Our research
There is much diversity in the research that we undertake. Therefore, we have divided it into six main themes and you can explore those below.
Research themes
Pain is interpreted and managed differently across different cultural groups. In Aotearoa, there are inequities in the impact of chronic pain and the benefits that people receive from our chronic pain services. Our research in this stream aims to understand and appreciate different cultural views of pain and how people respond to pain, to develop assessment tools that encompass these views more appropriately, and to devise strategies to improve management of pain for the multiple cultures in Aotearoa.
More specific information
This research stream is focused on perceptions and understanding of chronic pain. Within this area we have investigated the experience of stigma in chronic pain with a particular focus on the factors contributing to chronic pain stigma and the effect it has on people. One notable finding was that healthcare professionals sometimes contribute to perceived stigma, with many people reporting that clinicians do not believe that their pain is real. Relatedly, our research challenges the idea that clinicians should test for malingering in chronic pain, by demonstrating that proposed methods of testing for malingering lack validity in clinical settings, thus supporting the idea that clinicians should take pain reports at face value.
We are also interested in the way people with chronic pain manage their condition, and their ability to foster resilience and live valued lives despite chronic pain, with a particular focus on Complex Regional Pain Syndrome (CRPS). Within this series we have looked at the influence of psychological factors on recovery from early CRPS, whether people with CRPS benefit from pain management group programmes, the factors that are associated with living well with CRPS, and the ways in which people with CRPS understand their condition. This internationally recognised research stream is contributing to the understanding of psychosocial influences on CRPS and aims to improve outcomes for people with this challenging condition.
More specific information
- Anxiety, Disability, and Pain Predict Outcomes of Complex Regional Pain Syndrome: An 8-year Follow-up of a Prospective Cohort
- The Determinants and Effects of Chronic Pain Stigma: A Mixed Methods Study and the Development of a Model
- "I Don't Identify with It": A Qualitative Analysis of People's Experiences of Living with Complex Regional Pain Syndrome.
- Are Illness Perceptions Associated with Pain and Disability in Complex Regional Pain Syndrome? A Cross-Sectional Study
- You'd Better Believe It: The Conceptual and Practical Challenges of Assessing Malingering in Patients With Chronic Pain
- Do psychological factors influence recovery from complex regional pain syndrome type 1? A prospective study
Pain is trans-diagnostic, occurring across a diverse range of health conditions. Identifying characteristics of pain that span different diagnoses, risk factors for the development of chronic pain and prognostic factors that influence recovery from chronic pain allows for a more targeted, mechanism-based approach to treatment which is fundamental to precision medicine. Within this research stream we have focused on identifying different pain phenotypes within chronic pancreatitis, genetic and environmental influences on chronic pain over time, predictors of persistent pain and long-term opioid use after surgery, as well as prognostic factors that may influence treatment outcomes in people with complex regional pain syndrome, osteoarthritis and after multidisciplinary pain management programmes.
More specific information
- What Influences Outcomes From Inpatient Multidisciplinary Pain Management Programs?
- Extent of recovery in the first 12 months of complex regional pain syndrome type-1
- Do psychological factors influence recovery from complex regional pain syndrome type 1?
- Structural Brain Alterations Before and After Total Knee Arthroplasty
- The Prevalence, Impact, and Risk Factors for Persistent Pain After Breast Cancer Surgery in a New Zealand Population
- A Higher Grey Matter Density in the Amygdala and Midbrain Is Associated with Persistent Pain Following Total Knee Arthroplasty
- Persistent postoperative pain after total knee arthroplasty
- Predictors of persistent pain after total knee arthroplasty
- Twelve-year follow-up of chronic pain in twins: Changes in environmental and genetic influence over time
- Development of a prediction model to determine responders to conservative treatment in people with symptomatic hand osteoarthritis
- A combination of high preoperative pain and low radiological grade of arthritis is associated with a greater intensity of persistent pain 12 months after total knee arthroplasty
- Trajectories of Pain and Function Outcomes up to 5 to 8 Years Following Total Knee Arthroplasty
- What factors predict outcome from an inpatient multidisciplinary chronic pain service?
In this theme we are concerned with the influence of biomechanical and physiological mechanisms that might lead to impairments (range of motion, muscle performance, coordination) associated with tissue damage and repair. Such data can provide important information to allow targeting of specific impairments and hence increase the efficacy of rehabilitation protocols. Such work also highlights when such impairments are most apparent, allowing better staging of the elements within rehabilitation program. Our work has been focused on acute conditions such as Achilles tendon rupture, anterior cruciate ligament rupture, shoulder dislocation and hip fractures. Additionally, we are exploring long term conditions such as osteoarthritis of the knee and hand.
More specific information
- Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): a systematic review
- Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
- Experimental knee pain impairs submaximal force steadiness in isometric, eccentric, and concentric muscle actions
- Stretch reflex changes in ACL-deficient individuals and healthy controls during normal and surprise landings
- Sensorimotor performance and function in people with osteoarthritis of the hand: A case-control comparison
- Impairments in grip and pinch force accuracy and steadiness in people with osteoarthritis of the hand: A case-control comparison
- Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain
- Validity and Reliability of 3-D Ultrasound Imaging to Measure Hamstring Muscle and Tendon Volumes
- Central activation, metabolites, and calcium handling during fatigue with repeated maximal isometric contractions in human muscle
- The effect of Tubigrip and a rigid belt on rectus abdominus diastasis immediately postpartum: A randomised clinical trial
- Chronic effects of muscle and nerve-directed stretching on tissue mechanics
- Effects of stroke injury on the shear modulus of the lower leg muscle during passive dorsiflexion
To help to prevent complications, speed recovery, reduce costs and optimise surgical outcomes, our research has focused on better understanding and preventing problems such as orthostatic intolerance, postoperative delirium, intraoperative hypotension, fear of falling and functional recovery after common orthopaedic surgeries including hip fracture repair and total joint replacement.
More specific information
- The effect of dexamethasone on biomarkers of inflammation and neuronal damage in patients with hip fracture
- Trajectories of Pain and Function Outcomes up to 5 to 8 Years Following Total Knee Arthroplasty
- The effect of intra-operative hypotension on acute kidney injury, postoperative mortality and length of stay following emergency hip fracture surgery
- Steroids to reduce the impact on delirium (STRIDE): a double-blind, randomised, placebo-controlled feasibility trial of pre-operative dexamethasone in people with hip fracture
- Orthostatic intolerance following hip arthroplasty: incidence, risk factors and effect on length of stay: A prospective cohort study
- A systematic review of fear of falling and related constructs after hip fracture: prevalence, measurement, associations with physical function, and interventions
- A Prospective, Median 15-Year Comparison of Ponseti Casting and Surgical Treatment of Clubfoot
- A Comparison of Walking Gait Following Mechanical and Kinematic Alignment in Total Knee Joint Replacement.
- A combination of high preoperative pain and low radiological grade of arthritis is associated with a greater intensity of persistent pain 12 months after total knee arthroplasty.
A focus of our research is designing and evaluating novel treatments for chronic pain. Some examples include developing digital peri-operative interventions to improve pain outcomes after surgery and how virtual reality can be used to facilitate rehabilitation by making therapeutic movement more enjoyable, accessible, and engaging.
This research theme also draws on our understanding of pain mechanisms to develop innovative treatments for chronic pain. This includes brain-directed treatments for chronic pain such as transcranial direct current stimulation, EEG neurofeedback, and transcutaneous vagal nerve stimulation. To augment exercise-based rehabilitation in people with osteoarthritis, we have worked with clinicians to explore the use of blood-flow restriction training and investigate whether targeted education can enhance the acute pain-relieving effects of exercise.
More specific information
- Active Virtual Reality for Chronic Primary Pain
- Pain patterns in chronic pancreatitis and chronic primary pain
- Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine
- Six weeks of resistance training (plus advice) vs advice only in hand osteoarthritis
- Transcranial direct current stimulation for upper limb neuropathic pain
Meet the team
Our team consists of a number of experienced psychologists, physiotherapists and researchers who are interested in helping individuals, communities and populations with pain prevention, management and rehabilitation of musculoskeletal conditions.