Article

Pain catastrophizing and emotional distress can act as prognostic
factors for pain and disability. Research on how these variables interact within
individuals and over time is in an early stage. Understanding various patterns of
prognostic factors and how these factors change during treatment is important for
developing treatments targeting important factors. The primary aim of
this study was to investigate relationships between pain catastrophizing and
depressed mood in people seeking primary care for musculoskeletal pain. An
additional aim was to relate these patterns of prognostic factors to outcomes
during a 6-month period. DESIGN: The design was prospective; data were obtained
at baseline and at follow-up. METHODS: Forty-two physical therapists taking part
in an educational program recruited, from their clinical practices in primary
care, consecutive patients who were currently experiencing a pain problem.
Patients received various physical therapy interventions between baseline and
follow-up. RESULTS: On the basis of patterns of scoring for pain catastrophizing
and depressed mood, 4 subgroups of participants were found. Belonging to a
subgroup with elevated levels of either pain catastrophizing or depressed mood at
baseline was related to the absence of improvement and elevated levels of
disability after physical therapy interventions. Furthermore, elevated levels of
both variables were related to the highest levels of disability. LIMITATIONS: The
analyses relied on self-report. Neither treatment content nor pain-related fear
was measured. The sample was a mixture of participants reporting acute pain and
subacute pain. CONCLUSIONS: The results stress the importance of assessing and
targeting prognostic factors. Moreover, the results suggest the need to tailor
treatments to match patterns of prognostic factors and the need to target
depressed mood and pain catastrophizing in physical therapy interventions.

Langue : ANGLAIS