Papers by Bronwyn Thompson
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Hand Therapy
Introduction Complex Regional Pain Syndrome (CRPS) is most common in the upper limb and associate... more Introduction Complex Regional Pain Syndrome (CRPS) is most common in the upper limb and associated with high disability. The purpose of this review was to critically appraise and synthesise literature exploring non-pharmacological treatment for upper limb CRPS, to guide upper-limb-specific management. Methods Using an integrative review methodology, 13 databases were searched to identify all published studies on non-pharmacological management of upper limb CRPS. The Crowe Critical Appraisal Tool was used to provide quality ratings for included studies, and analysis employed a qualitative descriptive approach. Results From 236 abstracts reviewed, 113 full texts were read, and 38 articles selected for data extraction. Designs included single case ( n = 14), randomised controlled trial ( n = 8), prospective cohort ( n = 8), case series ( n = 4), retrospective ( n = 3), and mixed methods ( n = 1). Interventions were categorised as sensory retraining ( n = 13), kinesiotherapy ( n = 7), m...
Physiotherapy Theory and Practice
Background: Sensory profiles (SPs) may be useful in classifying patients based on sensory sensiti... more Background: Sensory profiles (SPs) may be useful in classifying patients based on sensory sensitivity and behavioral responses to stimuli to develop personalized treatments for nonspecific chronic low back pain (CLBP). The Adolescent/Adult Sensory Profile (AASP) identifies four sensitivity and behavioral response-related quadrants: Sensory Sensitive, Sensation Avoiding, Low Registration, and Sensation Seeking. It is an appropriate questionnaire for evaluating SPs; however, it has not been validated in CLBP. Objectives: To assess the internal consistency, test-retest reliability, agreement, and construct validity of the AASP in a CLBP population with nociplastic pain in primary care physiotherapy. Design: Two evaluations were performed at a 2-week interval in this non-experimental crosssectional study. Participants: Patients with CLBP. Methods: Questionnaires were used to compare outcomes with the AASP. Reliability was evaluated by assessing internal consistency and test-retest reliability. Construct validity was evaluated in response to the a priori hypothesis. Results: Ninety patients with CLBP were included. Internal consistency was excellent for all SPs (Cronbach's alpha, 0.91-0.92). Test-retest reliability Intraclass Correlation Coefficient (ICC (3,2)) 0.82-0.87, for the SPs (95% CI 0.74-0.91, p< .001). Construct validity correlated positively with Low Registration, Sensory Sensitive, and Sensation Avoiding and negatively with Sensation Seeking. Conclusion: The AASP is suitable for evaluating SPs in primary care CLBP patients.
Journal of Orthopaedic & Sports Physical Therapy
Participant data supporting Theme 1 â Knowledge: Certainty and Uncertainty. Additional data to su... more Participant data supporting Theme 1 â Knowledge: Certainty and Uncertainty. Additional data to support theme 1. (PDF 490 kb)
Consolidated criteria for reporting qualitative studies (COREQ) checklist. (PDF 280 kb)
Participant data supporting Theme 2 â Living with osteoarthritis. Additional data to support them... more Participant data supporting Theme 2 â Living with osteoarthritis. Additional data to support theme 2. (PDF 485 kb)
Pain, 2022
Classification of musculoskeletal pain based on underlying pain mechanisms (Nociceptive, Neuropat... more Classification of musculoskeletal pain based on underlying pain mechanisms (Nociceptive, Neuropathic and Nociplastic) is challenging. In the absence of a gold standard, verification of features that could aid in discrimination between these mechanisms in clinical practice and research depends on expert consensus. This Delphi expert consensus study aimed to: (1) identify features and assessment findings that are unique to a pain mechanism category or shared between no more than two; and (2) develop a ranked list of candidate features that could potentially discriminate between pain mechanisms. A group of international experts were recruited based on their expertise in the field of pain. The Delphi process involved two rounds; Round 1 assessed expert opinion on features that are unique to a pain mechanism category or shared between two A C C E P T E D 8 8 Copyright Ó by the International Association for the Study of Pain. Unauthorized reproduction of this article is prohibited. 2022 5 (based on a 40% agreement threshold); and Round 2 reviewed features that failed to reach consensus, evaluated additional features, and considered wording changes. Forty-nine international experts representing a wide range of disciplines participated. Consensus was reached for 196 out of 292 features presented to the panel (clinical examination-134 features, quantitative sensory testing-34, imaging and diagnostic testing-14, pain-type questionnaires-14). From the 196 features, consensus was reached for 76 features as unique to nociceptive (17), neuropathic (37), or nociplastic (22) pain mechanisms, and 120 features as shared between pairs of pain mechanism categories (78 for neuropathic and nociplastic pain). This consensus study generated a list of potential candidate features that are likely to aid discrimination between types of musculoskeletal pain.
Study): study protocol for a randomised
Meanings of Pain, 2019
Persistent pain is a common health problem and increasingly, qualitative research is being used t... more Persistent pain is a common health problem and increasingly, qualitative research is being used to explore the impact on daily lived experience. Stigmatisation and “othering” is reported in these studies, and health professionals indicate they struggle to know how best to help this group of people. In this autoethnography, I provide an account of my life as a clinician, educator, researcher and social media commentator who lives with fibromyalgia. Through this narrative I consider the social factors influencing my attitudes towards my own pain over time, and the position I hold as a member of many different social groups discussing persistent pain management. Clinical Implications People seeking help for their pain are influenced by family habits and attitudes towards healthcare and accepting clinical opinion. Although persistent pain is common, “othering” or the tendency to see those with persistent pain as different from clinicians (in a negative way) is frequently encountered. Th...
Meanings of Pain, 2016
Chronic pain is a perplexing and confusing experience for both the individual and the clinician. ... more Chronic pain is a perplexing and confusing experience for both the individual and the clinician. As meaning-making beings, people struggle to make sense of an experience that disrupts the sense of coherence and assumptions about who they are and what they can do. Individuals who successfully make sense of their pain, and can integrate this new reality into their self-concept are able to move forward in life. Findings from a classical grounded theory are used in this chapter to show the importance of making sense of pain as part of a process of regaining self-coherence. The overall process shows that a critical aspect of accepting chronic pain is learning to re-occupy a self-concept that integrates the impact of chronic pain while allowing the individual to express important values through activities in daily life. Clinicians are encouraged to place emphasis on creating a space where being present, listening and explaining can occur so that people living with pain can begin to feel that the world, and their place in it, makes sense.
Chapter One I ntrod uction What people with chronic pain say about returning to work 1 The differ... more Chapter One I ntrod uction What people with chronic pain say about returning to work 1 The difference between having pain and having pain but not working... 2 A multidimensional approach 3 The need for a new paradigm for work disability 6 An overview of interventions provided for work disability 8 Developing a model 10 Chapter Two , Chapter Three Problem Selection and Formulation Chapter Four Burwood Pain Management Centre and the Problem of Return to Work Outcomes Background to the problem Abductive method for theory development Features of the clinical setting Vocational status of individuals Referrals for Vocational Management Outcome variables selected for WorkAbilities Programme Model development: Assumptions for a new model of work disability 40 A framework model Boundaries Assessment Processes and Model Development Methods for looking at things differently ... Referrals for vocational management Case formulation in work disability 46 Case formulation origins and application Evaluation process Data collection Questionnaires The screening interview Stepping back: clinical abductive method in the WorkAbilities case formulation process Step One-Identify functional presentation (Phenomena detection) Step two-Generating explanations for the presenting features 58 Step Three-Generating a unique clinical model of presentation (Theory development) Step Four-Outcome evaluation (Theory appraisal) Data collection for model development Pattern detection Part A: The development of work disability Overview Questionnaires Summary of questionnaire presentations Goal related measures Qualitative analYSis of semi-structured interviews The five major groups 70
Acceptance and Commitment Therapy (ACT) is a third wave cognitive behavioural approach that has b... more Acceptance and Commitment Therapy (ACT) is a third wave cognitive behavioural approach that has been used in chronic pain management. Rather than emphasising the need to change thought contents, ACT emphasises changing an individual's awareness of, and relationship to their thoughts, emotions and behaviours (Steven C. Hayes & Duckworth, 2006). This paper illustrates ways occupational therapists can integrate ACT within occupational therapy when working with people who experience chronic pain.
British Journal of General Practice
Background: Osteoarthritis (OA) of the knee is a common cause of chronic pain. The currently avai... more Background: Osteoarthritis (OA) of the knee is a common cause of chronic pain. The currently available analgesics have limited efficacy and may be poorly tolerated. Aim: To investigate the analgesic efficacy of nortriptyline in people with knee OA. Design and setting: A two-arm parallel-group 1:1 double blind randomised placebo-controlled trial. Participants were recruited from orthopaedic outpatient clinics, primary care, and by public advertising. Method: Adults with knee OA and with pain rated as >20 points on the 50 point Western Ontario and McMaster University (WOMAC) pain sub-scale were randomised to receive either nortriptyline or identical placebo for 14 weeks. Primary outcome was knee pain at 14 weeks measured using the WOMAC pain sub-scale. Secondary outcomes included function, stiffness, non-steroidal anti-inflammatory drug, opioid and/or paracetamol use, participant global assessment, and adverse effects at 14 weeks. Results: Of the 205 randomised participants, 201 (9...
Spinal Cord Series and Cases
Study design A descriptive qualitative study. Objectives To explore why individuals with spinal c... more Study design A descriptive qualitative study. Objectives To explore why individuals with spinal cord injury (SCI) choose to use cannabis to manage their pain and their experiences in doing so. Setting Community-dwelling adults with SCI in New Zealand. Methods Semi-structured interviews were conducted with individuals who had a SCI, experienced pain, and self-reported use of cannabis to manage their pain. Interviews were recorded, transcribed, and subject to thematic analysis. Results Eight individuals participated in this study. We interpreted six themes that captured the participants' perspectives regarding their choice to, and perceptions of, using cannabis to manage SCI pain. Participants were motivated to use cannabis when other pain management strategies had been ineffective and were well-informed, knowledgeable cannabis consumers. Participants reported cannabis reduced their pain quickly and enabled them to engage in activities of daily living and participate in life roles without the drowsiness of traditional prescribed pain medication. Despite the positive aspects, participants were concerned about the irregularity of supply and inconsistent dosage. Conclusions Findings show that cannabis is used to reduce pain after SCI and enable increased community participation. Findings suggest that future studies examining the efficacy of cannabinoids in managing pain include function and participation outcome measures rather than solely focusing on measuring pain intensity. Focusing on meaningful outcomes may contribute to a greater understanding of the experiences of people with SCI.
BMC Rheumatology
Background: This study aimed to explore the beliefs of people with knee osteoarthritis (OA) about... more Background: This study aimed to explore the beliefs of people with knee osteoarthritis (OA) about the disease, and how these beliefs had formed and what impact these beliefs had on activity participation, health behaviour, and self-management. Methods: Semi-structured interviews were conducted with 13 people with knee OA recruited from general practices, community physiotherapy clinics, and public advertisements in two provinces of New Zealand. Data were analysed using Interpretive Description. Results: Two key themes emerged. 1) Knowledge: certainty and uncertainty described participants' strong beliefs about anatomical changes in their knee. Participants' beliefs in a biomechanical model of progressive joint degradation often appeared to originate within clinical encounters and from literal interpretation of the term 'wear and tear'. These beliefs led to uncertainty regarding interpretation of daily symptoms and participants' ability to influence the rate of decline and certainty that joint replacement surgery represented the only effective solution to fix the damaged knee. 2) Living with OA described broader perspectives of living with OA and the perceived need to balance competing values and risks when making decisions about activity participation, medication, attentional focus, accessing care, and making the most of today without sabotaging tomorrow. Misunderstandings about knee OA negatively impacted on activity participation, health behaviours, and self-management decisions. Conclusion: Biomechanical models of OA reduced participant exploration of management options and underpinned a perceived need to balance competing values. Improved information provision to people with knee OA could help guide positive health behaviour and self-management decisions and ensure these decisions are grounded in current evidence.
Disability and Rehabilitation
The New Zealand medical journal, Jan 30, 2018
Robertson/Clinical Reasoning in Occupational Therapy, 2012
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Papers by Bronwyn Thompson