Physio Global Podcast

In this special bite-sized episode, recorded live at the Pain Science in Motion Congress in Brussels, we sit down with Mark van Loo. Mark is a physical therapist and researcher at the University of Applied Sciences Rotterdam, specializing in knee osteoarthritis and physical activity behavior. Mark shares insights from his PhD poster presentation, focusing on a fascinating physiological mechanism to help patients overcome the pain barrier when exercising.A major clinical hurdle in treating knee osteoarthritis is that movement is inherently painful for these patients, making it incredibly difficult to increase their physical activity levels. Mark’s research investigates a potential workaround known as exercise-induced hypoalgesia. This phenomenon involves a temporary decrease in pain sensitivity immediately following an exercise session, creating a window of pain reduction that typically lasts anywhere from 5 to 30 minutes.The ongoing crossover study explores whether utilizing non-painful areas of the body can reduce pain in the affected joints. The study design includes:Upper Body Interventions: Participants perform a rowing exercise using elastic bands, tested at both high and lower intensities.Lower Body Comparison: A high-intensity cycling condition is used as a standard comparison.Objective Pain Tracking: Pain thresholds are measured globally at the shoulder and locally at the knee using a pressure algometer.Timing: These pressure measurements are taken before the exercise and immediately after to capture the temporary pain-relief window.The research focuses on individuals suffering from knee osteoarthritis. So far, the feasibility of the study is highly promising. The research team has successfully recruited 37 out of their target 45 participants, noting excellent adherence and zero dropouts related to adverse events or the exercise protocols.Data collection is utilizing a strong crossover design, where participants are their own control group, and is expected to conclude before the summer. The team hopes to publish their findings by the end of the year.If the systemic effects of exercise-induced hypoalgesia are proven effective, it could revolutionize behavioral change strategies for this population. Clinicians could potentially use high-intensity upper body exercises as a strategic "warm-up" to induce temporary pain relief, opening a vital window to safely load and exercise the painful lower body without triggering the patient's alarm system.Are you a clinician struggling to get patients with severe knee osteoarthritis active? Consider the systemic effects of movement. While waiting for the final publication of this study, you can start thinking about how to integrate upper body conditioning into your treatment plans to help desensitize the nervous system before moving on to targeted lower extremity exercises.Event: Pain Science in Motion Congress in BrusselsFeatured Mechanism: Exercise-Induced HypoalgesiaCollaborating Entities: University of Applied Sciences Rotterdam, Physio Global & Pain in MotionDo you want to know more about Physio Global? Visit our website: ⁠www.physioglobal.nl⁠Or do you have other ideas or a question? Please send us an email: ⁠[email protected]⁠Mark’s Research: Exercise-Induced HypoalgesiaThe Study Design and MeasurementsTarget Population and Study StatusClinical Implications: A Gateway to MovementCall to Action for CliniciansReferences & ResourcesFor the Jingle a special thanks to: Seize the Day en Andrey Rossi. Muziek van #Uppbeat. 

In this special bite-sized episode, recorded live at the Pain Science in Motion Congress in Brussels, we sit down with Anneleen, a 30-year-old lab scientist who shares her personal testimonial as a chronic pain patient. Diagnosed with fibromyalgia at the age of 12, Anneleen offers a profound, firsthand perspective on the challenges of navigating the healthcare system and the turning points that helped her regain her mobility and life.Anneleen’s symptoms began at an early age, involving severe fatigue, muscle pain, and brain fog. Guided by her mother's own experience with fibromyalgia, Anneleen was evaluated through questionnaires and diagnosed at just 12 years old.Her early interventions were heavily medicalized and highly restrictive:Intravenous TreatmentsIntravenous: She regularly received magnesium intravenously, which left her feeling highly fatigued and foggy.Activity Restriction: Her general practitioner advised her not to walk or bike more than 4 kilometers, and she was granted exemptions from various school classes.Pharmaceuticals: She received extensive pharmaceutical care, which ultimately steered her further into an inactive and sedentary lifestyle.At age 21, Anneleen experienced a drastic turning point when she found a multidisciplinary center for pain education. After enduring a difficult period involving severe side effects from prescribed medication—including extreme fatigue, weight loss, and depression—she chose to stop the medication and pivot her approach in collaboration with her care team.Instead, she focused on holistic understanding and gradual re-engagement:Understanding the Alarm System: She learned about the mechanisms of pain and nociception, realizing that her nervous system's alarm system was constantly on edge and giving false signals.Intuitive Movement: She began incorporating activities like walking, cycling, and Yin yoga into her daily life, moving intuitively without having strict physical goals in mind.Reframing Pain: She learned how to validate the pain she was feeling, while simultaneously understanding that experiencing pain does not necessarily mean the body is being damaged.Anneleen highlights the importance of having a support system that recognizes the small, gradual victories in recovery that a patient might overlook. She also strongly advocates for transparency; despite the fear of repercussions, being radically honest with her employer and friends about her condition opened the door to much-needed understanding and support.Are you a clinician working with chronic pain? Annelien’s story underlines the vital importance of providing comprehensive pain science education and avoiding overly restrictive movement guidelines. Clinicians are encouraged to be open-minded, transparent, and supportive in helping patients find their own intuitive path back to movement.Event: Pain Science in Motion Congress in BrusselsCollaborating Entities: Physio Global & Pain in MotionDo you want to know more about Physio Global? Visit our website: ⁠www.physioglobal.nl⁠ Or do you have other ideas or a question? Please send us an email: ⁠[email protected]⁠ For the Jingle a special thanks to: Seize the Day en Andrey Rossi. Muziek van #Uppbeat.

In this episode, recorded live at the Pain Science in Motion Congress in Brussels, we sit down with PhD researcher and physiotherapist Sophie van Dijk from the University of Antwerp. Sophie shares insights from her double poster presentation, focusing on the critical challenges and methodologies surrounding the assessment of physical activity in populations living with persistent pain.Sophie’s Study: Measuring Activity in Persistent PainWhile physical activity is a cornerstone of chronic pain rehabilitation, staying active remains a massive hurdle for patients. To design effective, tailored interventions, clinicians must first be able to accurately track a patient's movement. Sophie van Dijk’s research addresses a fundamental clinical question: how do subjective patient self-reports compare to objective technological tracking?The Trade-offs of MeasurementBoth assessment methods have distinct pros and cons:●       Subjective Self-Reports (e.g., the IPAQ questionnaire): These are cost-effective and provide rich context, showing exactly where and why a patient is active (e.g., at work vs. during leisure). However, they are highly susceptible to recall bias.●       Objective Tracking (e.g., smartwatches and accelerometers): These deliver unbiased, continuous data that can actively boost patient motivation. On the downside, wearing a device 24/7 can be intrusive, and the data lacks behavioral context.Target Population and Study StatusThe research focuses specifically on breast cancer survivors, a group where roughly 45% to 50% experience persistent pain after completing treatment. By directly comparing their questionnaire answers with accelerometer data, the study aims to map out exactly where measurement discrepancies occur.This project efficiently "piggybacks" on the baseline data of a larger randomized controlled trial, the PEAK trial. Recruitment for Sophie's sub-study concludes at the end of this year, with data analysis slated for next year. Future steps will also examine how pain variables—like pain intensity and disability—directly influence a patient's tendency to over- or underestimate their actual physical activity.Clinical Implications: A Combined ApproachSophie emphasizes that the goal is not to choose one method over the other, but to integrate both. Merging the hard numbers of objective tracking with the rich, personal context of a questionnaire gives clinicians the complete picture. Ultimately, this combined approach opens the door to much more meaningful and effective conversations in the treatment room.Call to Action for CliniciansThe PEAK trial is actively seeking breast cancer survivors who suffer from persistent pain after ending their treatment. The trial offers a comprehensive intervention combining pain science education with targeted behavior change strategies to safely promote physical activity. Clinicians are highly encouraged to refer eligible patients via the research group's official channels. Recruitment is still open till the end of 2026.Do you want to know more about this Physical Activity Assessment Study? Visit the website:https://www.caredon.org/researchers/projects/pragmatic-rct-belgian-primary-care-and-hospital-settings-effectiveness-ehealthReferences & ResourcesFeatured Assessment Tool: IPAQ Long Form (International Physical Activity Questionnaire)Associated Clinical Trial: The PEAK Trial (Investigating Pain Science Education and Activity Behavior Change)Collaborating Entities: University of Antwerp & Pain in MotionDo you want to know more about Physio Global? Visit our website: www.physioglobal.nl Or do you have other ideas or a question? Please send us an email: [email protected] For the Jingle a special thanks to: Seize the Day en Andrey Rossi. Muziek van #Uppbeat.

Does Perceived Spatial Extent Mediate the Spatial Summation of Pain?In this episode, recorded live at the Pain Science in Motion Congress in Brussels, we sit down with clinical physiotherapist and researcher Tom Frankenstein. This special episode was brought to you in close collaboration with Pain in Motion. Tom dives into the intriguing findings from his oral presentation, exploring whether the perceived spatial extent of a stimulus mediates the well-known phenomenon of spatial summation of pain (SSp).🎙️ Featured Guest: Tom Frankenstein Clinical physiotherapist, lecturer, and PhD candidate at the University of Lübeck, Germany. Tom splits his time between managing chronic pain patients in the clinic and conducting advanced research in experimental pain science, aiming to uncover the complex supraspinal mechanisms behind spatial pain perception.The Central Question: Spatial Summation & PerceptionTom explains his research into whether spatial summation of pain (SSp) is driven solely by actual noxious stimulus inputs or if it is significantly mediated by how large a person perceives the painful area to be (perceived spatial extent).The Discrepancy of Pain RadiationBuilding on an evolution of research—specifically a 2025 study by Adamczyk et al.—Tom outlines the concept of "pain radiation." This highlights a massive discrepancy between actual physical stimulus boundaries and a person's spatial perception, sparking key questions about the underlying brain mechanisms.Experimental Setup and MethodologyThe study was conducted in a specialized research laboratory environment at the university with 53 healthy participants. Using a trackball, participants continuously rated both pain intensity and their perceived spatial extent during the application of noxious heat (contact heat) as well as innoxious tactile and warmth stimuli for comparative analysis.Uncovering Supraspinal MechanismsWhile spatial summation is typically a mix of peripheral, spinal, and supraspinal pathways, this project isolates spatial perception as a key supraspinal factor, showing how top-down cognitive and perceptual processing directly influences the experienced intensity of pain.Moving Toward Clinical PopulationsWith his PhD thesis submission imminent, Tom looks ahead to the future of pain science. He calls for these experimental models to be expanded into clinical populations, noting that conditions like Complex Regional Pain Syndrome (CRPS)—which currently lacks spatial summation studies—low back pain, fibromyalgia, knee osteoarthritis, and polyneuropathy could benefit enormously from clearer spatial perception data.References & Resources2025 Foundation Paper (Adamczyk et al.): PubMed LinkSSp Supraspinal Involvement Studies: Exploring Supraspinal Pathways Paper 1Exploring Supraspinal Pathways Paper 2Preprint on Clinical Relevance of Spatial Pain: medRxiv PreprintSpeaker Info & ContactResearchGate Profile: Tom Frankenstein on ResearchGateUniversity Profile & Contact: University of Lübeck Staff DetailsVisit our website for more info: www.physioglobal.nl Contact email information: [email protected]  For the Jingle a special thanks to: Seize the Day en Andrey Rossi. Muziek van #Uppbeat.

In deze aflevering van Physio Global gaan we in gesprek met dr. Robbert van Amstel, fysiotherapeut, manueel therapeut en senior onderzoeker aan de Vrije Universiteit van Amsterdam. Centraal in deze uitzending staat de intrigerende rol van het fasciale systeem bij de diagnostiek en behandeling van patiënten met lage rugpijn.Robbert neemt ons mee in de nieuwste wetenschappelijke inzichten rondom fascieweefsel en de klinische relevantie hiervan binnen de fysiotherapie. Wat zegt de huidige literatuur over de effectiviteit van fasciale interventies? Hoe beïnvloeden deze technieken mechanismen zoals weefsel mechanica en nociceptie bij lage rugklachten? En hoe vertaal je deze complexe neurobiologische en biomechanische processen concreet naar de dagelijkse praktijk op de behandelbank? Een onmisbare aflevering voor elke clinicus die zijn mechanische en neurofysiologische denkkader bij rugklachten wil verdiepen.🎙️ Gastspreker: dr. Robbert van AmstelOver de gastsprekerdr. Robbert van Amstel is een vooraanstaand expert, clinicus en onderzoeker gespecialiseerd in het fasciale systeem, manuele therapie en musculoskeletale revalidatie. Met zijn unieke combinatie van praktijkervaring en wetenschappelijke expertise slaat hij op heldere wijze de brug tussen complexe weefselbiologie en effectieve patiëntenzorg.Meer ontdekken?Wil je meer afleveringen beluisteren of op de hoogte blijven van de nieuwste klinische inzichten?Bezoek onze website: www.physioglobal.nlHeb je een vraag of wil je in contact komen? Stuur dan een e-mail naar: [email protected] of bezoek de contactpagina op onze website.#PhysioGlobal #Podcast #Fascia #LageRugpijn #Fysiotherapie #ManueleTherapie #PhysioNews For the Jingle a special thanks to:Seize the Day en Andrey Rossi. Muziek van #Uppbeat.