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The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology.

Publication ,  Journal Article
Lentz, TA; Barabas, JA; Day, T; Bishop, MD; George, SZ
Published in: J Orthop Sports Phys Ther
April 2009

STUDY DESIGN: Cross-sectional. OBJECTIVES: This study examined the baseline relationship of pain intensity, physical impairment, and pain-related fear to shoulder function. BACKGROUND: There is no consensus regarding the influence psychological variable have on function and recovery in individuals with shoulder pathologies. While pain-related fear has been shown to predict disability for patients with low-back and cervical pain, this relationship has not been consistently reported for patients with shoulder pain. METHODS AND MEASURES: One hundred forty-two subjects (78 male, 64 female; mean age, 41.4 years) with nonoperative unilateral shoulder disorders were identified from a clinical database of impairment and outcome measures.Demographic information, duration of symptoms, mechanism of injury, pain intensity, pain-related fear, and range-of-motion (ROM) measures were collected. Self-report of function was measured with the Shoulder Pain and Disability Index (SPADI). Hierarchical regression analysis determined the proportions of explained variance in function. RESULTS: Demographic variables (duration of symptoms, sex, age, and mechanism of injury) collectively contributed approximately 9% (P=.003) of the variance in function scores. Average pain intensity and flexion ROM contributed an additional 22% (P<.001) of the variance, and Tampa Scale of Kinesiophobia (TSK-11) scores contributed an additional 3% (P<.001). In the final parsimonious model, presence of symptoms longer than 3 months (beta=.23, P=.003), pain intensity (beta=.25, P=.002), shoulder flexion ROM index (beta=-.35, P=.001), and kinesiophobia (beta=.17, P=.026) explained 33% of the variance in SPADI function score (P<.001). CONCLUSIONS: Presence of symptoms longer than 3 months, average pain intensity, flexion ROM index (strongest contributor in multivariate model), and fear-of-pain scores all contributed to baseline shoulder function. The immediate clinical relevance of these findings is unclear but they do provide direction for prospective studies.

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Published In

J Orthop Sports Phys Ther

DOI

ISSN

0190-6011

Publication Date

April 2009

Volume

39

Issue

4

Start / End Page

270 / 277

Location

United States

Related Subject Headings

  • Shoulder Pain
  • Shoulder Impingement Syndrome
  • Range of Motion, Articular
  • Prognosis
  • Prevalence
  • Physical Therapy Modalities
  • Pain Measurement
  • Orthopedics
  • Motor Activity
  • Male
 

Citation

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Lentz, T. A., Barabas, J. A., Day, T., Bishop, M. D., & George, S. Z. (2009). The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology. J Orthop Sports Phys Ther, 39(4), 270–277. https://doi.org/10.2519/jospt.2009.2879
Lentz, Trevor A., Josh A. Barabas, Tim Day, Mark D. Bishop, and Steven Z. George. “The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology.J Orthop Sports Phys Ther 39, no. 4 (April 2009): 270–77. https://doi.org/10.2519/jospt.2009.2879.
Lentz TA, Barabas JA, Day T, Bishop MD, George SZ. The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology. J Orthop Sports Phys Ther. 2009 Apr;39(4):270–7.
Lentz, Trevor A., et al. “The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology.J Orthop Sports Phys Ther, vol. 39, no. 4, Apr. 2009, pp. 270–77. Pubmed, doi:10.2519/jospt.2009.2879.
Lentz TA, Barabas JA, Day T, Bishop MD, George SZ. The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology. J Orthop Sports Phys Ther. 2009 Apr;39(4):270–277.

Published In

J Orthop Sports Phys Ther

DOI

ISSN

0190-6011

Publication Date

April 2009

Volume

39

Issue

4

Start / End Page

270 / 277

Location

United States

Related Subject Headings

  • Shoulder Pain
  • Shoulder Impingement Syndrome
  • Range of Motion, Articular
  • Prognosis
  • Prevalence
  • Physical Therapy Modalities
  • Pain Measurement
  • Orthopedics
  • Motor Activity
  • Male