EVIDENCE-BASED PRACTICE AND FUTURE TRENDS IN PAIN SCIENCE AND REHABILITATION

Abstract

For the last 30 years pain physiotherapy has transformed from a biomedical, structure-focused paradigm to an evidence-based and current pain neuroscience paradigm. In this chapter, that transition is explored and a glimpse is given into the future direction the discipline will take. It takes a look back at the principles of Evidence Based Practice (EBP) — best evidence, clinical expertise, and patient valuesand the relevance of new developments in both assessment and treatment, including the updated definition of Pain from the International Association for the Study of Pain (IASP) in 2020 and the addition of a third mechanistic descriptor, ‘nociplastic pain'. Current evidence is appraised for several guideline endorsed interventions such as active exercise, pain neuroscience education and multimodal rehabilitation. Then, emerging trends are discussed such as telerehabilitation, artificial intelligence and predictive analytics, wearable sensors, immersive virtual reality, and precision, phenotype matched rehabilitation. It concludes with a focus on challenging the ongoing research-to-practice divide, the issue of low-value care, and the equity and evidence- quality concerns that will continue to shape the field for the next 10 years.