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BMC Musculoskeletal Disorders

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Open Access 01-12-2018 | Research article

Emotional distress was associated with persistent shoulder pain after physiotherapy: a prospective cohort study

Authors: Kaja Smedbråten, Britt Elin Øiestad, Yngve Røe

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

Abstract

Background

There is a paucity of research on the association between psychological factors and persistent shoulder pain. The aim of this study was to investigate whether emotional distress was associated with pain intensity and self-reported disability after physiotherapy treatment in patients with shoulder pain.

Methods

Data from 145 patients treated at physiotherapy outpatient clinics aged ≥18 years with self-reported pain in the shoulder or arm, and movement activity problems related to the upper-extremity, were included. Outcome measures were pain intensity measured by Numeric Pain Rating Scale and disability measured by Patient Specific Functional Scale. Demographic and clinical characteristics, including emotional distress measured by Hopkins Symptom Checklist – 25, were obtained at study onset. Association between characteristics at study onset and pain and disability after physiotherapy treatment were analysed using multiple linear regression and a backward manual elimination method. The final models were adjusted for age and sex.

Results

Higher emotional distress at study onset (B 1.06, 95% CI 0.44 to 1.68) was associated with higher pain intensity after the physiotherapy treatment (P = 0.001). Emotional distress was not associated with self-reported disability after the physiotherapy treatment.

Conclusion

This study found that emotional distress at study onset was associated with shoulder pain intensity after physiotherapy treatment, but not with disability. The findings indicate that emotional distress should be included in the initial physiotherapy examination of shoulder pain.

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Luime JJ, Koes BW, Hendriksen IJ, Burdorf A, Verhagen AP, Miedema HS, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004;33(2):73–81. https://doi.org/10.1080/03009740310004667.CrossRefPubMed

van der Windt DA, Koes BW, Boeke AJ, Devillé W, De Jong BA, Bouter LM. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract. 1996;46(410):519–23.PubMedPubMedCentral

Hanratty CE, McVeigh JG, Kerr DP, Basford JR, Finch MB, Pendleton A, et al. The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Semin Arthritis Rheum. 2012;42(3):297–316. https://doi.org/10.1016/j.semarthrit.2012.03.015.CrossRefPubMed

Littlewood C, Ashton J, Chance-Larsen K, May S, Sturrock B. Exercise for rotator cuff tendinopathy: a systematic review. Physiotherapy. 2012;98(2):101–9. https://doi.org/10.1016/j.physio.2011.08.002.CrossRefPubMed

Page MJ, Green S, McBain B, Surace SJ, Deitch J, Lyttle N, et al. Manual therapy and exercise for rotator cuff disease. The Cochrane Database Syst Rev 2016;6:Cd012224. https://doi.org/10.1002/14651858.CD012224.

Struyf F, Geraets J, Noten S, Meeus M, Nijs JA. Multivariable prediction model for the chronification of non-traumatic shoulder pain: a systematic review. Pain physician. 2016;19(2):1–10.

Chester R, Jerosch-Herold C, Lewis J, Shepstone L. Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: a multicentre longitudinal cohort study. British J Sports Med. 2018;52(4):269–75. https://doi.org/10.1136/bjsports-2016-096084.CrossRef

Tveter AT, Major DH, Grotle M. FysioPol; a new electronical database for development of quality and knowledge in physiotherapy. Fysioterapeuten. 2015;9:8.

Stratford P, Gill C, Westaway M, Binkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiother Can. 1995;47(4):258–63. https://doi.org/10.3138/ptc.47.4.258.

10.

Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis. 1978;37(4):378–81. https://doi.org/10.1136/ard.37.4.378.CrossRefPubMedPubMedCentral

11.

Hefford C, Abbott JH, Arnold R, Baxter GD. The Patient-Specific Functional Scale: validity, reliability, and responsiveness in patients with upper extremity musculoskeletal problems. The Journal of Orthopaedic and Sports Physical Therapy. 2012;42(2):56–65. https://doi.org/10.2519/jospt.2012.3953.

12.

Koehorst ML, van Trijffel E, Lindeboom R. Evaluative measurement properties of the Patient-Specific Functional Scale for primary shoulder complaints in physical therapy practice. The Journal of Orthopaedic and Sports Physical Therapy. 2014;44(8):595–603. https://doi.org/10.2519/jospt.2014.5133.

13.

Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci. 1974;19(1):1–15. https://doi.org/10.1002/bs.3830190102.

14.

Grotle M, Vollestad NK, Veierod MB, Brox JI. Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain. Pain. 2004;112(3):343–52. https://doi.org/10.1016/j.pain.2004.09.020.CrossRefPubMed

15.

Johansen JB, Roe C, Bakke ES, Mengshoel AM, Storheim K, Andelic N. The determinants of function and disability in neck patients referred to a specialized outpatient clinic. Clin J Pain. 2013;29(12):1029–35. https://doi.org/10.1097/AJP.0b013e31828027a2.CrossRefPubMed

16.

Engebretsen K, Grotle M, Bautz-Holter E, Ekeberg OM, Brox JI. Predictors of shoulder pain and disability index (SPADI) and work status after 1 year in patients with subacromial shoulder pain. BMC Musculoskelet Disord. 2010;11:218. https://doi.org/10.1186/1471-2474-11-218.CrossRefPubMedPubMedCentral

17.

Brox JI, Brevik JI. Prognostic factors in patients with rotator tendinosis (stage II impingement syndrome) of the shoulder. Scand J Prim Health Care. 1996;14(2):100–5. https://doi.org/10.3109/02813439608997078.CrossRefPubMed

18.

Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Pearson; 2013.

19.

van der Windt DA, Kuijpers T, Jellema P, van der Heijden GJ, Bouter LM. Do psychological factors predict outcome in both low-back pain and shoulder pain? Ann Rheum Dis. 2007;66(3):313–9. https://doi.org/10.1136/ard.2006.053553.CrossRefPubMed

20.

Terluin B, Rhenen WV, Schaufeli WB, De Haan M. The Four-Dimensional Symptom Questionnaire (4DSQ): measuring distress and other mental health problems in a working population. Work & Stress. 2004;18(3):187–207. https://doi.org/10.1080/0267837042000297535.

21.

Badcock LJ, Lewis M, Hay EM, McCarney R, Croft PR. Chronic shoulder pain in the community: a syndrome of disability or distress? Ann Rheum Dis. 2002;61(2):128–31. https://doi.org/10.1136/ard.61.2.128.CrossRefPubMedPubMedCentral

22.

Klintberg IH, Cools AMJ, Holmgren TM, Holzhausen A-CG, Johansson K, Maenhout AG, et al. Consensus for physiotherapy for shoulder pain. Int Orthop. 2015;39(4):715–20. https://doi.org/10.1007/s00264-014-2639-9.CrossRefPubMed

23.

Lee H, Hubscher M, Moseley GL, Kamper SJ, Traeger AC, Mansell G, et al. How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain. Pain. 2015;156(6):988–97.PubMed

Title: Emotional distress was associated with persistent shoulder pain after physiotherapy: a prospective cohort study
Authors: Kaja Smedbråten
Britt Elin Øiestad
Yngve Røe
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-018-2142-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Emotional distress was associated with persistent shoulder pain after physiotherapy: a prospective cohort study

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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