Thread by @CraigLiebenson

@DerekGriffin86 LBP is complex & the social of BPS the code breaker between the dichotomization of pain science & biomechanics. I never got it when Waddell introduced Engel’s BPS model only focusing on biomechanics or YFs. Now I see social/environmental context as Job 1 to unmask. @_Tyson_Beach

@DerekGriffin86 @_Tyson_Beach “Kind Care Requires Unhurried Conversations
Health care providers must have time to know their patients in “high definition” to best meet their needs.”

catalyst.nejm.org/kind-care-requ…

@DerekGriffin86 @_Tyson_Beach “psychological factors are only the tip of the iceberg. Social & contextual factors,which have largely been overlooked in sports medicine, directly impact health outcomes,well-being & sport injury recovery by facilitating or impeding health & health behaviour change” @LKTphysio

@DerekGriffin86 @_Tyson_Beach @LKTphysio sci-hub.st/downloads/2020…

@DerekGriffin86 @_Tyson_Beach @LKTphysio “a shift to focus on the person is needed. This best practice approach will encourage clinicians to (1) focus on patients’ context and modifiable biopsychosocial factors that influence their pain and disability” bjsm.bmj.com/content/early/… @jpcaneiro @JanHartvigsen @PeteOSullivanPT

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT “When a patient presents with disability, clinicians need to explore the influence of contextual elements related to the patient’s occupation (work) and social context (ie, family) on the patient’s painful symptoms and disability.”dovepress.com/rehabilitation…

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT “contextual drivers...the social component of the BPS model is the weakest component of all current CSs for LBP & is scarcely mentioned in practice guidelines...Yet, like personal factors, environmental factors may have a significant influence on outcomes.” @chadcookpt

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “Patient-centred care incorporates each individual’s context, knowledge, needs, values, goals and preferences into shared decision-making about management.”

dx.doi.org/10.1136/bjspor…

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “Despite the development of critical thinking about PT, the assumptions of the still-dominant positivistic biomedical paradigm that values objective science above any other approach & sees the body-as-machine as a problem to be fixed, go unchallenged in the mainstream.”

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “person-centeredness entails listening and ‘being with’ rather than ‘doing to’ patients.” “effective person-centered practice means that “the clients expect from the professional to be an authority with regard to biomedical issues & to be a partner with regard to PS issues.”

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “it is not the person alone at its center, because rehabilitation is a social complex of practices that involves both the immediate stakeholders—patients, practitioners, family,& friends—and the macro-level of hospitals, politics, economics & taken-for-granted norms.”

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt jhrehab.org/2020/05/07/per…

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “Research is needed to understand the contextual factors that may cue the practice of defensive medicine, identify when it is most likely to occur, and develop strategies to prevent or reduce its occurrence when it results in unnecessary care.” …plementationscience.biomedcentral.com/articles/10.11…

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt podcasts.apple.com/us/podcast/bar…

@Peter_Stilwell work termed enactive gives a fresh scientific honest perspective on the Bio vs Pain Sci dichotomization. It’s not just blaming a disc or an output of brain but taking a broader approach.

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell Normally we try to simplify things in this case we try to appreciate the complexity. Of course the context is SOCIAL & this to me is where N=1 lives - their environment. readcube.com/articles/10.10…

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell “The recognition that each patient may present unique responses for a given health condition puts the client, his/her context and personal perspective at the center of the therapeutic process.”

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell “Traditional models of treatment prioritize remediation of defcits in structures & functions of the body, such as muscle strength & ROM. On the other hand, patients wish to improve their performance in activities they consider essential

@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell “... for their physical, psychological & social well-being. Correction of deficits may benecessary to therapy, but it cannot be its ultimate goal,because it is not sufficient for the promotion of patients’interests.”

researchgate.net/publication/31…