Discussion : While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR , poor pretreatment physical and psychological functioning influenced the prognosis negatively .
Thus , treatment should further target and optimize these modifiable factors and an increased focus on positive , psychological protective factors may perhaps provide an opening for yet untapped clinical gains
Objectives : This systematic review aim ed to identify and evaluate prognostic factors for long-term ( ≥6 mo ) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation ( MDR ) .
The impact of psychologically different patient groups on outcome after a vocational rehabilitation program for long-term spinal pain patients
& NA ; A better knowledge of differential treatment outcomes for subgroups of chronic spinal pain patients may , for instance , help clinicians in treatment planning or pain research ers in treatment outcome research . The purpose of this prospect i ve study was to evaluate the predictive validity of a subgroup classification based on the Swedish version of the ( West Haven Yale ) Multidimensional Pain Inventory , the MPI‐S. Patients referred to a vocational rehabilitation program  were classified into one of three groups , labeled ‘ adaptive copers ’ , ‘ dysfunctional ’ patients  , and ‘ interpersonally distressed ’ patients , and followed over an 18‐month follow‐up period . The outcome variables were absence from work ( defined as sick listing plus early retirement ) , general health status , and utilization of health care re sources . To our knowledge , the predictive validity of the MPI subgroups has not been evaluated regarding sick listing and early retirement after rehabilitation . As hypothesized , the results showed that the ‘ dysfunctional ’ patient group had significantly more registered absences from work and reported higher utilization of health care , over the follow‐up period compared to the ‘ adaptive copers ’ . Furthermore , as hypothesized , the ‘ interpersonally distressed ’ and ‘ dysfunctional ’ patient groups report a poorer general health status than the ‘ adaptive copers ’ over the whole follow‐up period . However , contrary to our hypothesis , the proportion of improved patients did not differ significantly between the subgroups . Altogether , the predictive validity of the MPI‐S subgroup classification was mainly confirmed . The clinical implication s of this study suggest that the matching of treatment to patient needs may enhance treatment outcome , reduce pain and suffering among chronic spinal pain patients and facilitate a better health economic allocation of treatment re sources
Discussion : While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR , poor pretreatment physical and psychological functioning influenced the prognosis negatively .
Thus , treatment should further target and optimize these modifiable factors and an increased focus on positive , psychological protective factors may perhaps provide an opening for yet untapped clinical gains
Objectives : This systematic review aim ed to identify and evaluate prognostic factors for long-term ( ≥6 mo ) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation ( MDR ) .