Precision Rehabilitation for Managing Pain

The assessment and management of pain is an international challenge and comes with substantial individual and societal costs.

Appropriate identification of patient-specific interventions are a major priority and comprehensive assessments, taking into consideration the multidimensional nature of spinal pain, are warranted to inform safe and precise rehabilitation. CPR Spine utilises cutting edge technology and multidisciplinary expertise to collectively advance the assessment of patients with spinal pain through the development of new assessment tools, and by establishing valid and reliable clinical testing protocols and evidence informed decision making frameworks, to inform safe and efficacious interventions.

Effective precision rehabilitation enables improved effectiveness (clinical and cost) as it identifies which patients to target with rehabilitation, when and how to target them; and therefore enables more effective use of rehabilitation resources.


Current Projects

Project Title: Development of a novel screening tool to identify patients at risk of developing ongoing post-traumatic pain and disability.

Pain is an expected and appropriate experience following traumatic musculoskeletal injury. By contrast, chronic pain and disability are unhelpful yet common sequelae of trauma-related injuries. Presently, the mechanisms that underlie the transition from acute to chronic disabling post-traumatic pain are not fully understood. Such knowledge would facilitate the development and implementation of precision rehabilitation approaches that match interventions to projected risk of recovery, with the aim of preventing poor long-term outcomes.

The aim of this study is to identify a set of predictive factors to identify patients at risk of developing ongoing post-traumatic pain and disability following acute musculoskeletal trauma. To achieve this, we will use a unique and comprehensive combination of patient-reported outcome measures, psychophysical testing and biomarkers.  This project intends to aid in formulating future clinical pathways to identify these potential predictive factors/risks among post-injury patients and facilitate delivery of effective interventions to prevent development of chronicity and poor recovery.


Project Title: Investigating the causal mechanisms of responsiveness to exercise interventions in people with chronic pain

A causal understanding behind the mechanisms by which different exercise-based interventions work is critical for clinicians to better manage the heterogeneous condition of chronic pain. We are using advanced statistical approaches to identify the causal mechanism(s) which might explain the differing clinical effectiveness of different types of exercise programmes for managing chronic pain. Our results are revealing several candidate modifiable mediators that could be the target of future intervention trials. In so doing, our statistical models could increase the precision of treatment and outcome assessment of individuals with chronic pain, as well as increase the predictability of improving this costly condition. 


Project Title: Secondary prevention of chronic pain: Building resilience in chronic disease

The biopsychosocial approach to study chronic conditions propose a framework that tries to create a comprehensive understanding of patients' problems. This understanding is essential for the secondary prevention of chronic pain. In line with the biopsychosocial model's assumptions and efforts for the secondary prevention of chronic pain, many researchers emphasized building resilience in patients and their families. Resilience is the capability to overcome the problems in the face of adversity. Being resilient helps a person to “bounce back" and determines success and better quality of life.

Psychological and cognitive factors have a determinant role in building resilience in patients, and cognitive rehabilitation protocols are developed on that basis. For example, attention training tries to help patients to disengage from the subject of their worries easier, and interpretation training protocols try to teach patients to find ambiguous bodily symptoms less worrisome. In this project, we are interested in the understanding of the underlying mechanisms of psychological vulnerability in chronic pain conditions and design of interventions that target the reciprocal influence of cognitive biases to improve the quality of life of patients.