Fear of movement and emotional distress as prognostic factors for disability in patients with shoulder pain: a prospective cohort study.
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
26 Feb 2022
26 Feb 2022
Historique:
received:
03
10
2021
accepted:
21
02
2022
entrez:
27
2
2022
pubmed:
28
2
2022
medline:
3
3
2022
Statut:
epublish
Résumé
Shoulder pain is a prevalent and often long-lasting musculoskeletal disorder. The overall prognosis of shoulder pain is highly variable with 40-50% of patients reporting persistent pain 6-12 months after consulting a clinician. The evidence for psychological prognostic factors for patients with shoulder pain is inconsistent. Therefore, the objective of this study was to investigate the association between fear of movement and emotional distress at presentation and self-reported disability over one year of follow-up. This is a prospective cohort study of consecutive patients referred to secondary outpatient care due to shoulder pain. Consenting patients underwent a physical examination and completed a comprehensive questionnaire at baseline, three months-, and one-year follow-up. Associations between baseline fear of movement (0-10) or emotional distress (1-4), respectively, and patient reported disability measured using Quick Disability of the Arm and Shoulder (QuickDASH, 0-100) over one year were analyzed with linear mixed-effects models (LMM) for repeated measures (baseline, 3 months and 1 year), adjusting for established prognostic factors. A total of 138 patients were recruited between March 2015 and January 2018, with response rates of 84.7% (n = 117) and 79.7% (n = 100) at three months and one year, respectively. Adjusted associations revealed that for every point increase in baseline fear of movement, the QuickDASH score increased (worsened) by 1.10 points (95% CI 0.2-2.0) over the follow-up year. For every point increase in baseline emotional distress, the QuickDASH score increased by 19.9 points (95% CI 13.9-25.9) from baseline over the follow-up year. Higher fear of movement and emotional distress scores at baseline were significantly associated with higher disability over one year in patients with shoulder pain referred to secondary care. Our study indicates that these psychological factors affect prognosis and should be considered by clinicians and researchers working with patients with shoulder pain.
Sections du résumé
BACKGROUND
BACKGROUND
Shoulder pain is a prevalent and often long-lasting musculoskeletal disorder. The overall prognosis of shoulder pain is highly variable with 40-50% of patients reporting persistent pain 6-12 months after consulting a clinician. The evidence for psychological prognostic factors for patients with shoulder pain is inconsistent. Therefore, the objective of this study was to investigate the association between fear of movement and emotional distress at presentation and self-reported disability over one year of follow-up.
METHODS
METHODS
This is a prospective cohort study of consecutive patients referred to secondary outpatient care due to shoulder pain. Consenting patients underwent a physical examination and completed a comprehensive questionnaire at baseline, three months-, and one-year follow-up. Associations between baseline fear of movement (0-10) or emotional distress (1-4), respectively, and patient reported disability measured using Quick Disability of the Arm and Shoulder (QuickDASH, 0-100) over one year were analyzed with linear mixed-effects models (LMM) for repeated measures (baseline, 3 months and 1 year), adjusting for established prognostic factors.
RESULTS
RESULTS
A total of 138 patients were recruited between March 2015 and January 2018, with response rates of 84.7% (n = 117) and 79.7% (n = 100) at three months and one year, respectively. Adjusted associations revealed that for every point increase in baseline fear of movement, the QuickDASH score increased (worsened) by 1.10 points (95% CI 0.2-2.0) over the follow-up year. For every point increase in baseline emotional distress, the QuickDASH score increased by 19.9 points (95% CI 13.9-25.9) from baseline over the follow-up year.
CONCLUSION
CONCLUSIONS
Higher fear of movement and emotional distress scores at baseline were significantly associated with higher disability over one year in patients with shoulder pain referred to secondary care. Our study indicates that these psychological factors affect prognosis and should be considered by clinicians and researchers working with patients with shoulder pain.
Identifiants
pubmed: 35219313
doi: 10.1186/s12891-022-05139-6
pii: 10.1186/s12891-022-05139-6
pmc: PMC8882288
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
183Informations de copyright
© 2022. The Author(s).
Références
Pain. 2000 Apr;85(3):317-332
pubmed: 10781906
Psychol Rev. 1977 Mar;84(2):191-215
pubmed: 847061
Br J Gen Pract. 2007 Aug;57(541):655-61
pubmed: 17688762
Ann Rheum Dis. 2005 Jul;64(7):1056-61
pubmed: 15640264
Man Ther. 2010 Aug;15(4):404-7
pubmed: 20434942
J Rheumatol. 1998 Aug;25(8):1612-5
pubmed: 9712108
Scand J Rheumatol. 2004;33(2):73-81
pubmed: 15163107
Phys Ther. 2011 May;91(5):790-803
pubmed: 21451095
BMJ. 1996 Sep 7;313(7057):601-2
pubmed: 8806252
Behav Sci. 1974 Jan;19(1):1-15
pubmed: 4808738
Pain. 1995 Sep;62(3):363-372
pubmed: 8657437
BMC Musculoskelet Disord. 2012 Feb 10;13:17
pubmed: 22325050
Br J Sports Med. 2019 May;53(9):554-559
pubmed: 29666064
Behav Res Ther. 1983;21(4):401-8
pubmed: 6626110
J Rheumatol. 2001 Sep;28(9):2090-5
pubmed: 11550979
Pain. 2006 Feb;120(3):276-285
pubmed: 16426760
PLoS Med. 2013;10(2):e1001380
pubmed: 23393429
BMJ Open. 2018 Apr 13;8(4):e020703
pubmed: 29654040
Br J Sports Med. 2018 Feb;52(4):269-275
pubmed: 27445360
Clin Orthop Relat Res. 2018 Oct;476(10):2062-2073
pubmed: 30179945
Phys Ther. 2006 Jul;86(7):1013-32; discussion 1033-7
pubmed: 16813480
CMAJ. 2013 Jul 9;185(10):E499-505
pubmed: 23339155
Scand J Prim Health Care. 1996 Jun;14(2):100-5
pubmed: 8792503
Phys Ther. 2014 Dec;94(12):1775-84
pubmed: 25060955
J Consult Clin Psychol. 2002 Jun;70(3):678-90
pubmed: 12090376
Rheumatology (Oxford). 2019 Mar 06;:
pubmed: 30843587
BMC Musculoskelet Disord. 2010 Sep 23;11:218
pubmed: 20863369
BMC Musculoskelet Disord. 2015 Oct 09;16:288
pubmed: 26453452
Musculoskelet Sci Pract. 2021 Dec;56:102437
pubmed: 34416559
BMC Musculoskelet Disord. 2020 May 27;21(1):328
pubmed: 32460743
J Rehabil Med. 2014 Oct;46(9):898-907
pubmed: 25103016
Lancet. 2011 Oct 29;378(9802):1560-71
pubmed: 21963002
Pain. 2004 Dec;112(3):343-352
pubmed: 15561390
BMC Musculoskelet Disord. 2006 May 18;7:44
pubmed: 16709254
Spine (Phila Pa 1976). 2005 Aug 15;30(16):E459-70
pubmed: 16103840
Pain. 2015 Jun;156(6):988-997
pubmed: 25760473
Clin Orthop Relat Res. 1994 Nov;(308):90-7
pubmed: 7955708
PLoS Med. 2012;9(5):e1001216
pubmed: 22675273
Br J Gen Pract. 1996 Sep;46(410):519-23
pubmed: 8917870
J Orthop Sports Phys Ther. 2017 Aug;47(8):538-547
pubmed: 28683232
Med Care. 2004 Feb;42(2):139-46
pubmed: 14734951
PLoS Med. 2007 Oct 16;4(10):e297
pubmed: 17941715
J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):920-6
pubmed: 19297202
J Physiother. 2012;58(4):249-54
pubmed: 23177227
Clin J Pain. 2013 Dec;29(12):1029-35
pubmed: 23370090