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The salutogenic model of health proposes that sense of coherence, a multi-dimensional construct representing individuals' perceptions that their environment is comprehensible, manageable, and meaningful, is a key determinant of stress management and well-being.Generalized resistance resources such as preventive health orientation, material resources, and social support are proposed as determinants of sense of coherence. Health behaviors, particularly physical activity, are proposed as indicators of a preventive health orientation and predictors of sense of coherence. We synthesized research on the relationship between physical activity and sense of coherence using three-level meta-analysis, and tested effects of key moderators of the relationship. Database and manual searches identified 52 studies meeting inclusion criteria with 73 effect sizes testing the relationship. The analysis revealed a small non-zero physical activitysense of coherence correlation with significant heterogeneity. Demographic variables, version of sense of coherence scale, physical activity measure, study design and quality, physical activity intensity, and time lag did not moderate the correlation. Findings suggest a robust but small correlation between physical activity participation and sense of coherence across studies. Studies that test the relationship using experimental or intervention designs, adopt more precise measures, and include measures of other health behaviors and generalized resistance resources are needed.
The salutogenic model of health proposes that sense of coherence, a multi-dimensional construct representing individuals' perceptions that their environment is comprehensible, manageable, and meaningful, is a key determinant of stress management and well-being.Generalized resistance resources such as preventive health orientation, material resources, and social support are proposed as determinants of sense of coherence. Health behaviors, particularly physical activity, are proposed as indicators of a preventive health orientation and predictors of sense of coherence. We synthesized research on the relationship between physical activity and sense of coherence using three-level meta-analysis, and tested effects of key moderators of the relationship. Database and manual searches identified 52 studies meeting inclusion criteria with 73 effect sizes testing the relationship. The analysis revealed a small non-zero physical activitysense of coherence correlation with significant heterogeneity. Demographic variables, version of sense of coherence scale, physical activity measure, study design and quality, physical activity intensity, and time lag did not moderate the correlation. Findings suggest a robust but small correlation between physical activity participation and sense of coherence across studies. Studies that test the relationship using experimental or intervention designs, adopt more precise measures, and include measures of other health behaviors and generalized resistance resources are needed.
BackgroundPain Exposure Physical Therapy is a new treatment option for patients with Complex Regional Pain Syndrome type 1. It has been evaluated in retrospective as well as in prospective studies and proven to be safe and possibly effective. This indicates that Pain Exposure Physical Therapy is now ready for clinical evaluation. The results of an earlier performed pilot study with an n = 1 design, in which 20 patients with Complex Regional Pain Syndrome type 1 were treated with Pain Exposure Physical Therapy, were used for the design and power calculation of the present study.After completion and evaluation of this phase III study, a multi-centre implementation study will be conducted.The aim of this study is to determine whether Pain Exposure Physical Therapy can improve functional outcomes in patients with Complex Regional Pain Syndrome type 1.Methods/designThis study is designed as a single-blinded, randomized clinical trial. 62 patients will be randomized with a follow-up of 9 months to demonstrate the expected treatment effect. Complex Regional Pain Syndrome type 1 is diagnosed in accordance with the Bruehl/International Association for the Study of Pain criteria. Conventional therapy in accordance with the Dutch guideline will be compared with Pain Exposure Physical Therapy. Primary outcome measure is the Impairment level SumScore, restricted version.DiscussionThis is the first randomized controlled study with single blinding that has ever been planned in patients with Complex Regional Pain Syndrome type 1 and does not focus on a single aspect of the pain syndrome but compares treatment strategies based on completely different pathophysiological and cognitive theories.Trial registrationClinical trials NCT00817128; National Trial Register NTR2090
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