoms for a population on long-term sick leave; and (2) See if this pattern in variation is correlated with autonomic activation and psychological appraisal. Methods: Our participants (n = 87) were referred to a 3.5-week return-to-work rehabilitation program, and had been on paid sick leave .8 weeks due to musculoskeletal pain, fatigue and/or common mental disorders. An extensive survey was completed, addressing socio-demographics, somatic and psychological complaints. In addition, a physician and a psychologist examined the participants, determining baseline heart rate, medication use and SCID-I diagnoses. During the 3.5-week program, the participants completed the Trier Social Stress Test for Groups. Participants wore heart rate monitors and filled out Visual Analogue Scales during the TSST-G. Results: Our participants presented a low cortisol variation, with mixed model analyses showing a maximal increase in free saliva cortisol of 26% (95% CI, 0.21-0.32). Simultaneously, the increase in heart rate and Visual Analogue Scales was substantial, indicating autonomic and psychological activation consistent with intense stress from the Trier Social Stress Test for Groups. Conclusions: The current findings are the first description of a blunted cortisol response in a heterogeneous group of patients on long-term sick leave. The results suggest lack of cortisol reactivity as a possible biological link involved in the pathway between stress, sustained activation and long-term sick leave.
Global Journal of Health Science, 2016
BACKGROUND: Specific stabilizing exercises activating deep local muscles in coordination with glo... more BACKGROUND: Specific stabilizing exercises activating deep local muscles in coordination with global muscles are recommended in the treatment of pregnancy-related lumbopelvic pain. Some studies have suggested that recruitment of the deepest abdominal muscle, transversus abdominis, is crucial in the development and improvement of lumbopelvic pain.OBJECTIVE: This exploratory study aimed to describe the development of pain, disability and transversus abdominis recruitment before, during and after an individually designed intervention including an exercise program for women with persisting lumbopelvic pain after delivery.DESIGN: A multiple-baseline, single-subject experimental design was applied.METHODS: Sixteen women with lumbopelvic pain after delivery were included and received tailored exercise therapy, including ultrasound-guided activation of deep muscles, strengthening and stretching exercises and advice. Pain, disability and ultrasound-recorded activation of transversus abdomini...
Scandinavian journal of psychology, 2020
Acceptance and Commitment Therapy (ACT) is potentially effective for treating chronic fatigue. Gi... more Acceptance and Commitment Therapy (ACT) is potentially effective for treating chronic fatigue. Given the paucity of studies on this topic, we aimed to assess long-term trajectories of primary (fatigue, quality of life and functional abilities) and secondary outcomes (anxious and depressive symptoms) of an ACT-based rehabilitation program for patients with chronic fatigue. Further, we examined if changes in potential process variables (psychological inflexibility, metacognitive beliefs, and cognitive and behavioral responses to symptoms) during ACT predicted change in all outcomes across follow-up. One-hundred ninety-five workers on sick leave (mean age: 43.61 ± 9.33 years; 80.5% females) with a diagnosis of chronic fatigue were enrolled in a manualized, 3.5-week intensive return-to-work rehabilitation program based on ACT. All completed a battery of questionnaires at pre-, post-treatment, 6 and 12 months follow-up. We found significant longitudinal changes in most primary and second...
BMC Musculoskeletal Disorders, 2021
Objectives The aim of the study was to explore the experiences of participants in non-pharmacolog... more Objectives The aim of the study was to explore the experiences of participants in non-pharmacological group-based treatments delivered as part of a randomised controlled trial at Norwegian tertiary care pain centres. Methods Individual semi-structured interviews with 15 persons were conducted. The data were analysed with a descriptive thematic cross-case analysis based on the method of systematic text condensation. Results All participants talked about some aspects of the group-based treatments as a positive experience, but mainly the outcome was in line with their expectations; they hoped it would reduce their pain but did not expect it. There were no clear-cut differences in the experiences between the participants from the two different intervention groups. The content was experienced as both relevant and interesting but also to introduce concepts that were difficult to grasp and understand. Similarly, the experiences of participating in a group-based treatment were mostly stimul...
BMC Musculoskeletal Disorders
Background There are large variations in symptoms and prognostic factors among patients sharing t... more Background There are large variations in symptoms and prognostic factors among patients sharing the same musculoskeletal (MSK) diagnosis, making traditional diagnostic labelling not very helpful in informing treatment or prognosis. Recently, we identified five MSK phenotypes across common MSK pain locations through latent class analysis (LCA). The aim of this study was to explore the one-year recovery trajectories for pain and functional limitations in the phenotypes and describe these in relation to the course of traditional diagnostic MSK groups. Methods We conducted a longitudinal observational study of 147 patients with neck, back, shoulder or complex pain in primary health care physiotherapy. Data on pain intensity and function were collected at baseline (week 0) and 1, 2, 3, 4, 6, 8, 12, 26 and 52 weeks of follow up using web-based questionnaires and mobile text messages. Recovery trajectories were described separately for the traditional diagnostic MSK groups based on pain lo...
European Journal of Pain
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde
Transfer from on-site rehabilitation to the participant's daily environment is considered a weak ... more Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. Various follow-up regimes have been implemented after multidisciplinary rehabilitation, however, consensus is lacking on recommended content, duration and intensity.
TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde
SamenvattingMost occupational rehabilitation programmes target specific disorders. Crossover betw... more SamenvattingMost occupational rehabilitation programmes target specific disorders. Crossover between programmes for mental and somatic disorders has been discussed and it has been pointed out that interventions may be applicable across different diagnostic categories. This study aimed to investigate the feasibility of introducing a novel transdiagnostic occupational rehabilitation programme that was delivered in groups mixing participants with chronic pain, chronic fatigue and common mental disorders.
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Papers by Astrid Woodhouse