2 Rehabilitation Research and Practice ANZ public education and exercise classes: 01 May 2010–01 Sept 2010 n = 236 Personal invitation to ANZ member to answer questionnaire and return by self- addressed and stamped envelope in mail n = 236 n = 2 refuse to participate n = 80 did not return questionnaire n = 10 over half incomplete and not entered into database n = 144 full responses 61% response rate entered into Statistica 9 Figure 1: Flow chart: Method of data collection. Although catastrophising and emotional distress have com- mon characteristics, it is diﬃcult to separate them in the direction of eﬀect. Thoughts about pain aﬀect physical functioning and contribute to disability; physical functioning is predicted by the beliefs of physical capabilities and not by the experience of self-reported pain [12–14]. There is evidence that addressing negative pain beliefs in the management of persistent pain can aﬀect treatment out- comes [4, 5, 15]. Negative pain beliefs can contribute to the transition from acute pain to persistent pain [6, 10]. It has been suggested that beliefs about persistent pain have two dimensions. These include organic pain beliefs (ref- erring to the physiological pain experience indicating phys- ical harm or threat to well-being) and psychological pain beliefs (referring to the internal inﬂuences and feelings aﬀecting the experience of pain that can potentially threaten well-being); these dimensions are considered to accurately reﬂect the general population’s perception of the pain expe- rience [16]. Both of these can potentially inﬂuence the beliefs about pain control either positively (having personal control over the pain experience) or negatively (feeling helpless to manage the potential threat to their well being). The aim of this study was to determine the relationship between functioning and pain beliefs in patients with mus- culoskeletal pain or rheumatologic conditions. The primary hypothesis is that a relationship exists, whereby beliefs about persistent pain are associated with functioning. It is expected that a low score (less negative beliefs about pain) of the Pain Beliefs Questionnaire (PBQ) will be associated with bet- ter functioning in the Arthritis Impact Measurement Scale, second version, short form (AIMS2-SF). Likewise it is expected that a high score (greater negative beliefs about pain) of the PBQ will be associated with poorer functioning in the AIMS2-SF. The hypothesis is that any observed relationship is simply due to chance. 2. Materials and Methods questions. All 236 members taking part in the above activ- ities were personally approached to participate in the study. Data was collected over six months, from 01 May 2010 to 31 October 2010. Care was taken to ensure that no particip- ant answered a questionnaire twice. Most returned the answered questionnaire by mail in a preaddressed stamped envelope. Two participants declined to take part in the study and were not issued with a questionnaire. Eighty-two participants responded as willing to participate, were issued with questionnaires, but did not return them. Ten question- naires were returned with less than half completed; these participants had missed out the middle pages as they ﬁlled them in. These were not entered into the database. Only if more than 50% of the questionnaire had been completed was it entered into the database. A total sample of 144 particip- ants completed the questionnaires (a response rate of 61%). A ﬂow chart (Figure 1) shows the details of the data col- lection. ANZ is a national voluntary organisation representing those with formal rheumatologic diagnoses. It functions as a charitable trust with modest government funding. Activities include member education on arthritis and pain manage- ment, exercise classes, and seminars [17]. Ethical approval was obtained from the Upper South Island A Regional Ethics committee (reference number URA/10/04/026). The process followed in this study was in accordance with the Helsinki Declaration of 1975, as revised in 1983. The questionnaires consisted of the PBQ and the AIMS2- SF. In addition further questions were asked about the fol- lowing: gender; duration of pain experience; age; number of months of physiotherapy intervention; type and frequency of regular exercise; enjoyment and conﬁdence with exercise; ability to stop exercise; previous physical and athletic ability; anger about pain; duration of membership with ANZ; eth- nicity (as deﬁned by Statistics New Zealand) [18], education level; rheumatologic diagnosis; number of months oﬀ work; smoking habit; medication use. Members of Arthritis New Zealand (ANZ) who attended an exercise class, an individual education session with an ANZ Educator, or an education seminar were asked to volun- tarily complete an anonymous questionnaire containing 72 2.1. Instruments to Measure Beliefs about Pain. Several ques- tionnaires are used to measure the beliefs about pain. The Pain Beliefs Questionnaire (PBQ) is a validated and reli- able questionnaire that taps into the two dimensions of