The following is a summary of “Guarding and flow in the movements of people with chronic pain: A qualitative study of physiotherapists’ observations,” published in the November 2023 issue of Pain by Williams et al.
Chronic pain often manifests as guarding, which is a movement adaptation associated with disability, and understanding the nuances of guarding and its relationship to flow is crucial for pain management.
Researchers delved into physiotherapists’ observations of movement patterns in individuals with chronic pain to inform the design of assistive technologies for daily living tasks.
They conducted interviews with 16 physiotherapists, who were specialists in chronic pain, as they repeatedly viewed brief video clips of individuals experiencing chronic low back pain while performing basic movements. Physiotherapists examined movements, particularly emphasizing guarding and flow, with subsequent thematic analysis elaborating on these concepts.
The results showed a moderate agreement observed concerning the level of guarding in the videos. There was a high agreement that protection indicated a sense of caution regarding movement, separate from biomechanical factors like stiffness or reduced speed. Regarding physiotherapists’ observations on flow, there was a slightly higher agreement, with descriptions of movement in terms of restriction (where the flow was absent or only partial), the tempo of the complete movement, and its naturalness (distinct from the normality of movement).
Investigators concluded that movement qualities in chronic pain can inform the design of self-management tools.
Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2195
