Are psychological factors prognostic indicators of outcome in patients with sub-acute neck pain?

Basert på resultatene fra denne studien virker det som at det er bare én faktor som hemmer resultater for de som kommer til muskel- og leddbehandling: Hvor redd er du for at plagen blir værre med bevegelse?

The short and long term results for the three outcomes were very diverse. The sub-scales of the used questionnaires, i.e. the Pain Coping and Cognition List (PCCL), and the 4 Dimensional Symptom Questionnaire (4DSQ), did not contribute significantly to all of the multilevel models. Only the factor ‘fear of movement’ was consistently and significantly present in the univariable analysis for all outcomes at both follow-up measurements. The explained variance in the short term ranged from 16% to 30%, and from 6% to 34% in the long term. This can be considered to be low.

We conclude that all psychological factors showed a considerable variation on the specific measurement and time point used. Only ‘fear of movement’ consistently impedes short term and long term recovery.

A single question was as predictive of outcome as the Tampa Scale for Kinesiophobia

The correlation coefficient between the TSK and its substitute question was r=0.46 (p<0.001). The substitute question was better at predicting pain severity in the leg at 1 year follow-up than the TSK (addition of explained variation of 11% versus 4% in a logistic regression analysis). The TSK and its substitute question did not significantly differ in their prediction of global perceived effect at 1 year follow-up. The other substitute questions and both the RDQ and EQ-5D did not contribute significantly to one or both of their prediction models.

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