Gamble A1, Dee J2, Jacobsen LJ3, Karrer A-M4, Kibet JJ5
1The Center for Victims of Torture, Amman, Jordan, 2University of Vermont, College of Nursing and Health Sciences, Department of Rehabilitation and Movement Science, Burlington, United States, 3Dignity - Danish Institute Against Torture, Rehabilitation Department, Family Team, Copenhagen, Denmark, 4Dignity - Danish Institute Against Torture, Rehabilitation Department, Copenhagen, Denmark, 5The Center for Victims of Torture, Nairobi, Kenya
- Discuss the application of modern pain science in the treatment of physical and psychological effects of torture and trauma.
- Describe evidence-based and trauma-informed interventions that enhance functional independence for survivors of torture and trauma.
- Reflect on the unique cultural, psychological, and social contexts which influence the physiotherapy care of survivors of torture and trauma.
The United Nations High Commissioner for Refugees has registered at least 13 million refugees or people who have moved outside of the country of his/her nationality due to fear of persecution.1 A conservative estimate indicates that 30 to 45 percent of these persons are survivors of torture or trauma that experience subsequent physical and psychological impairments.2 Physical impairments include chronic musculoskeletal pain and impairments of body awareness, sensory function, and self-regulation.3,4,5,6,7 Psychological dysfunction, including Post Traumatic Stress Disorder, Major Depressive Disorder, and anxiety disorders, contributes to greater physical impairments and activity limitations.7,8 A survey identified that physiotherapy provision to this population is limited globally.9 The complex picture of chronic pain coupled with psychological symptoms require physiotherapists to apply modern pain science within a trauma-informed model of care. Therefore, this symposium will discuss evidence-based interventions for addressing chronic pain and associated activity limitations while considering the unique psychological, social, and cultural context of treatment. Speakers will pose an international perspective by discussing culturally sensitive interventions for a variety of populations from low and high income countries.
Kibet and Dee will describe the evidence for the application of modern pain science in the treatment of this population including discussing central sensitization and pain education. Kibet will present a study investigating the effects of a physical activity intervention on chronic pain with persons that are refugees in Kenya. Dee will describe a trial examining the effects of exercise, pain education, and graded motor imagery conducted with persons from Somalia, Sudan, and Bhutan. Thirdly, Karrer will introduce the effects of Basic Body Awareness Therapy (B-BAT) on pain and anxiety in survivors of torture from Middle Eastern countries resettled in Denmark. The final speaker, Jacobsen, will also focus on the population in Denmark to describe the application of the biopsychosocial model in the treatment of both children and adults. She will present the results of a study investigating the role of the physiotherapist on an interdisciplinary team working to address chronic pain and psychological symptoms within families. This cohesive presentation will translate current evidence into practical approaches to effectively address the complex needs of survivors of torture and trauma across the globe.
Implications / Conclusions
This symposium will discuss the application of modern pain science in evidence-based and trauma-informed interventions for restoring function in survivors of torture and trauma. It will translate current evidence to clinical practice through the discussion of several studies in various global cultures.
- Chronic Pain
Relevance to physical therapy globally
The number of individuals surviving torture and trauma is increasing globally. A WCPT policy statement advises that all physiotherapists have proficiency in the treatment of this special population. This session will equip participants with knowledge regarding the evidence-based application of modern pain science in trauma-informed interventions for survivors of torture and trauma. It will translate evidence into clinical practice while discussing a variety of cultural, social, and psychological contexts.
This symposium is relevant to physiotherapist clinicians, researchers, and educators applying modern pain science to the treatment of individuals who have experienced torture or trauma.
Programme subject to change