Changes in catastrophizing and kinesiophobia are predictive of changes in disability and pain after treatment in patients with anterior knee pain

Purpose The purpose of the study was to investigate if changes in psychological variables are related to the outcome in pain and disability in patients with chronic anterior knee pain. Methods A longitudinal observational study on 47 patients with chronic anterior knee pain was performed in a second...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2014-10, Vol.22 (10), p.2295-2300
Main Authors: Doménech, Julio, Sanchis-Alfonso, Vicente, Espejo, Begoña
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adult
Anxiety
Arthralgia - complications
Arthralgia - psychology
Arthralgia - therapy
Catastrophization - etiology
Chronic pain
Cohort Studies
Coping
Culture
Depression - etiology
Disability Evaluation
Fear
Female
Humans
Knee
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Mental depression
Middle Aged
Movement
Orthopedics
Pain - psychology
Pain Measurement
Patellofemoral Pain Syndrome - complications
Patellofemoral Pain Syndrome - psychology
Patellofemoral Pain Syndrome - therapy
Phobic Disorders - etiology
Prospective Studies
Questionnaires
Regression Analysis
Surgery
Surveys and Questionnaires
Young Adult
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Summary:Purpose The purpose of the study was to investigate if changes in psychological variables are related to the outcome in pain and disability in patients with chronic anterior knee pain. Methods A longitudinal observational study on 47 patients with chronic anterior knee pain was performed in a secondary healthcare setting. Pain was measured with the visual analogue scale and disability with the Lysholm scale. The psychological variables, such as anxiety, depression, pain coping strategies, catastrophizing and fear to movement beliefs, were studied by using self-administered questionnaires. Results Among the pain coping strategies, only the catastrophizing subscale showed a significant reduction. Similarly, anxiety, depression and kinesiophobia were significantly reduced after treatment. Those patients who decreased the catastrophizing, kinesiophobia, anxiety and depression showed a greater improvement in pain and disability after a purely biomedical treatment. A multiple regression analysis revealed that changes in catastrophizing predicted the amount of improvement in pain severity and that changes in both catastrophizing and anxiety predicted changes in disability after treatment. Conclusion What has been found suggests that clinical improvement in pain and disability is associated with a reduction in catastrophizing and kinesiophobia. Therefore, co-interventions to reduce catastrophizing thinking and kinesiophobia may enhance the results. Level of evidence Prospective Cohort Study, Level I for prognosis.
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-014-2968-7