Article

The present study aimed to identify predictors of rehabilitation outcome
for patients with chronic musculoskeletal pain (CMP) and psychological problems.
METHODS: A retrospective cohort study including 230 adult patients with CMP
admitted for multidisciplinary pain rehabilitation. Potential predictors were
patient characteristics, duration of complaints, baseline functioning, pain,
personality, coping style, fear of movement, psychological distress and type of
treatment. Outcome measures were physical functioning, mental health, pain and
patient-reported effect. Multiple (logistic) regression models were used to
identify predictors. RESULTS: Patients who were more disabled and patients with
more pain benefitted more from the rehabilitation treatment than less disabled
patients or those with less pain. Age, work status, vitality, depression and
coping style also predicted outcomes significantly. The models explained between
27 and 80% of the outcomes. There was an interaction between type of treatment,
work status and the baseline pain score as regards the outcome in terms of pain.
CONCLUSIONS: No strong predictors of treatment outcome were found other than the
baseline scores of the respective outcome variables. More disabled patients and
patients with more pain benefitted more from the rehabilitation program. Other
predictors improved the prediction models slightly. Implications for
Rehabilitation It remains challenging to correctly predict the outcome of
treatment from patients' baseline sociodemographic and psychological
characteristics; predictors other than baseline scores of the outcome variables
are only slightly associated with treatment outcome. Patients with chronic
musculoskeletal pain and poor physical functioning or mental health benefit most
from pain rehabilitation. Older patients benefit less from a pain rehabilitation
program than younger patients in terms of physical functioning. Pain reduction
during a pain rehabilitation program is greatest in patients with high pain
intensity who are not at work at the start of the rehabilitation program. Coping
style influences the outcome of rehabilitation of patients with chronic
musculoskeletal pain.

Langue : ANGLAIS