Psychosocial Predictors of Physical Performance in Disabled Individuals With Chronic Pain
作者:
Thomas Rudy,
Susan Lieber,
J. Boston,
Lisa Gourley,
Elcin Baysal,
期刊:
The Clinical Journal of Pain
(OVID Available online 2003)
卷期:
Volume 19,
issue 1
页码: 18-30
ISSN:0749-8047
年代: 2003
出版商: OVID
关键词: Chronic pain;Lower limb amputation;Physical performance;Psychosocial factors;Spinal cord injury
数据来源: OVID
摘要:
ObjectivesFirst, to identify what physical performance differences existed between a group of disabled individuals with chronic pain and a control group of pain-free individuals with comparable disabilities; and second, to test a psychosocial model designed to evaluate which psychosocial constructs were predictive of performance in disabled individuals with chronic pain.DesignCase-comparison study.SettingAmbulatory university laboratory.ParticipantsA community sample of 62 individuals with lower limb amputations or paraplegia, 31 with chronic pain and 31 pain-free.InterventionStandardized lifting and wheel-turning tasks.Main Outcome MeasuresStatic strength, endurance, lifting speed, lateral and anterior–posterior sway, and multidimensional psychosocial measures.ResultsDisabled individuals with chronic pain had decreased endurance for both the lifting (p<0.001) and the wheel-turning (p<0.05) tasks. A psychosocial model of physical performance also was evaluated. Using confirmatory factor analysis, 31 measures were used to validate 8 theoretical constructs: emotional functioning, pain intensity, pain cognitions, physical functioning, social functioning, task-specific self-efficacy, performance outcome, and performance style. Regression analyses indicated that more than 90% of the variance in performance was predicted by psychosocial factors, with self-efficacy, perceived emotional and physical functioning, pain intensity, and pain cognitions showing the highest associations.ConclusionsChronic pain was found to significantly reduce the performance in individuals with lower limb amputations and paraplegia. A strong association was found between performance and psychosocial factors in disabled individuals with chronic pain. These findings extend the existing literature by validating that psychosocial models of chronic pain can be applied to the disabled population, with results similar to those of other chronic pain samples.
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