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Individually Tailored Treatment Targeting Motor Behavior, Cognition, and Disability: 2 Experimental Single-Case Studies of Patients With Recurrent and Persistent Musculoskeletal Pain in Primary Health Care

P Åsenlöf, PhD, is Registered Physical Therapist and Senior Lecturer, Department of Public Health and Caring Sciences/Section of Caring Sciences, Uppsala University, Uppsala Science Park, S-751 85 Uppsala, Sweden (pernilla.asenlof{at}pubcare.uu.se)
E Denison, PhD, is Registered Physical Therapist and Senior Lecturer, Department of Public Health and Caring Sciences/Section of Caring Sciences, Uppsala University
P Lindberg, PhD, is Associate Professor in Clinical Psychology, Department of Public Health and Caring Sciences/Section of Caring Sciences, Uppsala University

Address all correspondence to Dr Åsenlöf

Background and Purpose. This article introduces an individually tailored intervention targeting motor behavior, cognition, and disability in patients managed by physical therapists in primary health care. Effects on self-rated disability, pain intensity, and pain control are described. Subjects. Two women with recurrent or persistent disabling musculoskeletal pain were selected. Methods. Two experimental single-subject A₁-B-C-A₂ studies with multiple baselines across situations were used. Principal outcome data were collected daily with patient-specific continuous measures for 3 weeks before intervention, continuously during intervention, and for 2 weeks during each of the 1-, 4-, 6-, and 12-month follow-up examinations. Results. Disability and pain intensity decreased, and pain control increased in both subjects. The results were maintained at the follow-up examinations. Discussion and Conclusion. Positive outcomes of the intervention were reported from 2 subjects with recurrent and persistent disabling pain. Procedures for systematic tailoring of treatment to behavioral goals and individual patient characteristics are available as a result of the successful application. The results need to be replicated in future clinical controlled group studies.

Key Words: Behavioral medicine • Multiple baseline design • Musculoskeletal pain • Primary care • Self-efficacy