Abstract
BackgroundThe prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual. It is therefore important to find ways to predict the outcome of rehabilitation programmes in terms of function in daily life. The aims of this study were to investigate the improvements over time from multidisciplinary rehabilitation in terms of pain and function, and analyse the relative impact of individual and psychosocial factors as predictors of function in daily life in individuals with chronic musculoskeletal pain.MethodsA prospective study was conducted among one hundred and forty three (N = 143) musculoskeletal pain patients. Measures of pain, function, and functional health status were obtained at baseline, after 5 weeks of intensive training, at the end of the 57-week rehabilitation programme, and at a 1 year follow-up, using validated self-administrated measures. Linear regression analysis was applied to investigate the relative impact of musculoskeletal pain, individual-, and psychosocial factors in function.ResultsThe participants studied showed a significant increase in function during the 57 weeks rehabilitation period. There was also a significant increase in function from the end of the rehabilitation period (57th week) to the one year follow-up measures. Pain intensity associated significantly with pain experience over all measurement periods. High levels of pain intensity (β = .42**) and pain experience (β = .37*), and poor psychological capacity (β = -.68*) at baseline, as well as poor physiological capacity (β = -.44**) and high levels of anxiety (β = .48**) and depression (β = .58***) at the end of the rehabilitation program were the most important prognostic factors of variance in functioning over the 4 measurement periods.ConclusionThe data suggest that physical capacity, emotional distress and coping skills should be priority areas in rehabilitation programmes to improve functioning in daily life.
Highlights
The prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual
Response and baseline characterization of the sample All patients (N = 143) included completed the 57-week rehabilitation programme, which gave a response of 100 % at the end of the rehabilitation period
The non-response group reported mean pain and pain experience measured by Visual Analogue Scale (VAS) at respectively 75.4 and 68.0 at the end of the rehabilitation period
Summary
The prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual. A study by Rudy, Lieber, Boston, Gourley and Baysal [12] concluded that more than 90 % of the variance in performance among disabled individuals with chronic musculoskeletal pain was predicted by psychosocial factors; self-efficacy, perceived emotional and physical functioning, pain intensity, and pain cognition being the most important. This is supported by Geisser, Robinson and Miller [10] maintaining that individual and psychosocial factors were deemed to be of great importance in the experience of pain. The individual's understanding of the symptoms and the impact of the symptoms on everyday life might be an important way of understanding pain and function
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