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 ) .
Change in kinesiophobia and its relation to activity limitation after multidisciplinary rehabilitation in patients with chronic back pain
Purpose : To explore the change in kinesiophobia in relation to activity limitation after a multidisciplinary rehabilitation programme in patients with chronic back pain . Method : A prospect i ve cohort study was made including 265 patients . Data were collected at baseline , after rehabilitation , and at 6-months follow-up . Outcome measures were the Tampa Scale for kinesiophobia ( TSK ) and the disability rating index ( DRI ) . The smallest detectable change ( SDC ) in TSK was set to 8 scores . Relationships between kinesiophobia and activity limitation/physical ability were explored with regard to subgroups with high , medium and low baseline TSK scores , and for those patients who did or did not reach the SDC in TSK . Results : Improvements in TSK showed high effect sizes in the groups with high and medium baseline TSK scores . Improvements in DRI showed medium effect sizes in all three TSK subgroups . One third of the patients reached the SDC in TSK , and this group also improved significantly more in DRI . The correlation between change in TSK and change in DRI was low . Half of the patients with high TSK score at baseline remained having high DRI at follow-up . Conclusions : Improvement in physical ability was not related to the initial degree of kinesiophobia but to the SDC in TSK . To prevent patients with high kinesiophobia from preserving high activity limitations , it might be useful to include targeted treatment of kinesiophobia . Implication s for Rehabilitation Intensive multidisciplinary rehabilitation decreases kinesiophobia and activity limitation in patients with chronic back pain . Patients improving > 8 scores on the Tampa Scale for kinesiophobia are likely to increase their physical ability . Patients with an initially high degree of kinesiophobia as well as a high level of activity limitation need targeted treatment of kinesiophobia to increase their physical ability
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 ) .