Article

Multimodal rehabilitation programmes (MMRP) for chronic pain could be
improved by determining which patients do not benefit fully. General distress and
pain-related fear may explain variations in the treatment effects of MMRP.
DESIGN: Cohort study with a cross-sectional, prospective part. PATIENTS: Chronic
musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics. METHODS: The cross-sectional part of this study cluster analyses
patients (n = 1,218) with regard to distress and pain-related fear at first
consultation in clinical pain rehabilitation and describes differences in
external variables between clusters. The prospective part follows the subsample
of patients (n = 260) participating in MMRP and describes outcome post-treatment.
RESULTS: Four distinct subgroups were found: (i) those with low levels of
distress and pain-related fear; (ii) those with high levels of pain-related fear;
(iii) those with high levels of distress; and (iv) those with high levels of
distress and pain-related fear. These subgroups showed differences in
demogra-phics, pain characteristics, quality of life, and acceptance, as well as
the degree of MMRP participation and MMRP outcome. CONCLUSION: Among patients
with chronic pain referred to MMRP there are subgroups with different profiles of
distress and pain-related fear, which are relevant to understanding the
adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

Langue : ANGLAIS