J Sport Rehabil. 2022 Jan 1;31(1):60-68. doi: 10.1123/jsr.2020-0450. Epub 2021 Nov 25.
Chronic pain is a challenge for Athletic Trainers and Athletic Therapists working in a clinical or university setting. The fear avoidance model, including catastrophizing, is well established in other health professions but is not established in Athletic Training and Athletic Therapy and may affect rehabilitation outcomes.
To measure the influence of catastrophizing on rehabilitation outcomes of patients being treated in an Athletic Therapy setting.
Prospective single group pre-post design.
Student Athletic Therapy clinic.
A total of 92 patients were evaluated at initial assessment, and 49 were evaluated at follow-up.
All participants completed self-reported function questionnaires to assess level of injury and then received individualized treatments for a variety of musculoskeletal injuries. All measures were completed at initial assessment and at follow-up approximately 6 weeks later.
The authors measured function using a variety of patient self-reported functional questionnaires: the Disability of the Arm, Shoulder, and Hand; Lower Extremity Functional Scale; the Neck Disability Index; and the Oswestry Disability Index depending on injury site. Catastrophizing was measured using the Pain Catastrophizing Scale.
Function significantly improved from the initial assessment to the follow-up (P > .001). Patients with acute pain experienced a significantly greater improvement in function between the initial assessment and follow-up compared with participants with chronic pain (P = .050). Those with high catastrophizing presented with lower levels of function at initial assessment (66.8%) and follow-up (72.1%) compared with those with low catastrophizing (80.8% and 87.0%, respectively).
Similar to other studies in other professions, the function of patients with chronic pain does not improve as much compared with patients recovering from acute pain in an Athletic Therapy setting. It is important to measure patient-reported outcomes to evaluate patient rehabilitation progress. Rehabilitating patients with chronic pain is a challenge, and pain catastrophizing should be evaluated at the initial assessment since catastrophizing is associated with worse function.
在临床或大学环境中工作的运动训练师和运动治疗师面临着慢性疼痛的挑战。在其他健康专业中，恐惧回避模型（包括灾难化）已经得到很好的建立，但在运动训练和运动治疗中尚未建立，并且可能会影响康复效果。
测量灾难化对运动治疗环境中治疗患者康复结果的影响。
前瞻性单组前后设计。
学生运动治疗诊所。
共有 92 名患者在初始评估时进行了评估，其中 49 名患者在随访时进行了评估。
所有参与者都完成了自我报告的功能问卷，以评估损伤程度，然后接受了针对各种肌肉骨骼损伤的个体化治疗。所有测量均在初始评估时以及大约 6 周后的随访时进行。
作者使用各种患者自我报告的功能问卷来测量功能：手臂、肩部和手的残疾问卷；下肢功能量表；颈部残疾指数；以及根据损伤部位使用的 Oswestry 残疾指数。灾难化使用疼痛灾难化量表进行测量。
从初始评估到随访，功能显著改善（P >.001）。与慢性疼痛患者相比，急性疼痛患者在初始评估和随访之间功能的改善更为显著（P =.050）。高灾难化的患者在初始评估（66.8%）和随访（72.1%）时的功能水平低于低灾难化的患者（分别为 80.8%和 87.0%）。
与其他专业的研究类似，在运动治疗环境中，慢性疼痛患者的功能改善不如急性疼痛患者明显。测量患者报告的结果对于评估患者康复进展非常重要。治疗慢性疼痛患者是一个挑战，应在初始评估时评估疼痛灾难化，因为灾难化与功能下降有关。
