Does the patient exhibit this PB? If yes, with the integration of the patient’s context, beliefs, the frequency of this PB, etc., the clinician can interpret if the PB is adaptive or not and interferes with the rehabilitation process | |
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Verbal and nonverbal communication Pain-related behaviors that can be verbalized or executed by the patient to communicate with the therapist about his/her pain | |
• The patient stays focused on pain communication (e.g., always refers to his/her pain during conversation) [28, 29, 35, 41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56] | |
• The patient stays focused on disability or impairments despite clinical improvements [43, 52, 54, 57,58,59,60] | |
• The patient verbalizes hesitation or questions about his/her capacity to perform feasible tasks [42, 54, 55, 58, 61] | |
• The patient asks for help for tasks he/she can perform independently (alone) [27, 44,45,46, 49, 55, 60, 62,63,64,65] | |
Touching/rubbing the painful area after task accomplishment [11, 18, 28, 29, 31,32,33,34,35,36, 39, 42, 45, 51,52,53,54,55,56, 58, 61, 66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111] | |
Sounds Pain-related behaviors that can be heard by the therapist when the patient performs tasks or activities | |
• Groaning, Moaning, Whining, Whimpering, Crying, Screaming [11, 18, 27,28,29,30, 34, 35, 37, 39, 42, 44,45,46,47, 49,50,51, 53,54,55,56,57,58,59, 61,62,63, 67, 68, 70,71,72,73,74, 88, 97, 103,104,105, 107, 109, 111,112,113,114] | |
Sighing, Holding their breath, Taking a deep breath [11, 18, 27,28,29,30,31,32,33,34,35,36, 39, 42, 44, 50, 53,54,55,56,57, 61, 66, 68, 69, 71,72,73,74, 76,77,78,79,80,81,82, 85,86,87, 89,90,91,92,93,94, 96, 97, 100,101,102,103, 106, 107, 109,110,111, 115, 116] | |
Posture and movements Pain-related behaviors that can be seen by the therapist when the patient moves or remains in a static position | |
• Overcautious/overprotective during movements ○ Self-limiting range of motion ○ Stiff or rigid movements ○ Abnormally slow movements [11, 18, 26, 28, 29, 31,32,33,34,35,36,37,38, 42, 44,45,46, 49, 52, 53, 55, 57,58,59, 61,62,63, 66,67,68,69, 71, 72, 74,75,76,77,78,79,80,81,82, 85,86,87, 89, 90, 92,93,94,95,96,97,98,99,100,101,102,103,104, 106, 107, 109,110,111, 116,117,118,119,120,121,122] | |
• Strategies to minimize the threat and/or the load on the painful area during movement ○ Avoids or minimizes lifting, bending ○ Bending knees, kneeling, keeping the back straight ○ Moving the feet while rotating ○ Imbalance on the distribution of body weight [11, 18, 27, 28, 30, 32, 33, 37, 42, 45, 50, 52,53,54,55,56,57,58,59, 61,62,63, 66, 67, 69,70,71, 74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89, 92,93,94,95,96,97,98,99,100,101,102,103, 105,106,107,108,109,110, 119, 120, 123, 124] | |
• Keeps distorted gait despite clinical improvements ○ Limps ○ Drag one’s leg [11, 29, 33,34,35,36, 39, 41, 45, 46, 48, 49, 52, 54,55,56, 58, 62,63,64, 73, 74, 83, 84, 88, 91, 105, 113, 115] | |
• Delays activity execution ○ Drinks water between the order and the performance of a requested task/movement ○ Latency to initiate a requested task/movement ○ Misses therapy sessions if not reminded | |
• Excessive rest [34, 35, 43, 44, 51, 54, 55, 60, 62, 63, 70, 74, 84, 88, 105, 118, 119, 124,125,126,127,128] | |
Inconsistent findings during clinical examination Pain-related behaviors that can be provoked during the clinical examination | |
• Discrepancies between: ○ clinical findings and observed functional capacity or incapacity (dressing, …) ○ the demonstrated range of motion during clinical examination and during distraction tasks | |
Physical activities Pain-related behaviors that can be mentioned by the patient while talking about physical activities or performing tasks | |
• Avoid or minimize: ○ leisure activities ○ housework ○ sports ○ sexual intercourse [11, 33, 37, 43, 50, 51, 54,55,56, 60, 65, 67, 84, 125, 128, 130, 136] | |
• Undertakes nothing outside therapy time despite therapist’s encouragement [55] | |
Social and occupational activities Pain-related behaviors that can be mentioned by the patient while talking about social or occupational activities | |
• Avoids or minimizes spending time with people [50, 51, 55, 56, 62, 63, 74, 125] | |
Inappropriate use of Pain-related behaviors that can be mentioned by the patient while talking about or seen by the therapist | |
• Medication (prescribed or not) [27, 29, 45, 46, 51, 54,55,56, 58, 60, 67, 88, 105, 118, 119, 126, 127] | |
• Healthcare system | |
• Non-prescribed equipment ○ TENS ○ Cane or crutch ○ Brace [27, 29, 37, 39, 44, 46, 49, 52, 54, 55, 58, 62, 63, 67, 70, 86,87,88, 105, 119, 127] |