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 Pain
While 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 Measurement
Both 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 Status
The 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 Approach
Sophie 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 Clinicians
The 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:
References & Resources
Featured 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 Motion
Or do you have other ideas or a question? Please send us an email: info@physioglobal.nl
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 & Perception
Tom 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 Radiation
Building 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 Methodology
The 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 Mechanisms
While 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 Populations
With 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 & Resources
2025 Foundation Paper (Adamczyk et al.): PubMed Link
SSp Supraspinal Involvement Studies:
Preprint on Clinical Relevance of Spatial Pain:
Speaker Info & Contact
ResearchGate Profile: Tom Frankenstein on ResearchGate
University Profile & Contact: University of Lübeck Staff Details
This episode is brought to you bij Pain in Motion & Physio Global
In this episode, recorded live at the Pain Science in Motion Congress in Brussels, we sit down with manual therapist and researcher Roland Reezigt MSc. This special episode was produced in close collaboration with the Pain in Motion.
Roland dives into the neurobiological mechanisms behind manual therapy, exploring whether hands-on techniques can actually influence how the central nervous system processes pain in individuals suffering from neck pain.
🎙️ Featured Guest: Roland Reezigt MSc.Manual therapist, lecturer, and researcher affiliated with Hanzehogeschool Groningen and VU Amsterdam.An emerging voice in musculoskeletal physiotherapy, dedicated to bridging the gap between clinical manual therapy and advanced pain science.
The Central Question: Roland discusses his research into whether manual therapeutic techniques can directly modulate central pain processing mechanisms in people with neck pain.
Beyond the Joint: Shifting the perspective from purely mechanical explanations of manual therapy toward a neurophysiological and central nervous system-focused approach.
Live from PSiM: Key insights and discussions generated during the Pain Science in Motion Congress in Brussels, highlighting the future of pain research.
Clinical Relevance: How clinicians can integrate these insights into daily practice to better understand and treat patients with persistent neck complaints.
References
Yarnitsky D. Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states. Current Opinion in Anaesthesiology. 2010;23(5):611-615. doi:10.1097/ACO.0b013e32833c348b
Hermans L, Calders P, Oosterwijck JV, Verschelde E, Bertel E, Meeus M. An overview of offset analgesia and the comparison with conditioned pain modulation: A systematic literature review. Pain physician. 2016;19(6):307-326. doi:10.36076/ppj/2016.19.307
Ramaswamy S, Wodehouse T. Conditioned pain modulation—A comprehensive review. Neurophysiologie Clinique. Published online December 2020. doi:10.1016/j.neucli.2020.11.002