Nathalie Roussel

• PhD, MSc, PT
• Professor (Assistant) at University of Antwerp

Introduction: Despite the recommendations to use a bio-psycho-social framework, many physiotherapists still manage their patients mainly from a biomedical point of view. The purpose of this study is to analyze the impact of two different e-learning interventions on knowledge, attitudes, and clinical decision-making of physiotherapists managing low...

Introduction La lombalgie est une problématique mondiale qui devrait malheureusement augmenter dans les années à venir [1]. La première étape recommandée par les consensus scientifiques (guidelines) pour la prise en charge des lombalgies est le triage diagnostique [2], [3]. Cependant, des études antérieures ont mis en évidence des résultats préoccu...

Background/Objectives: White matter (WM) structural changes have been found in patients with chronic spinal pain (CSP). In these patients, pain neuroscience education followed by cognition-targeted exercise therapy (i.e., the Modern Pain Neuroscience Approach (MPNA)) was shown to be more effective than biomedically-focused education followed by sym...

Objective To summarise the evidence on the effect of physiotherapy-led versus physician-led care on clinical outcomes, healthcare use, and costs in persons with low back pain. Data sources PubMed, Web of Science, CINAHL, Embase, and PEDro were systematically searched with the latest search performed in July 2024. Reference lists of articles were h...

Background: Many physiotherapists still manage their patients mainly from a biomedical point of view. The purpose of this study was to analyze the effect of two different e-learning interventions on knowledge, attitudes and beliefs of physiotherapists managing low back pain (LBP). Methods: Physiotherapists were allocated (1/1) either to an experim...

Many physiotherapists still manage their patients mainly from a biomedical point of view. The purpose of this study was to analyze the effect of two different e-learning interventions on knowledge, attitudes and beliefs of physiotherapists managing low back pain (LBP). An interactive e-learning intervention focusing on patient’s reassurance, self-m...

Background In 2013, physical therapy students demonstrated low guideline-adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work. Objectives To assess the differences in physical therapy students’ attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis...

Neck-related arm pain is frequently encountered in clinical settings, yet its underlying pain mechanisms remain elusive. While such pain radiating from the neck to the arm is often attributed to injuries or diseases of the nervous system (neuropathic pain), it can also arise from nociceptive (referred) or nociplastic sources. Regrettably, patients...

Purpose Pain post-treatment is a debilitating symptom in the growing population of cancer survivors. While physical activity is an integral part of pain management, low levels of physical activity are often observed in this population. The aim of this systematic review is to gain insight into the barriers and facilitators to physical activity in ca...

Objectives.-The purpose of this cross-sectional study is to investigate the prevalence of impaired lumbopelvic motor control in elite tennis players with disabling episode of low back pain in the previous year. Material and methods.-Thirty-five elite tennis players (9 males and 26 females, mean age 17.4 ± 2.6 years) from two Belgian Tennis Academie...

Background: Joint pain is the hallmark of haemophilia; therefore it seems clinically rather a musculoskeletal than a bleeding disorder. Although joint pain in people with haemophilia (PwH) is a complex and multidimensional problem, pain assessment remains primarily focused on the structural evaluation of their joints. Whereas, only few data are av...

Background: While pain is influenced by multiple factors including psychosocial factors, previous research has shown that physiotherapists still favour a biomedical approach. Purpose: To evaluate: (1) how physiotherapists explain the patient’s chronic non-specific low back pain (LBP); (2) whether physiotherapists use one or multiple influencing fa...

Objectives: The aim of this systematic review is to compare the effectiveness of eHealth self-management interventions on pain intensity between oncological and musculoskeletal populations and to examine barriers and facilitators of the use of eHealth self-management tools. Content: In March 2021, a systematic search of the literature was conduc...

Background: Clinical practice guidelines promote bio-psychosocial management of patients suffering from low back pain (LBP). The objective of this study was to examine the current knowledge, attitudes and beliefs of physiotherapists about a guideline-adherent approach to LBP and to assess the ability of physiotherapists to recognise signs of a spe...

Background: A large proportion of people who sustain a whiplash injury will have persistent pain, disability, and participation problems. Several prognostic factors for functional recovery have been reported in the literature but these factors are often evaluated based on differing implementations in clinical practice. Additionally, physiotherapis...

Background: High intensity training (HIT) improves disability and physical fitness in persons with chronic nonspecific low back pain (CNSLBP). However, it remains unclear if HIT affects pain processing and psychosocial factors. Objective: To evaluate 1) the effects of HIT on symptoms of central sensitization and perceived stress and 2) the relat...

Introduction: Pain is highly prevalent in people with haemophilia (PwH), especially in those who did not receive adequate early prophylaxis. Despite the multifactorial aetiology of pain, its evaluation in PwH is commonly restricted to the evaluation of joint-related pain. Therefore, this study aimed at presenting a psychophysical assessment of pain...

Objectives: After total hip arthroplasty (THA), over 30% of individuals report activity limitations and participation restrictions. This systematic review aimed to determine the association between contextual factors and outcomes in the activity and participation domain after THA for hip osteoarthritis (OA). Methods: This systematic review was d...

Two previous studies showed kinematic differences between novice and experienced performers during unchoreographed movements executed in standing position. However, no study explores if these kinematic differences holds during unchoreographed movements executed in quadrupedal position. The aim of this study is to compare the movement behaviour of e...

Introduction: To assess activity limitations in people with haemophilia (PwH), the self-reported Haemophilia Activity List (HAL) is widely employed, despite several methodological limitations impacting the interpretation of categorical scores. Modern psychometric approaches avoid these limitations by using a probabilistic model, such as the Rasch...

Temporomandibular disorders (TMD) include a group of musculoskeletal disorders that may involve increased responsiveness of nociceptive neurons in the central nervous system (i.e. central sensitization). To test this hypothesis further, the present study examined whether, as compared with healthy subjects, patients with chronic TMD have a greater s...

Kinesiophobia is associated with pain intensity in people suffering from chronic pain. The number of publications highlighting this relationship has increased significantly in recent years, emphasizing the importance of investigating and synthesizing research evidence on this topic. The purpose of this scoping review was to answer the following que...

Introduction: Despite the fact that joint bleeds (haemarthrosis) frequently occur in people with haemophilia (PwH) with invalidating arthropathies as result, the clinical pain experience has received only limited attention. A sudden increase in pain intensity can be linked to a bleed, but in most cases, no acute bleed is confirmed. Nevertheless, a...

Low back pain (LBP) that radiates to the leg is not always related to a lesion or a disease of the nervous system (neuropathic pain): it might be nociceptive (referred) pain. Unfortunately, patients with low-back related leg pain are often given a variety of diagnoses (e.g. 'sciatica'; 'radicular pain'; pseudoradicular pain"). This terminology caus...

Many clinical guidelines promote a bio-psycho- social framework for the management of low back pain (LBP). The objective of this study was to examine the current knowledge, attitudes and beliefs of physiotherapists (PTs) about guideline- adherent approach in the management of LBP.

Great multidisciplinary experience for the team of the University of Antwerp and UCLouvain during the World Federation of Haemophilia congress. Nathalie Roussel and Valérie-Anne Chantrain were invited to speak on the necessity of implementing the biopsychosocial model to pain in men with haemophilia and women with bleedings disorders. The interplay...

Background: Conflicting results exist between somatosensory profiles of patients with temporomandibular myalgia (TMDm). The objective of this review was to examine whether adults with TMDm show altered responses to dynamic quantitative sensory tests compared with healthy controls. Methods: We searched five electronic databases for studies, exclu...

Introduction: Many people with haemophilia (PwH) report invalidating ankle pain. As the ankle is a weight bearing joint, its role in daily functioning is extremely important. While some studies investigated alterations in structure in the talocrural joint (TCJ), studies assessing the subtalar joint (STJ) are lacking and ankle pain in PwH is only po...

Abstract Background The assessment of cervical spine kinematic axial rotation performance is of great importance in the context of the study of neck sensorimotor control. However, studies addressing the influence of the level of provocation of spinal pain and the potential benefit of passive manual therapy mobilizations in patients with acute-subac...

Despite numerous guidelines promoting a bio-psycho-social approach in the management of patients with low back pain (LBP), many health care professionals (HCPs) still manage LBP patients mainly from a biomedical point of view. The purpose of this pilot study was to evaluate the feasibility of implementing an interactive e-learning module on the man...

Introduction: Low back pain (LBP) is ranked as the first musculoskeletal disorder considering years lived with disability worldwide. Despite numerous guidelines promoting a bio-psycho-social (BPS) approach in the management of patients with LBP, many health care professionals (HCPs) still manage LBP patients mainly from a biomedical point of view....

Background and purpose: Low back pain (LBP)-related misbeliefs are known to be among risk factors for LBP chronification and for persistence of chronic pain. The main objective of this study was to investigate the current LBP-related beliefs in the general population in Belgium, considering the fact that the last survey in Belgium about the topic...

Background Hemophilia is an X-linked hereditary bleeding disorder caused by deficiency in coagulation and a tendency for bleeding in muscles and large synovial joints (i.e. elbows, knees and ankles). Intra-articular bleeding (hemarthrosis) causes synovial hypertrophy and cartilage damage, with gradual but inexorable joint destruction (hemophilic ar...

The objective of this study was to explore the effects of static and dynamic hamstring muscles stretching on kinematics and esthetics of grand battement (high velocity kicks) in adolescent recreational dancers. Sixteen participants were assessed before and immediately after both stretching modalities. Kinematics of movement was measured by an optoe...

Background: Evaluation of kinematic axial cervical rotation performance is of major importance in the context of studying sensorimotor control of the neck. However, studies are missing on acute neck pain, on the influence of the level of provocation of spinal pain, and on the potential benefits of manual therapy mobilizations. Methods: A non-random...

Abstract Background From both evidence-based physiotherapy care and cost perspective, it is important that the duration of treatment episode and the number of physiotherapy sessions in traffic collision-related Whiplash-Associated Disorders (WAD) is tailored to the patient and can be prognosticated. However, little is known about the accuracy of ph...

Background Temporomandibular disorders (TMD) are characterized by complex symptomatology and their assessment can be enhanced using pain drawings (PD). Objectives To evaluate the location and extent of pain in people TMD using digital PD, and to explore their association with clinical features. Reliability of pain extent and pain location using PD...

Introduction: Chronic pain related to haemophilic arthropathy is a major concern in patients with haemophilia (PwH) and impacts their quality of life (QoL). At the present time, the majority of studies dedicated to pain assessment in haemophilia evaluated mainly severe and moderate PwH. Instead, this study focuses on two PwH subgroups that are negl...

BACKGROUND Low back pain (LBP) is ranked as the first musculoskeletal disorder considering years lived with disability worldwide. Despite numerous guidelines promoting a bio-psycho-social (BPS) approach in the management of patients with LBP, many health care professionals (HCPs) still manage LBP patients mainly from a biomedical point of view. Thi...

Operationalisation of variables of the clinical reasoning process at several different levels (nominal, ordinal, interval and ratio).

Background Whiplash-associated disorders (WADs) constitute a state of health characterized by a wide diversity of symptoms as a result of impairments of functions, activity limitations, and participation restrictions. Patient-reported outcome measurements (PROMs) and patient-reported outcomes (PROs) seem appropriate when describing and evaluating t...

We have studied the kinematics of ballet figures performed by adolescent recreational dancers and determined the most effective muscle stretching modality allowing to increase their physical performance while not harming the aesthetic perception of their motion. Sixteen participants aged between 10 and 19 years were recruited to perform a grand bat...

Objectives: to investigate the questionnaires used in French-speaking Belgian spine multidisciplinary rehabilitation centers for patients with low back pain and to propose a minimal core set of questionnaires based on the results of our survey and on the (inter)national guidelines. Methods: the spine centers offering the 36 two-hour sessions def...

Supplementary file 1. Overview of variables of context (n=9), process (n=9), outcome (n=7) and structure (n=2) indicators for physiotherapy in patients with Whiplash-Associated Disorders (WAD). Supplementary file 2. Variables per context indicator in patients with Whiplash-Associated Disorders (WAD). Supplementary file 3.Variables per process indic...

Background Prescription behavior in low back pain (LBP) differs between physical therapists with a biomedical versus a biopsychosocial belief, despite the presence of clinical guidelines. Objective To examine (1) the beliefs of physical therapy students and their adherence to clinical LBP guidelines in Belgium and the Netherlands; (2) whether the...

Cette note, rédigée dans le cadre du projet NOMADe ( http://nomadeproject.eu/ ), a pour but de pouvoir apporter des éclaircissements en matière de définition des troubles neuro-musculo-squelettiques, tout en opérant une différenciation avec la notion de douleur. / This note, written in the frame of the NOMADE project (http://nomadeproject.eu/), aim...

Background An increasing number of studies are focusing on secondary hyperalgesia to better understand central sensitization, as this phenomenon may play an important role in persistent pain. Recent studies have shown that, compared to the classical high frequency stimulation protocol (HFS) at 100 Hz, a protocol using 42 Hz stimulation induces a mo...

In deze periode van lockdown gelinkt aan het ernstig acuut ademhalingssyndroom coronavirus 2 (SARS-CoV-2), is het doel van dit artikel enerzijds om een opinie te formuleren over de doeltreffendheid van de kinesitherapeutische behandeling van neuromusculoskeletale aandoeningen (NMSA) via telerevalidatie (TR) en anderzijds om richtlijnen voor de kine...

En cette période de confinement liée au coronavirus 2 du syndrome respiratoire aigu sévère (SRAS-CoV-2), l’objectif de cet article est de formuler une opinion sur l'efficacité de la prise en charge kinésithérapique des troubles neuro-musculo-squelettiques (TNMS) par téléréadaptation (TR) ainsi que des guidelines pour les kinésithérapeutes. L’effica...

Background: Patients with chronic fatigue syndrome (CFS) and chronic whiplash associated disorders (cWAD) present a reduced ability to activate central descending nociceptive inhibition after exercise, compared to measurements before exercise. It was hypothesised that a dysfunctional motor-induced inhibition of nociception partly explains this dys...

In this period of containment related to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the objective of this article is to formulate an opinion on the effectiveness of physiotherapy management of Neuromusculoskeletal Disorders (NMSD) by telerehabilitation (TR) as well as guidelines for physiotherapists. The effectiveness of TR physi...

Objective: Laser-evoked potentials (LEPs) are among the reliable neurophysiological tools to investigate patients with neuropathic pain, as they can provide an objective account of the functional status of thermo-nociceptive pathways. The goal of this study was to explore the functioning of the nociceptive afferent pathways by examining LEPs in pa...

Background: In the context of interventions aimed at reducing pain, disability and maladaptive pain cognitions in chronic neck pain, it is hypothesized that patients who have greater symptom reduction, possibly also demonstrate greater improvement in cervical motor output. Therefore, the aim of this study was to examine the effect of pain neurosci...

Background Quality indicators (QIs) are measurable elements of practice performance and may relate to context, process, outcome and structure. A valid set of QIs have been developed, reflecting the clinical reasoning used in primary care physiotherapy for patients with whiplash-associated disorders (WAD). Donabedian’s model postulates relationships...

Objectives To investigate to which extent disability, psychological and pain-related factors are associated with the outcomes of an isometric trunk muscle strength test and a cardiopulmonary exercise test in persons with chronic nonspecific low back pain (CNSLBP). Design Cross-sectional study. Setting X Rehabilitation center. Participants Person...

Kinematic behavior during fast cervical rotations is a useful parameter for assessing sensorimotor control performances in neck-pain patients. However, the influence of age in asymptomatic individuals from children to older people still needs to be explored. Our aim was to assess the impact of age on sensorimotor control performance of the head-nec...

Background: Although the association of gray matter morphology alterations and pain-related psychosocial characteristics with pain intensity and chronification in people with chronic spinal pain is evident, research on their mutual interaction is scarce and does not account for possible gender differences. Gender-based differences are, however, of...

Objectives: To investigate the association of pain sensitivity and endogenous analgesia capacity, and training volume in a group of competitive swimmers. Design: An observational multi-center study. Setting: Multiple competitive swimming clubs. Participants: 102 healthy competitive swimmers. Main outcome measures: Training volume was estimated...

Rationale Kinematic behavior during fast cervical rotations is a useful parameter for assessing sensorimotor control performances in neck-pain patients. However, in asymptomatic individuals from children to seniors, the influence of age still needs to be explored. Aim and method We assessed the impact of age on sensorimotor control performance of...

Set of Quality Indicators (QIs) for physiotherapy care process of patients with Whiplash-Associated Disorders (WAD): steps of clinical reasoning, number of indicators, type of indicator, item measured, indicator, level of evidence and performance target

Steps of Clinical Reasoning Process. Overview of variables of Quality Indicators for the physiotherapy care process in patients with Whiplash-Associated Disorders (WAD) for analysis

Flowchart illustrating the steps of the clinical reasoning process in patients with Whiplash-Associated Disorders (WAD).

Purpose To develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011. Materials and methods The st...

Introduction An increasing number of clinical studies involving a range of chronic pain conditions report widespread mechanical pressure pain hypersensitivity, which is commonly interpreted as resulting from central sensitization (CS). Secondary hyperalgesia (increased pinprick sensitivity surrounding the site of injury) is considered to be a manif...

Background: Pain neuroscience education is effective in chronic pain management. Central sensitization (i.e. generalized hypersensitivity) is often explained as underlying mechanism for chronic pain, because of its clinical relevance and influence on pain severity, prognosis, and treatment outcome. Objectives: To examine whether patients with mo...

Despite the high prevalence of recurrent, constant and/or widespread pain in patients with haemophilia (PwH), there is an immense lack of studies examining the (patho)physiology of pain in this population. This contrasts to the bulk of literature in other pain conditions, such as osteoarthritis, low back pain or rheumatoid arthritis. Understanding...

Importance Effective treatments for chronic spinal pain are essential to reduce the related high personal and socioeconomic costs. Objective To compare pain neuroscience education combined with cognition-targeted motor control training with current best-evidence physiotherapy for reducing pain and improving functionality, gray matter morphologic f...

Objective: The objective of this cross-sectional study was to analyze the relationship between symptoms of central sensitization (CS) and important cognitive behavioral and psychosocial factors in a sample of patients with chronic nonspecific low back pain. Methods: Participants with chronic nonspecific low back pain for at least 3 months were i...

Background: Manual physical therapists (MPTs) working in primary care get limited information about patient's courses of (chronic) low back pain (LBP). Identification of kinesiophobia is mostly based on clinical perception. Objective: The aim of this study was to evaluate the association between the scores with which manual physical therapists i...

ABSTRACT Aim: To assess the effect of a pain neurophysiology education program plus therapeutic exercise for patients with chronic low back pain (CLBP). Design: Single-blind randomized controlled trial. Setting: Private clinic (Clínica Bonn) and Alcalá de Henares University, Madrid, Spain. Participants: 56 patients with CLBP for 6 months or more. I...

Chronicity and recurrence in musculoskeletal shoulder pain are highly prevalent and can possibly be attributed to the concept of central sensitization. Available studies suggest a role for central sensitization in explaining chronic shoulder pain, but so far a comprehensive quantitative sensory testing (QST) protocol has not been used. The aim of t...

Introduction: Although the importance of psychosocial factors has been highlighted in many studies in patients with chronic low back pain (CLBP), there is a lack of research examining the role of illness perceptions in explaining functional disability and physical activity in patients with CLBP. Aim: The aim of the study was to explore the value...

Auto-Targeted Neurostimulation Is Not Superior to Placebo in Chronic Low Back Pain: A Fourfold Blind Randomized Clinical Trial BACKGROUND: Myofascial trigger points (MTrPs) are common and may play a role in chronic nonspecific low back pain (CLBP). A potential treatment of MTrPs is the Nervomatrix Soleve® auto-targeted neurostimulation device, prov...

Background: Available evidence favors the use of pain neuroscience education (PNE) in patients with chronic pain. However, PNE trials are often limited to small sample sizes and, despite the current digital era, the effects of blended-learning PNE (ie, the combination of online digital media with traditional educational methods) have not yet been...

Pain physiology education is an important component in the management of patients with chronic musculoskeletal pain. The Neurophysiology of Pain Questionnaire (NPQ) was developed in English to assess pain physiology knowledge in patients. This study aimed to translate the NPQ into French (NPQ-Fr) and to investigate the main psychometric properties...

Background: In the last decade, attention for Pain Neuroscience Education (PNE) has increased remarkably. PNE aims at explaining the underlying physiology of chronic pain to increase the patients' understanding of the pain problem. PNE covers working mechanisms of both the peripheral and central nervous system and their changes in chronic pain (e.g...

Background: Nonspecific chronic spinal pain is a common problem within the chronic pain population and is characterized by high social, economic and personal impact. To date, therapists are still struggling in adequately treating these types of patients, as seen in the small and short-term benefits of frequently applied primary care treatments. It...

Theatre performers, more than common actors, experience high physical loadings. This study aimed at analysing the motor behaviour ofnovice performers (dancers/actors who were introduced to the acting method of Jan Fabre), by investigating the kinematics of a physical acting exercises in a prospective study. Two measurement sessions were organised,...

Introduction Compte tenu de l’existence repandue des croyances deleteres relatives au mal de dos [1] ; [2] et des limites des questionnaires existant, le « back pain attitudes questionnaire (Back-PAQ) » a recemment ete developpe pour mieux les identifier [3]. L’objectif de cette etude etait de traduire en francais la version courte (10 items) de ce...

Objectives: The term 'cephalalgiaphobia' was introduced in the mid-1980s and defined as fear of migraine (attacks). We hypothesized that a specific subtype of cephalalgiaphobia affects patients with cervicogenic headache (CEH). This study aimed to: (1) define the term 'cervico-cephalalgiaphobia'; (2) develop a set of indicators for phobia relevant...