Internet-Delivered Pain Resilience Therapy: A Multi-Subject Case Series
Keywords:
chronic pain, resilience, PRISM, musculoskeletal pain, salutogenesis
Abstract
Objective
Pain is a multifaceted phenomenon; therefore, innovative, multisystem approaches are recommended as a path to pain recovery. Pain Resilience Therapy (PRT) was developed as a novel, resilience-focused approach to pain management.
Methods
Three people with chronic pain received tele-physical therapy using PRT. The primary aim of PRT was to facilitate the development of pain resilience. Addressing vulnerability was a secondary aim. Treatment results were assessed using validated self-report measures for pain intensity, resilience, vulnerability, interference, patient outcome expectations, expectancies, and perspectives.
Results
All patients demonstrated a reduction in pain intensity and pain interference (PROMIS®) with associated improvements in activity, sleep, mood, and stress measured by the Defense and Veterans Pain Rating Scale (DVPRS 2.0). Resilience (positive affect/coping) and self-efficacy increased, as measured by the Pain Self-Efficacy Questionnaire (PSEQ), Self-Efficacy for Rehabilitation (SER), Chronic Pain Acceptance Questionnaire (CPAQ), and the Pain Resilience Scale (PRS). Certain measures related to vulnerability (negative mood and fear avoidance) also improved. The PRT intervention was safely delivered and patients reported their health as very much improved measured by the Patient Global Impression of Change (PGIC) survey.
Conclusion
This case series supports the application of PRT’s resilience-focused approach to attenuate pain and vulnerability while improving physical and psychological well-being. Although there is a need for research elucidating change mechanisms, assisting patients/clients in accessing resources that facilitate resilience is a valid pathway to pain recovery. This case series is a step toward integrating an understanding of resilience within the broader context of pain and disability.
Author Biographies
Joe, Integrative Pain Science Institute & Arcadia University
Joe Tatta, PT, DPT is the CEO of the Integrative Pain Science Institute and an adjunct professor at the Arcadia University Doctor of Physical Therapy Program. With a career spanning over 25 years, Dr. Tatta has been unwavering in his support for individuals suffering from pain, while also equipping healthcare professionals and stakeholders to enhance their pain management capabilities. His body of pain science research includes 10 peer-reviewed papers and three books including a textbook on Integrative and Lifestyle Medicine in Physical Therapy: A Guide for Primary Care, Health Promotion, and Disease Prevention. He is passionate about implementation science and strategies that facilitate the uptake of evidence-based practice into regular use by practitioners and stakeholders. The culmination of his work is PRISM: Pain Recovery and Integrative Systems Model – a cognitive behavioral approach for pain management and physical therapy.
Rose, Emory and Henry University
Dr. Rose Pignataro is the Assistant Chair and an Associate Professor in the Physical Therapy Program. She has 30 years of clinical experience as a physical therapist and 20 years of experience in physical therapy education.
EDUCATION
- Hunter College: City University of New York; BS Physical Therapy
- Stony Brook University, Stony Brook, New York; M.S. Health Science Education; post-professional DPT
- West Virginia University, Morgantown, West Virginia; PhD in Public Health
TEACHING
Dr. Pignataro’s primary areas of teaching are health promotion, pain, integumentary practice/ wound management, cardiopulmonary, professional issues, and research.
RESEARCH
Dr. Pignataro’s research agenda focuses on prevention, wellness, and health behavior change, with a special interest in reducing health disparities, particularly among people with disabilities. She has published articles on the use of motivational interviewing in physical therapist practice and clinical practice guidelines for tobacco cessation interventions.
PROFESSIONAL EXPERIENCE
Prior to joining the faculty at Emory & Henry, Dr. Pignataro was the Chair of Physical Therapy at AdventHealth University in Orlando. She has also served as a full-time or adjunct faculty member at University of South Florida, Florida Gulf Coast University, Gannon University, and Stony Brook University.
Her clinical background includes board certification in wound management and health education, with direct patient experience in acute care, wound care, cardiopulmonary, and geriatric physical therapy.
Janet, Texas State University
Dr. Bezner is Chair of the Department of Physical Therapy at Texas State University. She received her bachelor’s degree in physical therapy at the University of Texas Medical Branch, her master’s degree from Texas Woman’s University, a PhD in health education from the University of Texas, a DPT degree from Rocky Mountain University of Health Professions, and she is a National Board Certified Health and Wellness Coach. She was Vice President of Education, Governance and Administration at the American Physical Therapy Association (APTA) for 9 years. Bezner has practiced in a variety of health care settings, including hospitals, home health, long-term care, and corporate wellness. Bezner’s research has resulted in 10 book chapters, 25 published articles, 7 grants, and numerous conference presentations on health and wellness-related topics. Bezner served on APTA’s Board of Directors prior to joining its staff and is a recipient of the Lucy Blair Service Award and is a Catherine Worthingham Fellow of the APTA. She is an experienced speaker on topics related to health promotion and wellness, leadership, personal development, and strategic planning. Dr. Bezner has been facilitating strategic planning meetings and providing leadership training for non-profit organizations, academic units, and others for over 20 years.
Research Interests
Physical activity
Behavior change and health coaching
Culture of health
Carey, University of Central Florida
Carey Rothschild PT, DPT, OCS, SCS, CSCS is a Clinical Assistant Professor in the Doctor of Physical Therapy Program at the University of Central Florida. She received her Bachelor of Health Science degree from the University of Florida in 1999. She went on to earn her Doctorate in Physical Therapy in 2005 from Boston University. Rothschild is a dual board-certified clinical specialist in both Orthopaedic and Sports Physical Therapy. Rothschild has recently applied for her Certificate of Achievement in Pelvic Physical Therapy. She currently serves on the American Board of Physical Therapy Specialties Sports Specialty Council. Her research related to running and the female athlete has been published in the Strength and Conditioning Journal, the Journal of Strength and Conditioning Research, Sports Health, and the Journal of Women’s Health Physical Therapy. In 2019, Rothschild received the award for Excellence in Academic Teaching from the Florida Physical Therapy Association.
Credentials
- BS, Bachelor of Science, Physical Therapy, University of Florida
- PT, Licensed Physical Therapist, University of Florida
- DPT, Doctor of Physical Therapy, Boston University
- SCS, Board-Certified Clinical Specialist in Sports Physical Therapy, American Board of Physical Therapy Specialties
- OCS, Board-Certified Clinical Specialist in Orthopedic Physical Therapy, American Board of Physical Therapy Specialties
- CSCS, Certified Strength and Conditioning Specialist, National Strength and Conditioning Association
How to Cite
Tatta, J., Pignataro, R., Bezner, J., & Rothschild, C. (2024). Internet-Delivered Pain Resilience Therapy: A Multi-Subject Case Series. Journal of Physiotherapy in Mental Health, 1(1), 55–79. https://doi.org/10.70205/jptmh.v1i1.9277
