A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important

作者：Asenlof Pernilla^*; Soderlund Anne

来源：Clinical Rehabilitation, 2010, 24(5): 422-430.

DOI：10.1177/0269215509353264

Background: Tailored treatments are topical in pain rehabilitation. One key issue for correlational studies is the identification of factors having a potential causal impact on essential treatment outcomes.
Objective: To study associations between pain beliefs and disability with regard to the amount and time-frame of available data.
Design: A prospective, correlational design.
Subjects and setting: Ninety-two patients consulting physical therapists in primary care for persistent musculoskeletal pain.
Main measures: The Pain Disability Index, the Self-Efficacy Scale and the Tampa Scale of Kinesiophobia.
Results: Functional self-efficacy and fear of movement/(re) injury explained variance in pain-related disability pretreatment (adj R(2) = 0.41). Self-efficacy was the most salient predictor. Adding data from immediately post treatment decreased explained variance (adj R(2) = 0.25). Functional self-efficacy and fear of movement/ (re)injury lost their significant contribution in favour of pain-related disability at baseline. Change scores in functional self-efficacy and fear of movement/(re) injury accounted for a modest share of explained variance in change scores of disability (adj R(2) = 0.11). Fear of movement/(re) injury but not functional self-efficacy was related to a reliable change in pain-related disability.
Conclusions: Longitudinal data suggest that pretreatment levels of pain-related disability and changes in fear of movement/(re) injury are most important to immediate treatment outcomes and individual reliable change. Disability and elevated fear of movement/(re) injury should therefore be addressed in tailored pain treatments. A "

• 出版日期2010-5