Das biopsychosoziale Modell als Leitfaden für die Behandlung von muskuloskelettalen Schmerzen und Behinderungen durch bewegungsbasierte Therapie

Abstract

BACKGROUND: Whether or not pain patients presenting to physiotherapists are suited for rehabilitation using movement-based treatments depends critically on the nature of the underlying pathology. OBJECTIVE/METHOD/RESULTS: Examples are given of suitable and unsuitable pathologies. However, even when not contraindicated, where clinical decisions are based on the outmoded ”biomedical” (structure-based) model, which often seems to be the case, the chances of success are seriously limited. ”Best practice” evidence indicates that better clinical outcomes, along with therapists’ improved perceptions of self efficacy, are likely to be achieved by strategies that also address psychological drivers of musculoskeletal pain. On the basis of examples and evidence it is argued, that well-trained physiotherapists are ideally positioned to utilise appropriate strategies based on the principles and practice of cognitive behavioural therapy. CONCLUSION:Cognitive behavioural therapy is a product of the now preferred biopsychosocial model of pain and pain-related disability.