oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Prognostic Factors for Physical Functioning After Multidisciplinary Rehabilitation in Patients With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Law, Psychology and Social Work.ORCID iD: 0000-0001-9429-9012
Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stokholm, Sweden.
Department of Medical and Health Sciences.
Show others and affiliations
2019 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 35, no 2, p. 148-173Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVES: This systematic review aimed to identify and evaluate prognostic factors for long-term (≥6 mo) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation (MDR).

MATERIALS AND METHODS: Electronic searches conducted in MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL revealed 25 original research reports, published 1983-2016, (n=9436). Potential prognostic factors relating to initial pain and physical and psychological functioning were synthesized qualitatively and quantitatively in random effects meta-analyses. The level of evidence (LoE) was evaluated with Grading of Recommendations Assessment, Development and Evaluation (GRADE).

RESULTS: Pain-related factors (intensity and chronicity) were not associated with function/disability at long-term follow-up, odds ratio (OR)=0.84; 95% confidence interval (CI), 0.65-1.07 and OR=0.97; 95% CI, 0.93-1.00, respectively (moderate LoE). A better function at follow-up was predicted by Physical factors; higher levels of initial self-reported functioning, OR=1.07; 95% CI, 1.02-1.13 (low LoE), and Psychological factors; low initial levels of emotional distress, OR=0.77; 95% CI, 0.65-0.92, low levels of cognitive and behavioral risk factors, OR=0.85; 95% CI, 0.77-0.93 and high levels of protective cognitive and behavioral factors, OR=1.49; 95% CI, 1.17-1.90 (moderate LoE).

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.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019. Vol. 35, no 2, p. 148-173
Keywords [en]
chronic musculoskeletal pain, GRADE, interdisciplinary rehabilitation, meta-analysis, prognostic factors, treatment outcome
National Category
Physiotherapy Anesthesiology and Intensive Care Neurology
Identifiers
URN: urn:nbn:se:oru:diva-72051DOI: 10.1097/AJP.0000000000000669ISI: 000458401700006PubMedID: 30371517Scopus ID: 2-s2.0-85055665160OAI: oai:DiVA.org:oru-72051DiVA, id: diva2:1288000
Funder
Swedish Research CouncilAFA InsuranceForte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding Agencies:

Doctoral School in Health Care Sciences, Karolinska Institutet, Sweden

Research-ALF  

County Council of Östergötland, Linköping 

Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-06-18Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Boersma, Katja

Search in DiVA

By author/editor
Boersma, Katja
By organisation
School of Law, Psychology and Social Work
In the same journal
The Clinical Journal of Pain
PhysiotherapyAnesthesiology and Intensive CareNeurology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 50 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf