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- Bergbom, Sofia, et al.
(författare)
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Relationship among pain catastrophizing, depression mood, and outcomes across physical therapy treatments
- 2011
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Ingår i: Physical Therapy. - 0031-9023. ; 91:5, s. 754-764
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Tidskriftsartikel (refereegranskat)abstract
- Background 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.Objective 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.
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| 2. |
- Overmeer, Thomas, 1960-, et al.
(författare)
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Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? : A randomized controlled trial
- 2011
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Ingår i: Physical Therapy. - 0031-9023. ; 91:5, s. 804-819
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychosocial risk factors are important in the development of chronic pain but treatment providers often lack knowledge and skills to assess and address these risk factors.Objectives: We examined the effects of a course on psychosocial factors for physical therapists on patient outcome in terms of pain and disability. Design: A randomised controlled trail.Participants: Forty-two primary care physical therapists attended an eight-day university course over eight weeks aimed at identifying and addressing psychosocial risk factors.Methods: They were randomised to either the course or a waiting list. The physical therapists collected consecutive acute and sub-acute patients with musculoskeletal pain both before and after the course.Results: There were no significant differences in outcome for pain or disability for allpatients of physical therapists who had participated in the course or for risk patients with higher levels of catastrophizing or depression compared to patients of physical therapists who had not participated in the course. Outcome for low risk patients on pain and disability and for high risk patients on pain was not dependent on if their physical therapists changed their attitudes and beliefs during the course. Yet, outcome on disability for high risk patients may have been influenced if their physical therapists change their attitudes and beliefs.Limitations: no measure of actual practice behaviour.Conclusions: An eight-day university course for physiotherapists did not improve outcome for the group of patients as a whole or patients at risk of developing long term disability. Yet, risk patients with higher levels of catastrophizing or depression may have had a greater improvement in disability if their physical therapist changed attitudes and beliefs during the course.
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