1 Rehabilitation Research Center (REVAL), Biomedical Research Institute (BIOMED), Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
2 Department of Rehabilitation Sciences & Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Clin Rehabil. 2019 Jun;33(6):980-991. doi: 10.1177/0269215519831056. Epub 2019 Feb 22.
To examine the predictive, moderating and mediating role of cognitive, emotional and behavioral factors on pain and disability following shoulder treatment.
Electronic databases (PubMed, Web of Science, Embase and PsycINFO) were searched until 14 January 2019.
Studies including persons with musculoskeletal shoulder pain that describe the predictive, moderating or mediating role of baseline cognitive, emotional or behavioral factors on pain or disability following treatment were selected.
A total of 23 articles, describing 21 studies and involving 3769 participants, were included. Three studies had a high risk of bias. There was no predictive role of baseline depression, anxiety, coping, somatization or distress on pain or disability across types of shoulder treatment. No predictive role of fear-avoidance beliefs was identified in patients receiving physiotherapy, which contrasted to the results found when surgical treatment was applied. Baseline catastrophizing was also not predictive for pain or disability in patients receiving physiotherapy. After conservative medical treatments, results on the predictive role of catastrophizing were inconclusive. Treatment expectations and baseline self-efficacy predicted pain and disability in patients receiving physiotherapy, which was not the case in patients receiving conservative medical treatment. Finally, there was a moderating role for optimism in the relationship between pain catastrophizing and disability in patients receiving physiotherapy.
There is evidence that expectations of recovery and self-efficacy have a predictive role and optimism a moderating role on pain and/or disability following physiotherapy for musculoskeletal shoulder pain. After surgical treatment, fear-avoidance is a predictor of pain and disability.
研究认知、情绪和行为因素对肩部治疗后疼痛和残疾的预测、调节和中介作用。
电子数据库（PubMed、Web of Science、Embase 和 PsycINFO）进行了检索，检索时间截至 2019 年 1 月 14 日。
选择了包括肌肉骨骼肩部疼痛患者的研究，这些研究描述了基线认知、情绪或行为因素对治疗后疼痛或残疾的预测、调节或中介作用。
共纳入 23 篇文章，描述了 21 项研究，涉及 3769 名参与者。有 3 项研究存在高偏倚风险。基线抑郁、焦虑、应对方式、躯体化或困扰对各种肩部治疗后的疼痛或残疾无预测作用。在接受物理治疗的患者中，恐惧回避信念无预测作用，但在接受手术治疗的患者中则相反。基线灾难化也不能预测接受物理治疗的患者的疼痛或残疾。在接受保守治疗后，灾难化对疼痛或残疾的预测作用的结果并不明确。治疗期望和基线自我效能感预测接受物理治疗的患者的疼痛和残疾，但在接受保守治疗的患者中则不是这样。最后，乐观在接受物理治疗的患者的疼痛灾难化和残疾之间的关系中起调节作用。
有证据表明，在接受肌肉骨骼肩部疼痛的物理治疗后，期望恢复和自我效能感具有预测作用，而乐观具有调节作用。在接受手术治疗后，恐惧回避是疼痛和残疾的预测因素。
