Article

OBJECTIVES: To investigate how sociodemographic and clinical factors are
associated with psychosocial functioning and disability at admission to a
musculoskeletal pain rehabilitation program and at 1-year follow-up. DESIGN: A
cohort pre-post study. SETTING: A University hospital specialized pain
rehabilitation unit. PARTICIPANTS: Five hundred nine participants with
musculoskeletal pain (neck disorders, 29%; fibromyalgia, 24%; low back pain, 24%;
myalgia, 14%; and other pain diagnoses, 8%). INTERVENTION: A 5-week outpatient,
group-based, and goal-oriented comprehensive musculoskeletal interdisciplinary
pain rehabilitation program based on cognitive behavioral principles. MAIN
OUTCOME MEASURES: The Multidimensional Pain Inventory (MPI), the Disability
Rating Index (DRI), and forms including sociodemographic factors (gender, age,
ethnicity, marital status, educational level, and vocational situation) and
clinical factors (pain duration and pain diagnoses). Data were analyzed with
multivariate logistic regression. RESULTS: At admission, factors associated with
more positive scores on the MPI were being older than 40 years, being at work,
being Nordic born, attainment of a higher educational level, and a diagnosis of
fibromyalgia (compared with a neck disorder) (P < .05). Being at work and a
diagnosis of fibromyalgia (compared with low back pain) were associated with more
positive scores on the DRI (P < .05). On the basis of cut points for clinically
important change on the MPI, participants rated themselves as most improved on
the Affective Distress (52%), Life Control (49%), and Pain Severity (43%)
subscales, and on the DRI index, the improvement rate was 22%. At the 1-year
follow-up, neither sociodemographic nor clinical factors were associated with
clinically important improvements of the MPI and the DRI, but younger age was
related to deteriorations in pain severity. CONCLUSIONS: The lack of an
association between sociodemographic and clinical factors and psychosocial
functioning and disability at a 1-year follow-up after a musculoskeletal pain
rehabilitation program suggests that the program was effective regardless of the
participants' initial characteristics, except for age. The changes at the 1-year
follow-up indicate that the program influenced the participants' psychosocial
functioning more than their perception of disability.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS