Addressing pain through physical therapy

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Torture survivors introduction to physiotherapy: Torture and sequelae after torture

Prip, K & Amris, K. (2003), Rehabilitation and Research Centre for Torture Victims, 45 pages.
 
This booklet was reviewed by Brittany Burton, doctoral physical therapy student at the University of Minnesota, 2014.
 
Link is to the article from the Dignity-Danish Institute Against Torture library. 
 
Introduction: Explanation of what the Rehabilitation and Research Centre for Torture Victims (RCT) is and the objectives of this organization which is based in Denmark.

Building Clients’ Trust Through Physiotherapy

Since I joined CVT in 2015, I have had the opportunity to see healing and change happen. I see torture survivors who come into the program afraid, with limited mobility and an inability to talk about what has happened to them. But by the end of the ten-week cycle, I see them talking, helping each other and increasing their movements – I believe that building trust is one of the most important things that leads to healing....

Chronic Pain and PTSD: The Perpetual Avoidance Model and its Treatment Implications

This article examines the interplay between chronic pain and PTSD and treatment implications. Various risk factors, models and treatment recommendations are explored. The authors conclude that the treatment for traumatized patients suffering from PTSD and chronic pain should include a biopsychosocial approach, combining education about the maladaptive behaviors leading to disability, as well as exposure therapy, relaxation, biofeedback, and therapeutic exercise.

Complementary therapies for treating survivors of torture

Vargas, C., O’Rourke, D. & Esfandian, M. Refuge: Canada’s Periodical on Refugees, 22(1), 129-137.
 
This article was reviewed by doctoral physical therapy student from the University of Minnesota, Angela Pitar, 2014.
 
Link to full text article from the Dignity-Danish Institute Against Torture is below.
 
Background - the assumptions that physical pain, unexplained by medical or physical findings, is psychosomatic in nature has been long standing and pervasive as was pain reported by survivors of torture attributed to psychological trauma.

Examination by the Physiotherapist

Amris, K. & Prip, K. (1994). Torture Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture, Suppl. 1, 14-27.
 
This article was reviewed by Angela Pitar, doctoral physical therapy student at the University of Minnesota, 2014. 
 
The link to the full text of the article from Dignity-Danish Institute Against Torture is below.
 
Purpose - the purpose of physical therapy is to reduce pain, improve function, and educate patients on how to cope with pain.

Increasing Activity and Improving Function in Chronic Pain Management

Chronic pain is a condition of complexity that requires a multi-dimensional approach. Unfortunately, not many patients who suffer from chronic pain are able to use a clinic or program that addresses chronic pain management due to their location or finances. The goal of this article is to give an overview of approaches that may be helpful to physiotherapists in their own practice relating to chronic pain.

Mind and body-Physiotherapy and complementary therapy

Hough, A. (1992). Paper presented at the International Conference of Centres, Institutions and Individuals Concerned With the Care of Victims of Organized Violence: Health , Political Repression and Human Rights, Santiago, Chile. 
 
This article was reviewed by University of Minnesota physical therapy doctoral student, Angela Pitar, 2014. 
 
The article may be obtained free of charge by emailing library@dignityinstiture.dk. 
 
Background - Torture victims often present with a multitude of problems and complementary therapy seeks to address each problem using a comprehensive and collaborative

Pain: physiologic mechanisms used in physical therapy

 Skjoerboek, I. (1994). Torture Quarterly, Suppl. 1, 33-35.
 
This article was reviewed by Angela Pitar, doctoral physical therapy student at the University of Minnesota, 2014. 
 
The link to the article from the Dignity-Danish Institute Against Torture, is below.
 
Background - the definition of pain is an unpleasant sensory and emotional experience associated with the actual or potential tissue damage, or described by the patient in terms of such damage. Detailed descriptions of mechanisms of pain and treatment implications are made.
 
Physiology of pain - the perception of pain is either affected

Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: A literature review

This article includes an overall review of the literature about the efficacy of physiotherapy when working with clients who have pelvic floor issues, including incontinence, painful sexual functioning and other concerns.

Rosenbaum, T.Y. The Journal of Sexual Medicine, 2007; 4: 4-13.

This article was reviewed by doctoral physical therapy student from the University of Minnesota, Torey Tilahune, 2019.

Link to full text article is found below.

Background

The sphincteric and supportive functions of the pelvic floor are relatively well understood, and the specialized field within physical therapy

Physical Therapy for Survivors of Torture

Description

Some specialized torture treatment centers have observed benefits among their patients from physical treatment modalities such as physical therapy or massage. Primary care or other clinics treating torture survivors may also consider such interventions when addressing complaints of chronic pain and physical symptoms.  Because torture is usually directed in part toward the physical being of the victim, attention to the body can be especially therapeutic, both emotionally and physically.

Physical Therapy in Nairobi

Last November, I made my fourth trip to Nairobi to visit our CVT project. As a physical therapy advisor to our Kenya staff, I serve as a consultant, supervisor and colleague to Jepkemoi Kibet, our physical therapist/trainer in Kenya. Jep, in turn, supervises and trains our local physical therapists, Stephen, Jennifer and Collins. We have four treatment sites where we lead physical therapy sessions: at our main offices in the Westlands neighborhood we work with young women; in the Eastleigh neighborhood we work with Somali refugees; and in the Riruta and Kayole areas we see mixed groups of refugees from Rwanda, Burundi and the Congo.

Physical Therapy/Physiotherapy

Physiotherapy (Physical Therapy: these terms will be used interchangeably on this website) is a growing field in the area of torture survivor treatment. Survivors of torture are often affected by chronic pain and by difficulty in carrying out functional activities.
 
Research carried out by Dignity-Danish Institute Against Torture suggests that up to 80% of torture survivors could benefit from receiving physiotherapy. A worldwide survey of torture treatment centers carried out by the Center for Victims of Torture staff shows that a majority of clients receive physical therapy 51% of the time

Physiotherapy as empowerment : Treating women with chronic pelvic pain

Mattsson, M., Wilkman, M., Dahlberg, L. & Mattson, B. (2000). Advances in Physiotherapy, 2(3), 125-143.
reviewed by Aaron O’Donnell, University of Minnesota doctoral physical therapy student, 2014
This article is available free of charge from Dignity-Danish Institute Against Torture. Please email them at library@dignityinstitute.dk and include a list of desired articles and your mailing address.
 
Background: A large group of CPP (chronic pelvic pain) patients are “inexplicable” from a medical point of view.

Physiotherapy examination and treatment

Jacobsen et al.
Link and reference information will be posted soon.
This article was reviewed by Mark Deschepper, physical therapy doctoral student at the University of Minnesota, 2014.
 
Introduction:
Most torture survivors complain of pain the locomotor system with many experiencing pain through all daily routines including sleep. Living with pain and performing daily tasks are significantly difficult for survivors. Physical torture leads to damage in the muscles, joints, and neurovascular system, concentration, and memory.

Physiotherapy for torture victims I: Chronic pain in torture victims: Possible mechanisms for the pain

Prip, K. & Amris, K. Torture Quarterly: Journal on Rehabilitation of Torture Victims and Prevention of Torture, 10(3), 73-76.
 
This article was reviewed by doctoral physical therapy student, Angela Pitar, from the University of Minnesota, 2014. 
 
A link to the article from the Dignity-Danish Institute Against Torture library is below.
 
Background - Throughout the years, several chronic muscular pain syndromes have been described in victims of torture with common findings of:  regional or diffuse pain in the musculoskeletal system often associated with poor sleep, tiredness, paresthesia, headache,

Physiotherapy for torture victims II: Treatment of chronic pain

Amris, K. & Prip, K. (2000), Torture Quarterly: Journal on Rehabilitation of Torture Victims and Prevention of Torture, 10(4), 112-16.
 
This article was reviewed by Stephanie Greer, University of Minnesota doctoral physical therapy student.
 
The link to the article from the Dignity-Danish Institute Against Torture, follows below.
 
Background - Several studies of torture victims have shown that physical complaints are common even years after torture and that pain in relation to the musculoskeletal system is a dominating symptom.

Physiotherapy to Help Survivors of Torture in Their Darkest Hours

Most people will have the experience of having a nightmare at some time. It’s not pleasant, but we deal with it. For a survivor of torture, however, a nightmare can be an extremely difficult situation. During a nightmare, the torture survivor relives his trauma. And by “relive” I mean it’s like a video he is watching of the experience. His body reflects this in his sleep. He may wake up in the same position as when he was tortured. This is one of the things I help people with in my work as a physiotherapist at CVT.

Prevalence of pain in the head, back and feet in refugees previously exposed to torture: A ten-year follow-up study

This article looks at the change over 10 years concerning pain in the head, back, and feet among previously tortured refugees now residing in Denmark, and to compare associations between methods of torture and pain at baseline and after 10 years. Pain in the head, back, and feet were chosen because they are frequently reported symptoms. Conclusions were that: Pain increased, despite treatment at RCT; Treatment does not decrease risk of continuing or increasing symptoms of pain; 20 years after torture took place, increasing proportions of survivors seems to suffer from pain associated with the type and bodily focus of the torture. This presents a considerable challenge to future evidence based development of effective treatment programs.

Psychosomatic group treatment helps women with chronic pelvic pain

Albert, H. (1999). Journal of Psychosomatic Obstetrics and Gynaecology, 20(4), 216-225.
 
Reviewed by Brittany Burton, doctoral physical therapy candidate from the University of Minnesota, 2014. 
 
Please email them at library@dignityinstitute.dk and include a list of desired articles and your mailing address.
 
Background: In this study, group treatment for women with chronic pelvic pain based on physical, psychosomatic and behavioral therapeutic principles of treatment was assessed.

Sequelae in Soft Tissues after Beating, Suspension, and Fixation

Prip, K. (1994), Torture Quarterly, Suppl. 1, 28-31.
 
This article was reviewed by University of Minnesota doctoral physical therapy student Angela Pitar, 2014. 
 
The link to the full text from Dignity-Danish Institute Against Torture is below.
 
Background: Many movement impairments are found in torture survivors, since they were placed in fixed positions for prolonged periods of time.  This article discusses the effects of tissue stress/strain, the phases of injury, and different management approaches for the different phases. 
 
 
Background -
  • when tendons are loaded, all the fibers straighten out

Survivors of torture and trauma: A special group of patients with chronic pain

Roche, P. (1992). Australian Physiotherapy, 38(2), 156-157.
This article was reviewed by a physical therapy student at the University of Minnesota. More information is to follow. 
A copy of the article may be obtained free of charge from Dignity-Danish Institute Against Torture by emailing them at library@dignityinstitute.dk and including your mailing address.
This brief letter describes where physical therapists may find more information about the special needs of torture survivors as well as common sequelae from torture and recommendations for physical therapy treatment.
 
Two major sources of

Torture Survivors: Pain Pattern and Disability

Prip, K. (2005). Lunds University. 37 pages.
This booklet is available free of charge from Dignity-Danish Institute Against Torture. Please email them at library@dignityinstitute.dk and include a list of desired articles and your mailing address.
This booklet was reviewed by Victor Chow, doctoral physical therapy student at the University of Minnesota.
Background: In “Torture Survivors: Pain Pattern and Disability”, the researchers strived to categorize their subjective and objective findings regarding physical impairments of torture victims.

Torture! Violence! Physiotherapy?

Faure, M. (1995). South African Journal of Physiotherapy, 5(3), 49-51.
This article was reviewed by Charlotte Hoium, doctoral physical therapy student at the University of Minnesota.
It is available free of charge by request to Dignity-Danish Institute Against Torture by emailing library@dignityinstitute.dk. 
Background: In this brief article, a description of a four day long training seminar about physical therapy and torture was made, as well implications for physical therapy education are made. Special considerations for treating torture survivors are described.
Possible Implications for

Tortured Refugees' Expectations of a Multidisciplinary Pain Rehabilitation Programme

Refugees have often been exposed to torture in their countries of origin. Rehabilitation of tortured refugees living in Denmark is offered by the specialized Rehabilitation and Research Centre for Torture Victims in Copenhagen. After an interdisciplinary assessment eligible patients are recommended rehabilitation. In this article, it is noted that there is diversity among refugees in their expectations from pain programs and that the clients expect to have dialogue with the members of their health care team about participation in recommended activities, and to question and not just to accept professional suggestions.

WCPT Congress - Focused symposium: Pain Management

Video of WCPT Congress 2011 - Focused symposium: Teaching people about pain Speakers: Lorimer Moseley (Australia), David Butler (Australia), Michael Thacker (United Kingdom), Adriaan Louw (United States of America) This symposium brought several world leaders in pain education together. Every physiotherapist will deal with someone in pain. Evidence demonstrates that if they understand the true biology of pain instead of an outdated understanding of pain, their outcomes will be better. Taking this symposium will enable you to gain a basic understanding of what is currently known about the biology of pain and to be familiar with principles of conceptual change theory and evidence based strategies to teach people about pain. Integration of the International Association for the Study of Pain core curriculum and modern concepts of pain biology into clinical reasoning were also addressed.