du.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • 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
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 in journal (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).

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 GRADE.

RESULTS: Pain related factors (intensity and chronicity) were not associated with function/disability at long-term follow up, OR=0.84, 95% 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 behavioural risk factors, OR 0.85, 95% CI: 0.77-0.93 and high levels of protective cognitive behavioural 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 pre-treatment 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.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

Place, publisher, year, edition, pages
2019. Vol. 35, no 2, p. 148-173
Keywords [en]
chronic musculoskeletal pain, GRADE, interdisciplinary rehabilitation, meta-analysis, prognostic factors, treatment outcome
National Category
Clinical Medicine Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-28867DOI: 10.1097/AJP.0000000000000669ISI: 000458401700006PubMedID: 30371517Scopus ID: 2-s2.0-85055665160OAI: oai:DiVA.org:du-28867DiVA, id: diva2:1260725
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2019-02-28Bibliographically approved

Open Access in DiVA

fulltext(1650 kB)73 downloads
File information
File name FULLTEXT01.pdfFile size 1650 kBChecksum SHA-512
26e6cc19c8c6a56138b1acb7961d37920cd6186a05bb41dee2417b9d02eb1f51086d95ef74d9fa14f3adac4f3e6033932f6f019e2f87614d21c340a48e75d1fe
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Äng, Björn

Search in DiVA

By author/editor
Äng, Björn
By organisation
Medical Science
In the same journal
The Clinical Journal of Pain
Clinical MedicineHealth Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 73 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

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

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • 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