The effectiveness of psychologically-informed physiotherapy for people with neck pain and the mediating role of illness perceptions: a replicated single-case experimental design study

What is the main takeaway?

The study titled "The effectiveness of psychologically-informed physiotherapy for people with neck pain and the mediating role of illness perceptions: a replicated single-case experimental design study" investigates the impact of psychologically-informed physiotherapy on individuals with chronic neck pain. Using a replicated single case experimental design, the study examined how psychologically-informed physiotherapy interventions - integrating cognitive behavioural approaches into physiotherapy - can modify pain intensity, disability, and illness perceptions. Over multiple treatment phases, patients demonstrated clinically meaningful improvements in pain and function, while changes in illness perceptions, particularly beliefs about control and emotional responses to pain, were identified as significant mediators of these outcomes. These findings suggest that addressing psychological factors alongside physical treatment could improve outcomes for people with chronic neck pain.

What is the real-world impact?

This study reinforces the value of multidisciplinary approaches in managing chronic musculoskeletal conditions, offering actionable insights for physiotherapists and rehabilitation specialists. Incorporating psychologically informed frameworks into standard physiotherapy could enhance treatment, reducing pain and improving long-term function in patients with chronic neck pain. Rehabilitation centres and digital health platforms focused on tele-physiotherapy could leverage these findings to develop tailored, holistic treatment protocols. Moreover, this research underscores the importance of addressing illness perceptions, guiding the development of patient education tools and behavioural interventions. For researchers, the use of single case experimental designs highlights the value of highly personalised assessments in studying complex, multidimensional therapies, contributing to advancements in psychosocial rehabilitation.

What do we think about it?

We note that this study exemplifies the suitability of a replicated single case experimental design for evaluating personalised physiotherapy at the individual level. This design robustly captures within-individual changes, demonstrating how shifts in illness perceptions mediate improvements in pain and function. The study showcases a novel application of SCEDs for evaluating personalised psychology informed physiotherapy interventions.

Who are the authors and where can I read the paper?

This study showcases a coordinated research effort led by Maaike Kragting, bringing together physiotherapists, methodologists, and clinical researchers across multiple institutions in the Netherlands and beyond. The project reflects a multidisciplinary approach, with contributions from experts such as Lennard Voogt, Annelies Pool-Goudzwaard, Jos Twisk, and Michel Coppieters. Their combined expertise spans physiotherapy, clinical epidemiology, and rehabilitation sciences, strengthening the study’s methodological rigour and practical relevance. (The study can be accessed here.)